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Home My WebLink About2016-01546 - windows 1111101 11101111111 CITY OF ORONO * 2 0 1 6 - 0 1 5 4 6 2750 KELLEY PARKWAY DATE ISSUED: 12/15/2016 ORONO,MN 55356- (952) 249-4600 FAX: (952)2494616 ADDRESS 375 WAKEFIELD RD PIN 36-118-23-31-0017 LEGAL DESC UNPLATTED 36 118 23 LOT 000 BLOCK 000 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,426.00 NOTE: REPLACE 3 WINDOWS IN EXISTING OPENINGS APPLICANT PERMIT FEE SCHEDULE 154.85 STATE SURCHARGE(VALUATION) 3.21 RENEWAL BY ANDERSON MAIL-IN FEE 2.00 1920 COUNTY RD C. WEST TOTAL 160.06 ROSEVILLE,MN 55113 Payment(s) (612)502-4777 Minnesota State License#: BUIL-BC130983 CREDIT CARD 8788 160.06 OWNER WARNER,DALE&ANN 375 WAKEFIELD RD WAYZATA,MN 55391- 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. r/, n` Applicant Permitee Signature Date Issued By ignature Date �- City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, ptc.) Mailing ddBox 66 'Permit number: Crystal Bay,MN 55323-0066 Date recelved: StreetAddrew: Received by: 2750 Kelley Parkway plan review fee; r• � Orono,MN 55356 Total Fee: Main: 952-249-4WO Fa)c 952-249-4616 www.d.orono.mmus 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: 5 WoLy -. Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes ❑ No gym,a spoebi event pem/t is required With Police Department and City Counp7 approval 60 days prior to tine event. Shuttle bub sen4o9 will be required unless applicant demonstrates sufficient on-site perlang is avalable. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 1Cr�tivao.\ 'tel �A �CSe�N State License# I tC-\309 9'3 Expiration Date: '1501,31 Lead Certification Number: �j ^r r oZ'�.oZ$3 1 Expiration Date: 4116 (tbr work on homes that www constructed priar to 1978 Phone; lot 1- a(e�} q0 gl-%N An (ice) (cell) Mailing Address: kq alt CO. -12,rj Wec ZIP:_5S llr3 - Contact Person: Applicant is: ntra / Homeowner (circie one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: A.h t1 Wo- Phone o-Phone(day): q5 2 ..41-3 -(0$1 PL Address; City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Protect: Any earth movement may require MCWD review$permits; ❑Door(s) ❑Remodel ❑Fire Ramage Minnehaha Creek Watershed District(MCWD) ❑Re-roof,asphalt ❑ Repair ❑Storm Damage 18202:Minnetonka Blvd ❑Re-roof,cedar ❑Restoration ❑Water Damage Deephaven,MN 55391 Phone: 952-471-0590 ❑Re-roof,other(specify) ❑Siding ❑Other(specify) l=ax: 852471-0682 Window(s) des www.minnehahacreek.orc Overall Project Description- (A-3);n 4j)c;S 'r!5 OP-e-�192 Estimated Construction Valuation of Project(excluding land) (a, t{a(p 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 da 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 ba.given to the public but can be given to the subject of the data. Confidential data Is Wormaation 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 t(oo supply ,the information.thea application may not be issued. Aoolicant's Sianature: � Date: �✓ �� TIME CITY OF ORONO CALLED IN INSPECTION E /1f SCHEDULED PERMIT NO. (��! COMPL ED ADDRESS O cl Z4 OWNER 4 TF EPHONE NO. CONTRACTOR Anbw DESCRIPTION �j J ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING UOj ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT X�EJNAL ❑WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v [3 DEMO-SITE [3 SEPTIC INSTALL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: c ✓'a i 1 Q /.cam K elb mi n J US ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK A PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. cai for the next Inspection 24 hours in a&anee. (952) 249-4600 OwnwiComractoron site. 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