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Home My WebLink About2009 - 00202 - adv plan review CITY OF ORONO PERMIT NO.: 2009-00202 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 05/01/2009 (952) 249-4600 FAX: (952)249-4616 P'DRESS : 835 WINDJAMMER LA PIN : 07-117-23-11-0008 LEGAL DESC : PIRATES COVE : LOT 004 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 225,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL-ENTIRE INTERIOR REMODEL,NEW WINDOWS,SIDING& ROOFING,PLUS ADDING ENTRY PORCH&ENCLOSING UNDER EXISTING OVERHANG PERMIT#THIS PRE-PAYMENT IS TIED TO: 2009-00203 APPLICANT ADVANCED PLAN REVIEW 1,174.39 T J B REMODELING&DESIGN,INC. TOTAL 1,174.39 9100 BALTIMORE ST NE BLAINE,MN 55449- PAID WITH CC# 0444 (763)780-2944 Minnesota State License#:20396490 OWNER HANSON, SCOTT&JENNIFER 835 WINDJAMMER LA MOUND,MN 55364 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 Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application • Mailing Address: O\ PO Box 66 Permit number. Z C09- Z 03 70 �' \ Crystal Bay, MN 55323-0066 Date received: J I M OC1 Si S A ,a, �, Street Address: Received by: V P I LJ(') '' tiF 2750 Kelley Parkway _` ZCOR'0 bz0 ct �� t�, it Y Y P(� 4., I (5�— Plan review fee: 9 i �9kESH04� Orono, MN 55356 . V I d 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 print) GENERAL INFORMATION: Job Site Address: 835 WINDJAMMER LANE ORONO,MN 55364 s Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ✓❑ Yes El No 0 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. v CONTRACTOR/APPLICANT INFORMATION: S Name: T J B REMODELING AND DESIGN INC -(k) , State License# BC-20396490 Expiration Date: 03/31/10 = Phone: (763)780-2944 (office) (763)286-4299 (cell) Mailing Address: 9100 BALTIMORE ST NE City: BLAINE. MN ZIP: 55449 S Contact Person: RICK BUDZYNSKI Applicant is: <contractor9/ Homeowner (Circle One) /2— Email 1Email and/or Fax: RICKTJBHOMES.COM 763-767-1372 I PROPERTY OWNER INFORMATION: Name: SCOTT AND JEN HANSON Phone (day): (952)567-0601 s S Address: 835 WINDJAMMER LANE City: ORONO, MN ZIP: 55364 t Email and/or Fax CL PROJECT INFORMATION: ;,l I Type of Project: Any earth movement may require MCWD review&permits D 0 Door(s) ll] Remodel 0 Water Damage ci Minnehaha Creek Watershed District(MCWD) i 0 Window(s) 0 Repair ❑Storm Damage 18202 Minnetonka Blvd _ Deephaven, MN 55391 0 ® Siding 8 Restoration ❑Other: (specify) Phone: 952-471-0590 0 Fax: 952-471-0682 0 Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: REMODEL ENTIRE INTERIOR OF HOUSE, NEW WINDOWS, SIDING, ROOFING Estimated Construction Valuation of Project(excluding land) $ 225,000.00 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: (._... t,, • Date: y -3 0 - Reset Form 411 Building Permit Fee Estimation for valuations greater than $500 Valuation } Permit Fee Surcharge Plan Review Total Fees 1,806.75 112.50 1,174.39 3,093.64 Total if No Plan Review 1,919.25 g35- w/ a m ! City of OroN I I 1 2750 Kelley PeoAay \ i Orono AN 55353 1 1 , \ Reeipt, No; ,00053e, a.:;.., 4inciOmme( Lane . I , PPrmitsI a35 witAlamu.s. Lane 1)i74 A 101-341t1 . 1 I Plan Dock/Site Exath 1 Ttal: 1,174.39 i 1.2.T0 . , rayor,;. 1 1335 WinOaTwff Lan 1 'total qpplieO; 1,174.,,, i , ------------ I Cilano dr—i,f,; \ T:liTt/09 J2:67P% i I \ \ it I City Of Orono 2750 Kelley Parkway Orono,MN 55356 (952)249 4600 Friday, May 1,2009 12:05:13 PM Trans.No: 173501985 Invoice: 835 Windja Card No: XXXXXX0444 EXP:03/11 Auth No: 211050 Amount: $1,174.39 x(14 Ai 4111)411, ....,_ .... ik I,RICHARD D BUD •: I, •e•E: t• PAY THE ABOVE AMOUNT ACC•'DI •THE CARD ISSUER AGREEME ANT AGREEMENT IF CREDIT V• , , Thank you !