HomeMy WebLinkAbout2013 - 00815 - siding CITY OF ORONO 0 I 1 if 1 Ill II II 1111111 I Il
2750 KELLEY PARKWAY * 2 T 13 - 0081S
DATE ISSUED: 08/19/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1801 WEST FARM RD
PIN : 27-118-23-44-0019
LEGAL DESC : N/A
: LOT MB BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 24,396.00
NOTE: WINDOW REPLACEMENT AND SIDING FROM STORM DAMAGE
APPLICANT
GIERTSEN COMPANY PERMIT FEE SCHEDULE 413.00
8385 10TH AVE N STATE SURCHARGE(VALUATION) 12.20
GOLDEN VALLEY, MN 55427- TOTAL 425.20
(763)546-1300 PAID WITH CC# 1523
Minnesota State License#: BC 1796
OWNER
MULDOON,PAUL& SAMANTHA
1801 WEST FARM 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 conforri1 nce with the St e Building Code.This permit may be
revoked at any time for with
Applicant Permitee Signature Date
Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Ak City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�OlV Mailing Address: Permit number: Q/3 COT-5-
O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
Plan
Street Address: Received by:
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... 2750 Kelley Parkway Plan review fee:
�' Orono, MN 55356 �j
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Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please pr. t)
GENERAL INFORMATION:
Job Site Address: ''-g<r __e_ST - ,W) c Cfl';
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o
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 IRMATION:
Name: (....:- :—e, N O}/ "'•(3--,k-'2 , g
State License# / xpiration Date: ' f
Lead Certification Number: 7�' i —/ Expiration Date: .yA.- /
(for work on homes that wereconstructed pri•r to 1978
Phone: (cell) - " 0 7�3 iii (office) ,.. 13 --,1,•1"
Mailing Address: -40' e:,,---1-4(21111111M11111=11110 ,,—� IP: _-";'---z -�/
Contact Person: _<j 17e, cA Applicant is: 'ontracto Hom:.wner (circle One) /
Email and/or Fax: Cr-,,v^,V/Y : y/< ce y2C_ ) c /?
PROPERTY OWNER INFOR ATION: �%'�" /6/4047)Name:
1-:?--., I r�� �1 c-
Phone (day): _
Address: - �, �� City: ZIP:'� 1
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)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
111 Re-roof, other(specify) Sding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
1= Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ ---7_,,,,, G, 3��
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 inform-tion is to annually update our records and records of other governmental agencies required by law. If
you refuse to supply t <• ormation, the a.. ':- 'on may not be issued.
Applicant's Signature: N.„ 'Z----/ -3
Owner's Signature: Date:
Last Updated: 03/06/2013
DATE TIME
CITY OF ORONO C LLED IN
INSPECTION NpIIC �� ,j 4.--SCHEDULED /0-Z/-1-3
A
PERMIT NO. - COMPLET D
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ADDRESS /SO/ /..L�C'S 1 /
OWNER /' TELE NE NO.263 23e 53e
CONTRACTOR 6/erg-
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DESCRIPTION a-44:/Arg(--) S 4
Uj ❑ FOOTING ❑ PLUMBINFINAL s!� ❑ EXCAV/GRADING/FILLING
•
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING 0 MECHANICAL FINAL
❑ TREE REMOVAL
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q 0 RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
0 DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES NO
o COMMENTS:
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❑WORK SATISFACTORY:PROCEED ApROJECTCOMPLETE
CC
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: ��6P�
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice