HomeMy WebLinkAbout2012-00699 - windows CITY OF ORONO
* 2012 - 00699 *
2750 KELLEY PARKWAY DATE ISSUED: 07/23/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS 1160 TONKAWA RD
PIN : 08-117-23-13-0007
LEGAL DESC AUDITOR'S SUBD.NO.217
LOT 009 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE WINDOWS
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 10,652.00
NOTE: REPLACE(4)WINDOWS INTO EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 206.50
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 5.33
10751 EXCELSIOR BLVD
HOPKINS,MN 55343 MAIL-IN FEE 2.00
(952)277-1600 TOTAL 213.83
Minnesota State License#:BC239369 PAID WITH CC# 3989
OWNER
STANTON,MARSHALL S&MARLA K
1160 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 du cause.
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Applicant Permiture ee SignatDate IssulBy Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Ju1. 23. 201210: 21AM No- 9325 P. 1
City of Orono
Building Permit Application for Maintenance I Renovation
windows, doors, siding, re-roof, etc.)
Mailing Address: Permit�number.
Ogir 0.�0 PO Box 66
Crystal Bay, MN 65323-0066 Date.received: 7
a Sheet Address: Received by:
off' 2750 Kelley Parkway Plan review
—�� Orono,MN 55356
Total Fee':::'
Main: 952-2494600 Fax: 952-249.4616 www.ci.orono.mn.U �.. O
This application fvrrn must be completed in full and all required information must be submitted.
GENERAL INFORMATION: Incomplete applications will be returned. (Please print)
Job Site Address: ZJ L T t,
Will this be a Parade of Homes,Remodelers Showcase Home or other isplay Home? El Yes M No
If yes,a Veda/event pen»if is required with Polios Department and City Councd approve!60 days prior to the event, Shuttle bus service wr71 be
required unless applicant demonstrates suftent on-site perking Is available. Nonpeimitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ,� 5-
State
State License# IDC a 3�� Expiration Date: 3
Lead Certification Number: PK _ f a c Expiration Date:
(for work on homes OW wane lconstructed prior to 19
Phone: QS Q -ZkC7rl-(s. SCI (ice) (cell)
Mailing Address: 'Q S, I 1C Cel S r� es( t city: 1,I=O K; ,a ZIP, S5_'3 4f l
Contact Person: Q& ztQ Applicant is: Contractor / Homeowner (arms Ons)
Email and/or Fax: Oi Q-A:]—( k' � �3
PROPERTY OWNER INFORMATION:
Name: S -f
Phone(day): U 1 a - 3 _ 7 k'o
Address: I I ke u w C, A City: ZIP:
Email and/or Fax L o
PROJECT INFORMATION:
Type of Project Any earth movement may require
❑ Door(s) ❑Remodel ❑Fire Damage MCWD review&permits:
[I Re-roof,asphalt Minnehahs Creek Watershed District(MCWD)
❑Repair ❑Storm Damage 18202 Minnetonka Blvd
❑Re-roof,cedar ❑Restoration ❑Water Damage Deephaven,MN 55391
[I Re-roof,other(s Phone: 952-471-0590
(specify) ❑Siding ❑Other.(specify) Fax: 952.471.0682
findow(s) www.minnghahacreek.oro
Overall Pro ect Description:
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 or 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 information,the application may not be issued.
Applicant's Signature: �c ,g, C Date: c] A._-o,l/-i— _
Last updated: 08.09-2011