HomeMy WebLinkAbout2012-01226 - windows CITY OF ORONO � � J(1 1 11111(111 I I HII11
2750 KELLEY PARKWAY 1 P1 6
DATE ISSUED:: 12/05/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4705 WATERTOWN RD
PIN : 31-118-23-22-0003
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
VALUATION : $ 30,946.00
NOTE: REPLACE 21 WINDOWS IN EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 477.50
RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 15.47
1920 COUNTY RD C. WEST
ROSEVILLE, MN 55113 MISC FEE 0.00
(612)502-4777 MAIL-IN FEE 2.00
Minnesota State License#: BC 130983 TOTAL 494.97
PAID WITH CC# 8788
OWNER
PRCHAL,DEREK&KELLY
4705 WATERTOWN RD
MAPLE PLAIN,MN 55359-
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.
Applicant Permitee Signature Date Issued By Sig lure L / Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
Mailing Address_
0O7. 4 PO Box 66 Permit number:Q Crystal Bay, MN 55323-0066 Date received:
14ii, ,y� Ar Street Address: Received by:
*,,t 2,14 • o'
tiltit2750 Kelley Parkway
ti044. Orono, MN 55356 Plan review fee:
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: , 1 1OS 1W �� `
Job Site Address: y --?NA
Will this be a Parade of Homes, Remadeiers 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: 'ntwo l A trSe�
State License# —6C-1-009 8-3
Expiration Date: 3/31
Lead Certification Number:
i\ ,A'T- al.a' 3 — 1 Expi ation Date: 4/16
(for work on homes that were constricted prior to 1978
Phone: (05 i— tD4_4}-}-1, (office)
Mailing Address: ( li)
19 a o co. ►id c. Wes+ City:?. tV;ut ZIP: Ss 113
Contact Person:
Applicant
Email and/or Fax: pp is: [contractor / Homeowner (circle orlo
PROPERTY OWNER INFORMATION:
Name: AtI` Y CSA_\
Phone (day): ka 12" X91 -- ( 21.10
Address: t S..-�
Email and/or Fax City: ZIP:
PROJECT INFORMATION:
Type of Project:
❑ Door(s)
Any earth movement may require
❑ Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof, asphalt Minnehaha Creek Watershed District(MCWD)
❑Repair 0 Storm Damage 18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration 0 Water Damage Deephaven, MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
Re-roof,other(specKy) 0 Siding ❑ Other. (specify)
❑Window(s) www.minnehahacreek.oro
Overall Project Description: A0.46, Z1 o 5CA.S :v-1._
`
Estimated Construction Valuatio of Project (excluding land) $ �-0 C ' ��
0
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 applica t recognizes that t ey
are solely responsible for submitting a complete application being aware that upon failure to do so, the taff has no alternatve
but to reject it until it is complete;
i
• 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 b law. If you refuse to supply the information, the application may not be issued.
goolicant's Sianature: Q 07eN.0 Date: Sbe c i Z
2 'd 06I917L9TS9 33IAN3S .INN d a B S I'1 SS =ZT 2102 SO Dell
I
P.
i D E. TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE 1- SCHEDULED I: C i I
PERMIT NO. (.7Y)1, --61 - ICJ COMPLETED
ADDRESS II C L (A -f cr 1i tui ed p
OWNER TELEPHONE NO. ( 'f J a�'�/ UGae
CONTRACTOR 134'at,t)1/4_ et./ r-1-1-}+-7a,„
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DESCRIPTION tic i v lc( (-- (,'`-,
W ❑ FOOTING 0 PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
• ❑ POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS
ti
0 FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL
• 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
I, 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
0 DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL
0 PLUMBING RI 0 SEPTIC FINA'�` 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES j� NO
o COMMENTS: /`
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W ElWORK SATISFACTORY:PROCEED ^eROJECT COMPLETE
CCW
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CZ) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. LAY0? l�l
White Copy/Inspector's File Canary Copy/Site Notice