HomeMy WebLinkAbout2014-00797 - siding CITY OF ORONO * 2 0 1 4 - 0 0 7 9 7
2750 KELLEY PARKWAY DATE ISSUED: 07/29/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 4685 TONKAVIEW LA
PIN : 07-117-23-32-0065
LEGAL DESC : N/A
LOT MB BLOCK MB
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE SIDING
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION $ 3,500.00
NOTE: SIDING
APPLICANT PERMIT FEE SCHEDULE 103.25
COMMERCIAL BUILDING SERVICE
STATE SURCHARGE(VALUATION) 1.75
.00
15405 NORTH EDEN DRIVE MISC FEE TOTAL 10 00.00
EDEN PRAIRIE, MN 55346-
(952)975-0920 Payment(s)
Minnesota State License#: BUIL-20636753 CHECK 12531 105.00
OWNER
MEYER,DENNIS
4680 NORTH SHORE DRIVE
MOUND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether r not spe ified herein.This permit will
expire and he�me nu}�and v d if couction authorized is not
commenced within]8 da of the to of issuance,or if construction is
suspended for a period f 0 da at any time after work has commenced.
The applicant is respo le I suring all required inspections are
ffequested in conform e i the State Building Code.This permit maybe
evoked at any tjm ause.
r . —
Applic tmitee Signature ,Date I ssu#By Signature Date
` -� City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
Mailing Address:
PO Box 66 Permit number: el f"_Pv 7�
If/ l Crystal Bay, MN 55323-0066 Date received:
! ) Street Address: Received by:
AI I
` 2750 Kelley Parkway
xrstfo � Orono, MN 55356 Plan review fee: N
b 5
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us Total Fee:
This application form must be completed in full and all required information must be submitted.
GENERAL INFORMATION: Incomplete applications will be returned. (Please print)
Job Site Address: _
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes ❑ No
If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLI ANT I ON: .
Name: '
State License# Expiration Date: j -75
Lead Certification Number: Expiration Date:
(for work on homes that were onstructedprior to 1 8
Phone: (cell) (office)
Mailing Address: / City: ZIP:
Contact Person: / 1 Applicant is: Contr r / Homeowner circle one)
Email and/or Fax: /"` ^ ''
PROPERTY OWNER INFORMATION:
Name: / ,ter /_
Phone(day):
Address: f i �f n r-- A(, City: �' ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
El Re-roof,cedar 18202 Minnetonka Blvd
❑ Restoration ❑Water Damage Deephaven, MN 55391
(specify) � g ❑Other: (specify) Phone: 952-471-0590
E] Re roof,otheridin Fax: 952-471-0682
� ' www.minnehahacreek oro
Estimated Construction Valuation of Project(excluding land) $ �•S � — '� U�
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are
solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to
reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is infor ation which g nerally cannot be given to the public but can be given to the subject of the data.
Confidential data is information wh h g cy nnot be given to either the public or the subject of the data. Our purpose and
intended use of this irtiformation is n date our records and records of other governmental agencies required by law. If
you refuse to su the informa'ti n, ion mav not sued.
Applicant's Signature. Date: "S
Owner's Signature: / Date:
Last Updated:03/06/2013