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Home My WebLink About2015-00423 - addn/remodel/repair CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 5 - 0 0 4 2 3 DATE ISSUED: 04/14/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS 455 TONKAWA RD PIN 06-117-23-41-0105 LEGAL DESC MINNETONKA SUMMIT PARK LOT 000 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 5,000.00 NOTE: BATHROOM REMODEL APPLICANT PERMIT FEE SCHEDULE 123.91 STATE SURCHARGE(VALUATION) 2.50 RAJA,NASIR H TOTAL 126.41 455 TONKAWA RD Payment(s) LONG LAKE,MN 55356- CREDIT CARD 0257 126.41 OWNER RAJA,NASIR H 455 TONKAWA RD LONG LAKE,MN 55356- 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. Applicant Permitee Signature Date Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) A, Mailing Address: Permit number: 2 I SG ��l U VO PO Box 66 Crystal Bay, MN 55323-0066 Date received: L/ — - Street Address: Received by: tiF G� 2750 Kelley Parkway Plan review fee: lg kf S H OOrono, MN 55356 Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us v,l< -to )CIWA-L, 6"LA1 �. This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 4-� S Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? El Yes o ff 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/APPLICANT INFORMATION: Name: t n`� , � s k- � � State License# Ti-, i XL_41�xpk4tion Date: Lead Certification Number: ViLExpiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (office) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (circle one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: N1 f�,G�f- 2( �_ A Phone(day): j --7 a'Q — 3a--I Address: -TG t,4y- rZ1\17 City: E fbu ZIP: S Email and/or Fax: (-A �tcl-1S1 Corn 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) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven,MN 55391 ❑ Re-roof,other(specify) [I Siding ❑Other: (specify) Phone: 952-471-0590 � Fax: 952-471-0682 ElWindow(s) f� YY Fax: Estimated Construction Valuation of Project (excluding land) $ 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 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 required by law. If you refuse to supply the infbrmationA the application may not be issued. Applicant's Signature: AJ"` Date: ULf- I Owner's Signature: ', Date: 0 (� Last Updated:January 2015 DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.o20/6- -60-923 COMPLETED ADDRESS ySb Tb 01!fes�_ P40- OWNER TELEPHONE NO. CONTRACTOR i DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y0 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q JNIMRAMING ❑ MECHANICAL FINAL ❑ PROGRESS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL r ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: a /y✓s n c. C�i��✓�cti L P127-1 "tet 0 b4 .4;.r cc � !� �l Cdr✓ /'G��' i��sOYV W QC Q 2 W Z W CC J 0 W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE Cr. ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: � - / Inspector. Q!w 5"— White Copyllnspector's File Canary Copy1Site Notice ATE ��=� �/ CITY OF ORONO CALLED IN eey` INSPECTION NOTI SCHEDULED PERMIT NO COMPLETED ADDRESS 155 OWNER TELEPHONE CONTRACTOR DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ TIC INSTALL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR T MEET YOU: YES—NO COMMENTS: W a J O O W cc Q f2 2 W W cc CI J , W I WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.i BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24urs in adva 52) 249-4600 Owner/Contractor on site: l7 — Inspector. White Copy/Inspector's File Canary C pylSite Notice