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HomeMy WebLinkAbout2016-01283 - windows CITY OF ORONO 2750 KELLEY PARKWAY * 216 - 01 DAT0 E ISSUED: 10/10/2010 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 1340 VINE PL PIN 07-117-23-42-0031 LEGAL DESC SAGA HILL REVISED LOT 000 BLOCK 017 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOWS ACTIVITY O/S BUILDING-UNDEFINED VALUATION $ 8,055.00 NOTE: WINDOW REPLACEMENT APPLICANT PERMIT FEE SCHEDULE 185.83 STATE SURCHARGE(VALUATION) 4.03 SCHERER BROS LUMBER MAIL-IN FEE 2.00 10751 EXCELSIOR BLVD HOPKINS,MN 55343 TOTAL 191.86 Payment(s) (952)277-1600 Minnesota State License#:BUIL-BC239369 CREDIT CARD 3281 191.86 OWNER CHERBA,RICHARD 1340 VINE PL MOUND,MN 55364- AGREEMENT 5364AGREEMENT 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. /'0/ Applicant Pertnitee Signature Date I ued ignature Date ct. 10. 2016 12:26PM No. 3099 P. 1 City of Orono Building Permit Application for Maintenance/Replacement/ Remodel—) ientla.�;FQN "Y (i.e. windows, doors, siding, re-roof, etc.—NO STRUCTURAL EXPANSION) Martin Address: Q PO Box 66 MN 55323-0066 `Date ;1iVeiit jj;''' __ ►?r;,l.l :'r1r;' ;- Crystal Bay, .. . ...,C�.. ...: _ ... .,.,.._...:•.:......-- Ftec�iva�py:._ Street Address: A2750 Kelley _ Orono MN 55356 E" Q - N - etital'�se�''� - - T _ : � R` Main: 952-249A600 Fax 952-249 4616 www.ci, rano.mn.us -=.�:s,:;:;;=�: = This application form must be completed in full and all required information must be submitted. Incomplete t) ,applications will be returned. (Please print) GENERAL INFORMATION:1 3„19 11) e 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 Coundl approval 60 days prior to the event. Shuffle bus service wiz!be required unless applk'snt demonstrates suftient on-+fe parking is available. Avon-permitted events will not be al/owed. CONTRACTOR/APPLICANT INFORMATION: Name: onhipr State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1976 Phone: (cell) (office) a Mailing Address: City: Contact Person: Applicant is: I Horricowner—pircitonelf Email and/or Fax: �r PROPERTY OWNER INFORMA ION: C �” C•b Name: �'i► Phone(day): Address: City,6an () ZIP: 55 3 T Email and/or Fax: PROJECT INFORMATION: Overall project description, Type of Project: Any earth movement may also require ❑Door(s) El Remodel ❑Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) [IRe roof,asphalt ❑Repair El Storm Damage 15320 Minnetonka Blvd ❑Re-roof,cedar ❑Restorallon ❑Water Damage Minnetonka,MN 55345 ❑Re-roof,other(specify) ❑ iding ❑Other(specify) Phone: 952-471.0590 Fax: 952-471-0682 indow(s) nehahscreek.oLg Estimated Construction Vi6luation 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 su t the information the application may notbeIssued. Applicant's Signature: Date: Owner's Signature: Date: Last Updaled:January 2016 0CPF ✓ DATE TIME CITY OF ORONO CALLED IN _W — 9 INSPECTION NgTIC ©t ,pZ SCHEDULED PERMIT NO. OfC2_Ga jJf,COMPLETED ADDRESS 13`t7 Jy / I A-7V f) b OWNER TELEPHONE NO. 10- 2 ? CONTRACTOR vhQh l� S DESCRIPTION V` ?( 1ca �— W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z .1 ❑ DEMO-SITE []/SEPTIC INSTALL Z OWNEWCONTRACTOR TO MEET YOU: YES_NO y COMMENTS: ac kJ I !U(20 (eDAgGe wk-,,l t� �'S e a; 0 W I,c��lG �►M.,���c — yT 2 � w LAj ❑WORK SATISFACTORY PROCEEDPROJECT COMPLETE QC W ❑CORRECT WORK&PROCEED / ❑ISSUE CERTIFICATE OF OCCUPANCY C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Ct BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑NATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. A-,, 61 White CopynnspectWs File Canary Copy/We Notice