HomeMy WebLinkAbout2015-00473 - doors CITY OF ORONO * 2 0 1 5 - 0 0 4 7
2750 KELLEY PARKWAY DATE ISSUED: 04/23/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRES 1185 TONKAWA RD
PIN 08-117-23-13-0017
LEGAL DESC REG.LAND SURVEY NO.0853
: LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE DOORS
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 3,572.00
NOTE: REPLACE 1 PATIO DOOR IN EXISTING OPENING
APPLICANT
PERMIT FEE SCHEDULE 108.42
STATE SURCHARGE(VALUATION) 1.79
THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00
2690 CUMBERLAND PKWY,STE 300
ATLANTA,GA 30339- TOTAL 112.21
Payment(s)
(763)542-8826
Minnesota State License#:BUIL-CR268257 CREDIT CARD 0174 112.21
OWNER
MARGARIT,GREGORY&JULIE
1185 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.
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Applicant Permitee Signature Date Issued By Signature Date
APR/22/2015/WED 09; 45 PM FAX No. 952 854 4909 P. 002
City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
`--� Mailing Address: Permit number=
g,0 PO Box 66
/ Crystal Bay, MN 55323-0066 Date received: L4 - Z3'No `
f Street address_ Received by
2750 Kelsey Parkway Plan review fee: -�
Orono, MN 55356
= Total Fee: 1 �o`
Main: 952-249-4600 Fax: 952-249-4616 www.ci.crono.mn.us , 1,14
This application form must be completed in full and all required information must be submitted,
Incomplete applications will be returned_ (Please print) ! Q(
GENERAL INFORMATION' 9 S
Job Site Address: 0 n I d W& R 0 0
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? O-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/APPLICANT INFORMATION:
Name; M/Zll yS- Loy?
State License# THD At-Home Service, Inc,
Phone: 2690 Cumberland Pkwy, Ste 300 (cell)
Mailing Address: Atlanta, GA 30339-3913 ZIP:
Contact Person: Lic#CR268257 Ph. 763/542-8826 iomeowner (Clrcie one)
1nmail and/or Fax:
PROPERTY OWNER I FORMATION•
Name: A f' .-
Phone(day):
Address: 11 Ur 7-6/1 Ci :4 Cil 10h ZIP.-5"-V3 -5 L
/Q b (,�
Email and/or Fax
PROJECT INFORMATION: -
Type of Project: Any earth movement may require
• MCWD review&permits
15Qoor(s) ❑ Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd
Deephaven,MN 55391
❑Siding ❑Restoration ❑Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Re-roof ❑Fire Damagewww.minnehahacreek.org
Overall Project Description: p [0dr 0 Of ^E w P
Estimated Construction Valuation of Project(excluding land) $ 317 2
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 information,the application may not be issued.
Applicant's Signature: Date:
Last Updated: 05-04-2009
1 DATE TIME
C2 CITY OF ORONO CALL
C" INSPECTION NOTICE SCHEDULED
PERMIT NO. w`1�3COMPLETED
ADDRESS � --FI)
OWNER l t ( e_ TELEPHONE NO. Cts 0-2 9V
CONTRACTOR 1=
DESCRIPTION T VI �QQ't1 C) Q_
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
-d AFINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
ILT-SURVEY St WER HOOK-UP ❑ HARD COVER REMOVAL
WO -SITE SPTIC INSTALL ❑ FOUNDATION/REMOVAL
N ONTRACTOR TO MEET YOU: YES_NO
c.� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED .4gQJECT COMPLETE
cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
[I STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: Salt e
Inspector.
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