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Home My WebLink About2017 - 01192 - doors CITY OF ORONO 1111111111111111111111111111111111111111111111111 2750 KELLEY PARKWAY DATE ISSUED: 09/25/2017 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 55 WEAR LA N PIN : 33-118-23-34-0006 LEGAL DESC : ROLLING MEADOWS 2ND ADDN : LOT 002 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 7,938.00 NOTE: REPLACE(2)PATIO DOORS WITHIN EXISTING OPENINGS. APPLICANT PERMIT FEE SCHEDULE 170.34 STATE SURCHARGE(VALUATION) 3.97 RENEWAL BY ANDERSON MAIL-IN FEE 2.00 1920 COUNTY RD C. WEST ROSEVILLE,MN 55113 TOTAL 176.31 (612)502-4777 Payment(s) Minnesota State License#:BUIL-BC130983 CREDIT CARD 8788 176.31 OWNER KELDERMAN,MICHAEL&JUDITH J 55 WEAR LA N 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. ` (1444/ � a�- rPo ,� () 9 /C5/ /7 Applicant Permitee Signature Date Issued r Signature Date ! '-. City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Marling Address: Permit number: D1-7 O P------ 1.0:4-;:\ PO Box 66 /�� a - 0 „ Q Crystal Bay, MN 55323-0066 Date received: /` 1 Received by: - Street Address' ' 4;4 , . 2750 Kelley Parkway Plan review fee: < •0.0-k:,f.+` Orono,MN 55356 ' / ��_ � `'/ `�'rv•'° Total Fee: ` J Main: 952-249-4600 Fax: 952-249-4616 wwvi,cs.orono.ina s ; This application form must be completed In full and all required information must be submitted. /i/j(,' Q� Incomplete applications will be returned. (Please print) a) GENERAL.INFORMATION: Job Site Address: a:) R ..; L . , " Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? I 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 onsite parking is available. Non permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 1%-L a_. - A .-vt" .erg State License# '$G13raqExpiration Date: — 3131 Lead Certification Number: (\31:VT- a--o:$3 -L Expiration Date: Lf/l'G (for work on homes that were constructed nrlor to 1978 (cell) Phone: (os 1- a[04-4.oS$- QC ,» (office) Mailing Address: • • ►. --*. " " t.. e.S4 City: .• ; t ZIP: SS 1 _ Contact Person: Applicant Is: • = / Homeowner (circle one) Email and/or Fax: _ -- PROPERTY OWNER INFORMATION: Name: .ir. ti, ICo-Liei-e-irv'' t„ Phone (day): — (` �2 • d Li _ Address: .1„ City: ZIP: Email and/or Fax — PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits: Ci Door(s) ❑ Remodel ❑Fire Damage Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,asphalt ❑Repair LI Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 0 Re-roof,cedar ❑Restoration 0 Water Damage Phone: 952-471-0590 0 Re-roof,other(specify) ❑ Siding 0 Other:(specify) Fax: 952471-0682 www.min nehahac,_reek.orq ❑Window(s) _ Overall Protect Descrn: to. "nc8 6.6v6. ---7:7-T-1,(1);A. t..', i f". e Estimated Construction Valuation of Project exicludin. land) $ 1. ': T 3.O! 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 a••iloatlon ma not be issued. Aoolleant's Signature: OK 0 , • Date: c2� l9- / DATE TIME CITY OF ORONO CALLED IN INSPECTION NOT CE SCHEDULED /2151/7 PERMIT NO.. -08COMPLETED a , ADDRESS 53 k) OWNER TELEPHONE CONTRACTOR % ��' >, DESCRIPTION 1k r/c/-41--) W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS 1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ❑ DEMO-SITE 0 SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO cl• COMMENTS: h e,w 51, J h S pe 'a �avYS • �'v)Sfi1.l1,A G. Ike Thr JclTika�� • 3/',"041_ e�iG�"o r-_, a 1/N 2. CD (vim Ct W CC CC • N• WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CI CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. s$ 1✓ White Copyllnspector's File Canary Copy/Site Notice