HomeMy WebLinkAbout2013 - 00901 - siding II CITY OF ORONO 11 II 11 u III 1
* 2013 - 00901 *
2750 KELLEY PARKWAY DATE ISSUED: 09/04/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1110 WILLOW DR S
PIN : 10-117-23-24-0011
LEGAL DESC : UNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 3,250.00
NOTE: SIDING REPLACEMENT
APPLICANT PERMIT FEE SCHEDULE 103.25
ALL AROUND PROPERTY PRESERVATION STATE SURCHARGE(VALUATION) 1.63
701 DECATUR AVE W
GOLDEN VALLEY, MN 55427- TOTAL 104.88
(763)228-0324 PAID WITH CC# 7566
Minnesota State License#: BC635665
OWNER
GLASER,ROBB
1110 WILLOW DR S
WAYZATA,MN 55391
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 goveming 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.
/ / ,�, A 9 / /13
Applicant Permitee Signature Date Issue :y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OT'ER THAN DESCRIBED ABOVE.
SEP.03.2013 23:45 18004198422 All Around #0346 P.001_ /001
V - .c
L City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
A, Mailing Address; 7e)/ OV
/'�/ 0f VQ PO Box 66 Permit number: pl - y
I Crystal Bay,MN 55323-0066 Date received: c9—41--/�
�, Street Address: Received by: _
-1
` 2750 Kelley Parkway Plan review tea:
�-kcs sit o�j Orono,MN 55356 /O
,_r Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www,ci,prono.rnn.,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:
Job Site Address: •0 °� t,a n, 0ru.,1c ,5 Ci
V'�IU�J
Will this be a Parade of Homes, Remodelers Showcase Home 6r other Display Home? 0 Yes No
it yes,a special oven!permit is required with Police Department and City Council approval tin days prior to the event. Shuttle bus se ice will be
required unless applicant demonstrates sufficient nn sile parking is available. Non perinitled events will not be allowed.
CONTRACTOR/APP ICANT INFORMATI N:
Name:
State License#
yritru.eta,
Expiration Date: 0.6-? t-Co S,
Lead Certification Number: OqA 1-- '-Tr c , 3(0 - 4 _ Expiration Date:9 - :.19-- 0 s
(for work on homes that were constructed prior to 1978 ^"�---
Phone: (cell) 10_, Gly (Office) -7C:1--4/417-51,2.5-
Mailing Address:
70 i Pr e-eL.0- Ar rr,. / City: 'c, ,/- , yZIP:
5S''Y.17
Contact Person: y_-C Applicant is: -• ractor / Hdmeowner
"a' :���»�.�Wit,,:.. .. __. (circle one)
Email and/or Fax: —
PROPERTY OWNER INF�O~RMATION:
Name: -,.. �e. u,�
Phone (day): _, --�,.,......_—�_.,........_.__ ..,.,.
Address:
City: ZIP:
Email and/or Fax: _...._.
PROJECT INFORMATION: Overall project description: 'C IC:� ^c 1d-
Type of Project - "` T'—""�" L-
-
Any earth movement may also require
O Door(s) O Remodel O Fire Damage MCWD review&permits:
Re-roof,asphalt D Repair ❑Storm Damage Mlnnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
O Re-roof,cedar O Restoration El Water Damage
Deephaven,MN 55391
O Re-roof,other(specify) iding O Other:(specify) Phone: 952-471-0590
L Fax: 952-471-0682
❑Window(s) www.minnehahacreek or
Estimated Construction Valuation of Project(excluding land) $ Q.c
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 ere
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 - to annually u..- -.our re •rds and records of other governmental agencies required by law. If
you refuse to suppl the infrsfma • e ;r.. -tion
;,,� of b: I d.
Applicant's Signature;:_ , _ a- _ /�� Date: j'-Jn/0
Owners Signature: - v Date:
/test Updated.03/001 013
c_\. -_,1„ pi,,.,..6_1 1 76.E d d r ct r )9 ) Cj
j� 1572474-1AT TIME
CITY OF ORONO l CALLED IN ��
INSPECTION NOTICESCHEDULEDSCHEDULED 10-3-/3 _
PERMIT NO.o2D/3-00 1)61 I COMPLETED
ADDRESS 1 1 l O cuillow Dr S
OWNER n TELEPHONE NO. M3 2Z8 037-11
CONTRACTOR Ali Pre tris PT Pres
DESCRIPTION S r!O. 1
ti, ❑ FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q ❑ POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS
ti ❑ FRAMING 0 MECHANICAL FINAL
❑ TREE REMOVAL
❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
0 FINAL 0 SEWER HOOK-UP ❑ COMPLAINT
❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
cc
W
a
CC
O
CC
O
U.
W
CC
W
W
CC
O
WLU 0 WORK SATISFACTORY:PROCEED OJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISS CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. 1-1 (/'-1/2/ 7
White Copy/inspector's File Canary Copy/Site Notice