HomeMy WebLinkAbout2018-00106 - windows CITY OF ORONO * 2 0 1 8 - 0 0 1 0 6
2750 KELLEY PARKWAY DATE ISSUED: 01/31/2018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS 3520 WATERTOWN RD
PIN 32-118-23-43-0014
LEGAL DESC N/A
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE WINDOWS
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 5,355.00
NOTE: WINDOW REPLACEMENT
APPLICANT PERMIT FEE SCHEDULE 139.36
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 2.68
10751 EXCELSIOR BLVD MAIL-IN FEE 2.00
HOPKINS,MN 55343 TOTAL 144.04
(952)277-1600 Payment(s)
Minnesota State License#:BUIL-BC239369 CREDIT CARD 3281 144.04
OWNER
SCHULENBERG,THOMAS&JENNIFER
3520 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 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.
Li&P-ef
Applicant Permitee Signature Date Issued By ature Date
�ftn. 30. 2018 . 11 :400 No. 4351 P. 1 .
City of Orono
Building Permit Application for Maintenance/Replacement/Remodel— tes . r>IQ'�VLx
(i.e. windows, doors, siding, re-roof, etc. —'NO STRUCTURAL EXPANSION
Q A, Mailing Address:
{V PO Box 66
Crystal Bay, MN 55323-0066 'Ikca vetl -- -r4;A LL„:�`
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.� Street Address: fecelved
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yakO�� Orono,MN 55358
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Main: 952-249-4600 Fax 952-249-4616
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This application form must be completed In full and 211 required Information must be submitted.
GENERAL INFORMATIO
Incomplete applications will be returned. (Please print)
�
Job Site Address; '2-
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes o
Nyes,a special event permit rs required with Police Department and City Council approval 60 days prior to the event. Shuttle bus sa6ioa NY be
required unless applicant demonstrates sufficient onsite parking is available. Non permitted events will not be allowed.
CONTRACTOR/APPL CANT INFORMATION:
Name: v'
State License# Expiration Date:
Lead Certification Number: C7 r Expiration Date:
(for work on homes that were constructed prior to f 78
Phone: (cell) (office)
Mailing Address: t� City: ZIP.
Contact Person: �. Applica t is; on / Homeowner (Circle ones
Email and/or Fox; .f C C
PROPERTY OWNER INFORMATION:
Name:
� khylqs
Phone(day):
Address: 4 �. �� Vy� City: f( ZIP:
Email and/or Fax;
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑Door(s) ❑Remodel ❑Fire Damage MCWD review$permits:
❑Re-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
❑Re-roof,cedar ❑Restoration15320 Minnetonka Blvd
❑Wafer Damage Minnetonka,MN 55345
❑Re-roof,other(specify) ❑Siding ❑Other:(specify) Phone: 952-471-0590
indow(s)
Fax 952-471-0682
m8my.minnehahacregKom
Estimated Construction Valuation of Project(excluding(and) $
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department,
• Certifies that the information supplled 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 Slate 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 thifinfa on is tb
update our records and records of other g vemme tal agencies required by law. If
ou refuse to su Io attarcation ma not be issued. �(
Applicant's Signature: Date: V
Owner's Signature: Date:
Last Updated:January 2016