HomeMy WebLinkAbout2012-00487 - windows CITY OF ORONO * 2 0 1 2 - 0 0 4 8 7
2750 KELLEY PARKWAY DATE ISSUED: 06/08/2012
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 3085 WATERTOWN RD
PIN 04-117-23-22-0032
LEGAL DESC WALNUT CREEK
LOT 001 BLOCK 001
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 15,304.00
NOTE: REPLACE(4)WINDOWS AND(3)PATIO DOORS
(1)WINDOW IS BEING BUILT UP FROM PATIO DOOR OPENING.
APPLICANT PERMIT FEE SCHEDULE 280.25
THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 7.65
2690 CUMBERLAND PKWY,STE 300
30339- MAIL-IN FEE 2.00
(763)542-8826 TOTAL 289.90
Minnesota State License#:20268257
OWNER
GERHART,RICHARD&JANICE
3085 WATERTOWN 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 apmmenced.
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 Si a re ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
J J
City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
Qv 0 PO Box 66
a Crystal Bay, MN 55323-0066 Date received:
Street Address: Received by:
2750 Kelley Parkway Plan review fee:
L�kE`ss0 Orono, MN 55356
--
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us Total Fee:
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: 11 / //__ /�
Job Site Address: J O S S 1A)OT! r-A W A /"� 0 a 4/
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 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:
State License# THD At- Home Services, Inc.
Phone: 2690 Cumberland Pkwy, Ste 300 4 VS (cell)S (ceell)
Mailing Address: Cumberland Office Park ZIP:
Contact Person: Atlanta, GA 30339-3913 lomeowner (Circle One)
Email and/or Fax: Lic#20268257 Ph. 763/ 542-8826
PROPERTY OWNERI FORMATION:
Name: �G n( LA G ( rho r A
Phone(day): SCSI G Y! • p�
7 6 0 2
Address: 3 0 6715 W4 e P _o W`? �'S d, City: ZOA� Cd�� ZIP: 'S s 3 5 `
Email and/or Fax
IF
PROJECT INFORMATION:
Type of Project: Any earth movement may require
oor(s) ❑ Remodel ❑Water Damage MCWD review&permits
.WindowMinnehaha Creek Watershed District(MCWD)
(s) Repair ❑Storm Damage 18202 Minnetonka Blvd
❑Siding ❑ Restoration Deephaven, MN 55391
❑Other:(specify) Phone: 952-471-0590
ElRe-roof
Fax: 952-471-0682
❑ Fire Damage www.minnehahacreek.or
Overall Project Description: I W!A 4t L4 3 pa r 0 U InIA-f-s
Estimated Construction Valuation of Project(excl din land) $ /S 3 o y
one r�,n o W ss e•n Q u, c• nom rvo io ou!' oP,11/?
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: ��`r Date: L ` y
Last Updated: 05-04-2009
TE TIME
CITY OF ORONO CALLED IN -�
INSPECTION NOTICE SCHEDULED (
PERMIT NO. OMP��LETED
ADDRESS 365 �a�TLL�
OWNER TELEPHONE N
CONTRACTOR (30
DESCRIPTION 7 `'
tu ❑ FOOTING ❑ PLUMBING FINAL alEX AV/ N LI
04—
UL Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
VE ING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
ATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
N SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ SEWER HOOK-UP ❑ COMPLAINT
-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
ti COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED XROJECT COMPLETE
cc ❑CORRECT WORK&PROCEED UE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. i
Call for the next inspection 24 hours' advance 2 9-4600
Owner/Contractor on site:
Inspector.
White CopylInspector's File / Canary Copy0te Not