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Home My WebLink About2011 - 01511 - addn/remodel/repair • CITY OF ORONO PERMIT NO.: 2011-01511 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/05/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4550 WOLVERTON PL PIN : 31-118-23-31-0005 LEGAL DESC : FOXFYRE ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 2,500.00 NOTE: REMOVE FIREPLACE/ENCLOSE ROOF/CEILING APPLICANT PERMIT FEE SCHEDULE 88.50 BRENNAN PROPERTIES LLC STATE SURCHARGE(VALUATION) 1.25 8452 153RD PLACE SAVAGE,MN 55378- TOTAL 89.75 (612)616-4447 Minnesota State License#:20381410 OWNER STEPHENSON, REVIS L 4550 WOLVERTON PL MAPLE PLAIN, MN 55359- 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• Hod of 180 days at any time after work has commenced. The applic. t'.r,sponsible for assuring all required inspections are requesjetfin•.nfs . e with the State Building Code.This permit may be rev ed at y time for•ue cause. / / r CA /.071) / plican{Permitee Signature Date Issu.4 By Signature Date r! SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. - . City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address. Permit number: Q.0 t(-- 0(`j it D,hr PO Box 66 - /^ ' Crystal Bay, MN 55323-0066 Date-received: / �{ `�# [( • (,a nF s, Street Address: Received by: �.(D �� i, rj!' o~ 2750 Kelley Parkway Plan review fee: i'kESH04" Orono, MN 55356 Total Fee: 1 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: �3 S� C,OD(ve,7 ),-N oz_ L Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes t&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 I FORMATION: Name: 5i"«✓lq ` ro_pr-' [C'S State License # Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: ',, k )- (.,,llv--Lk'r t t 7 (office) (cell) Mailing Address: ISZo$0 E=,5\e- tvi ( ,/1 S[ City: p,,,,,,,_ L0(_P ZIP: X3 -7Z Contact Person: Lot, 4e>-re vl 0 4 n t Applicant is: Contracto / Homeowner (circle one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: L0,---,. (-Ott e —e .. Phone (day): 6 c2 070•- -(22_8' Address: ..c1 Yc „)1-4i, -.,ti City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) -0 Remodel ❑ Fire Damage MCWD review& permits: ❑ Re roof, asphalt ❑ Repair Minnehaha Creek Watershed District(MCWD) p ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 E Re roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description:ge ic,/e t s,rC.plft(e /ey1C/C tt>of /('e//i. Estimated Construction Valuation of Project(excluding land) $ di 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 _tio to annually update our records and records of other governmental agencies required by law. If you refuse to s•.ply • e inf. mation,the application may not be issued. Applicant's Signature: e' .. Date: /J � _ i / Last Updated: 08-09-2011 /Fe C D TTIME CITY OF ORONO CALLED IN l02----' INSPECTION NOTICE D/.57/ SCHEDULED / 2..- 3 :e)-D PERMIT NO. 0P44-1/ --41,01COMPLETED// ADDRESS ( d&/ /,i--te--- OWNER I TELEP ONE NO. i/' - 0 '" 7 CONTRACTOR 51'G4 vIIII:4/I -�S - 0---e_ /WG`/ y2DESCRIPTION fIif fA"a' le / ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLI G Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLAND' y ❑ FRAMING D MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q 0 RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS 1, ❑ FINAL 0 SEWER HOOK-UP 0 COMPLAINT v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP ? 0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL v ElPLUMBING RI ElSEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU: YES_NO o COMMENTS: cc W Q.CC O 'rrAkili ,71 G 0 d e,t) F/a' 0 A-co c)ke atioAdeGI o Li)Its Kelm cifeD W cc Q W Z W CC d W2 *WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: MS' Inspector. White Copy/Inspector's File Canary Copy/Site Notice . C;-9- (--- D T TIME CITY OF ORONO CALLED IN / /s2_ INSPECTION NOTICE 0%S7/ SCHEDULED / p.— 3 :OD PERMIT NO. aU// COMPLETED ADDRESS 9 LWO/ �� OWNER I tri TELEP ONE NO. o'/' — * -" __CONTRACTOR JV L _ NI, >. DESCRIPTION 4 ""4 , " / / ✓' . I- ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLI G Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLAND' y 0 FRAMING 0 MECHANICAL FINAL Q ❑ TREE REMOVAL Q ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS 1, 0 FINAL 0 SEWER HOOK-UP ❑ COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL ' OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: ccW a cc o .r/'!�-m ,rh o O e) Fto r- CC ig-e0 Q)k W (,1)AS Kelm fee cc Q W Z LU CC LIZWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W 0 CORRECT WORK&PROCEED El. ISSUE CERTIFICATE OF OCCUPANCY OO 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT 0 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: /�/r% Ar 7� Inspector. White Copy/Inspector's File Canary Copy/Site Notice