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CITY OF ORONO * 2012 - 0091S *
2750 KELLEY PARKWAY DATE ISSUED: 09/13/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS 4690 TONKAVIEW LA
PIN : 07-117-23-32-0047
LEGAL DESC TONKAVIEW GARDENS
LOT 089 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,196.00
NOTE: REPLACE(12)WINDOWS IN EXISTING OPENINGS.
APPLICANT PERMIT FEE SCHEDULE 132.75
2211 WINDOW WORLD STATE SURCHARGE(VALUATION) 2.60
#130 11TH AVE.E. MAIL-IN FEE 2.00
#13
ST PAUL,MN 55109- TOTAL 137.35
(651)770-5570 PAID WITH CC# 0074
Minnesota State License#: BC356847
OWNER
BULL,MR&MRS WILLIAM
4690 TONKAVIEW LA
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 or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
(i//.-I-//..;L-
Applicant Permitee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application for Maintenance / Renovation
windows, doors, siding, re-roof, etc,
eo
O� Mailing
Box as Address' • ank number: D/!* -Da 9
Vol" Crystal Bay, MN 55323-0066 .pp rem :
&metAddmss; RecelVed by:.
2750 Kelley Parkway . Piet1•reviewflse:
Orono,MN 56358
Main: 062-248-4800 Fax: 962-249.4010 i ono. us Tntai Fee:
Thls 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; ono 6
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
11Yft a specki event penin!to required with Polka Depkrhnenf and OQy Council approval eo days p
roqulred unless appNCknt d Mmsfratea huff ant on,s/to park/ng is @VWMble, rior to the avant Shulfk bus aeroh:e MY beCONTN
onpermrfled evkgra will nor be allowed.
Name:1�CTOR/APPS N�INPOR�fiAATlp�l:
A L,! Or
State License# Expiration Date:
Lead Certification Number Expiration Date:
(for work on homes that weak coneftetrd prior re 1871
Phone: – 77v qj( (office) celq
Mailing Address: L( tt N4. je 1 V CI ZIP: N,
Contact Person: G �O `1
Applicant is: (Contractor / Homeowner Icims one)
Email and/or Fax: h,, L, k-VI-IJ
/"IV,L•o A, r`S - 7 7 e> U(
PROPERTY OWNER INF RMTION:
Name: ,,
Phone(day); 3�
Address:
Email and/or Fax Clly: 6 D a zip:
PROJECT INFORMATION:
Type of ProjW: '
Any earth movement may require
❑Door(s) - []Remodel ❑Fire Damage MWD review a permits:
❑Re-roof,asphalt 11 Repair Storm Damage Minnehshe Creek Watershed Dlstrict(MCWD)
18202 Minnetonka Blvd
❑Re-roof,cedar ❑Restoration ❑Water Damage Deephaven, MN 56391
❑Re-roof,other(spec fy) ❑Siding ❑Other, (specify) PFaxe•952-47- 600
ndow(s) Mmm-Minnahahumak,
Overall Project Descri on:
Estimated Construction Valu ati n of P eat excluding land) k l
k4 I
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 hialher 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 aitemative
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 Information which generally cannot be given to the public but can be given to the subject of the
data. Confidential data Is information which generally cannot be given to either the public or the subject of the data. Our
Purpose and Intended use of this Information is to annually update our records and records of other governmental agencies
u)red by law, if Vou refuse to supciv the inform ion ths OPPIleation may not be issued.
Applicant's Signature:
Date:
Leal Updated: 08-09.2011
X<dd 1317213Std-1 dH Wdl* : i 2102 21 deS
Opel-, A2TE TIME
CITY OF ORONO CALLED IN [ 3 11.2
INSPECTION NOTICE SCHEDULED 4 )
PERMIT NO. )12 39C91,ScOMPLETED
ADDRESS ! & —Tc- "Af a bt.) `4
OWNER TELEPHON"O.&SI —770 -?ell
CONTRACTOR "o /13 Lt f /}-
>: DESCRIPTION
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q El TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FIN ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES NO
COMMENTS:
CC
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cc
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W
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W
CC
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W El WORK SATISFACTORY:PROCEED kROJECT COMPLETE
LU ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
11 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector.
White CopylInspector's File Canary Copy/Site Notice