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Home My WebLink About2011 - 00770 - replace door CITY OF ORONO PERMIT NO.: 2011-00770 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/10/2011 (952)249-4600 FAX: (952)249-4616 ADDRESS : 1995 WEST FARM RD PIN : 27-118-23-43-0013 LEGAL DESC : THE FARM AT LONG LAKE : LOT 011 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 6,482.00 NOTE: REPLACE(1)DOOR WITHIN EXISTING OPENINGS APPLICANT PERMIT FEE SCHEDULE 147.50 RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 3.24 1920 COUNTY RD C.WEST ROSEVILLE,MN 55113 TOTAL 150.74 (612)502-4777 Minnesota State License#:20130983 OWNER PARRISH,RICHARD 1995 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 conformance with the State Building Code.This permit may be revoked at any time for due cause. / / r Applicant Permitee Signature Date Issued By Si;j,ature /f ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB E. City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: 020U"tZ 77D g+ .l�j PO Box 66 Q Q Crystal Bay, MN 55323-0066 Date received: O / K ;;.. i* ` Street Address: Received by: �it� ;Lrigs;;" 2750 Kelley Parkway Plan review fee:Orono, MN 55356 Total Fee: 4500 .71 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 print) GENERAL INFORMATION: Iq`9 b Wes- TCJ( m 1�OC�d Job Site Address: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes El 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: Renewal By Andersen State License# 1920 County Road "Co West Expiration Date: Phone Roseville, MN 55113 (cell) Mailing Address: City: ZIP: Contact Person: License #20130983 It is: Contractor / Homeowner (Circle one) Email and/or Fax: 651-264-4777 PROPERTY OWNER INFORMATION: `i ` Name: fa lt��t`lS r'1 Phone (day): ciS a -444 _01Q E. Address: (1-\ City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8 permits [ )oor(s) ❑ Remodel 0 Water Damage Minnehaha Creek Watershed District(MCWD) 0 Window(s) 0 Repair ❑ Storm Damage 18202 Minnetonka Blvd 0 Siding 0 Restoration Deephaven, MN 55391 0 Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof 0 Fire Damage yvww,mInnehahacreek,org Overall Project Description:` �.e`p ` clOcJ^r ),, it *Lir',', Estimated Construction Valuation of Project(excluding land) $ to j y 60,9.CJO 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 application may not be issued. Applicant's Signature: f * ` Date 1 Last Updated: 05-04-2009 'd 06T9-L9IS9 331AN3S III4N3d Q '8 S i9 S2 :9T 1102 TO 2nd C)Pe K1 A ii TIME CITY OF ORONO CALLED IN "3/ INSPECTION NOTICE _ SCHEDULED ate//1 PERMIT NO. C)b I (Cd7 70 COMPLETE) ADDRESS 19C c--•-) ctrrm OWNERTELEPHON 3 tI LtE CONTRACTOR < c L /3(/ DESCRIPTION T/ �`� / Dooms 61/ LI ❑ FOOTING 12PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS y 0 FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION • ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP I ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI 0 SEPTIC FINAU 0 FOUNDATION/REMOVAL ▪ OWNER/CONTRACTOR TO MEET YOU: YES NO orark Et C'�./� u ` he O COMMENTS: Or 5icLL ,O 7�j / bOLZ. W 0. cc O cc O 0. W W CC • 0 WORK SATISFACTORY:PROCEEDROJECTCOMPLETE W ❑CORRECT WORK&PROCEED -❑ I UE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY u BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP 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: Inspector. (.. ..../ó-i G 2S White Copy/Inspector's File Canary Copy/Site Notice