HomeMy WebLinkAbout2012-00047 - siding CITY OF ORONO PERMIT NO.: 2012-00047
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 01/19/2012
952 249-4600 FAX: 952 249-4616
ADDRESS 3535 WATERTOWN RD
PIN 32-118-23-43-0005
LEGAL DESC UNPLATTED 32 118 23
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE SIDING
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION $ 23,500.00
NOTE: RESIDING
APPLICANT PERMIT FEE SCHEDULE 398.25
CRAFTSMAN'S CHOICE,INC. STATE SURCHARGE(VALUATION) 11.75
26219 FREMONT DRIVE#105
ZIMMERMAN,MN 55398- MAIL-IN FEE 2.00
(763)633-1390 TOTAL 412.00
Minnesota State License#:20384780 PAID WITH CC# 6694
OWNER
ROBERTSON,ROBERT
3535 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 ime for due cause.
// / l / 2 A4
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Applicant PerrnitZW Signature Date d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
i
it
�Y�fO r _. City .of Orono
Blv110ing Permit Application for Internal Work
doors siding, re-roof, etc.)
(windows,
Mailing Address PiRrrrk rtumt�r
PO Box 66
Crystal Bay,MN 55323-0066 Date reoeived: •
Street Address:
.. 2750 Kelley Parkway Plan•reyiew fee:,
Orono,MN 55356
Total Fee..'.
m 952-249-4616, ww •ci.orono.mn us
Main: 952 249.4600 Fax
This application form must be completed In full and all required information must be submitted.
1 10'Incomplete applications will be returned. (Please piInt)
0E$rzRAL INFORMATION:',
35 1rQJJY__-6A)h Ad
Job Site Address:
WUJ#his•lie a Parade of Homes.Remodelers Showcase Home or other Display Home? Yes No'
if yj,a special event penrlt is required with ponos Department and City Counal approval 60 days prior to the evdnt Shuft bus SWW=w0/be
required unhSs,appGcpr�t clemonstraton suAklent on-sire policing is avauable. Aloe-pe►rnitted events will not be allowed
tgt4TRACTOR I PPLI NT INFORMA N:
Name:
Expiration Dalte
I�ad certification Numbe
_. _ . Expiration Date:'
-
La R
--(for work on homes t hat were consvncrw prior to 1978 (cell)
Phone: - '1 3- -1
(office)
� ,• City-. ZIP: •. q ..
miling Address: al
jCoritaet Person: Applicant is- on / Homeowner cam• ).,
Emall and/or Fax. -
PROPERTY OWNER INFORMATION:
�h
Name':.
da - ,
(day). l� QiCI. city; ZIP• 6cS)bE. u
� ddmss: -
Email and/or Fax _
PIO,ICT INF
ORMATION: �`=
TIS d��rolec>w,, � ,: Any earth movement may require
MCWD"Mew&permits:
❑Door(s) ❑Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑Repair ❑Storm Damage 18202
pM � ll
Dh N5v
Siding ❑Restoration ❑Other.(specify) Phone: 952-471.W90
❑Re-roof ❑Fire Damage Fax 952.471-0662
.minneha
Overall Project o"cription: 1(
Estimated ConGtruetion Valuation of Project(excluding land) S ,
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all Information required or requested by the Building Department;
es
• Certifithat the intbrmation supplied is true and correct to the best of histher 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
corrfiderrtial. 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.
wired law. If u n3fuse to su I e information the application m not be issued.
reqApplicant's Signature; %—JWDate:
Last Updated: 03.012011