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Home My WebLink About2012 - 00030 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2012-00030 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 01/12/2012 • (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 : $ 3,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING BATHROOM/CLOSET APPLICANT PERMIT FEE SCHEDULE 88.50 BRENNAN PROPERTIES LLC STATE SURCHARGE(VALUATION) 1.50 8452 153RD PLACE SAVAGE,MN 55378- TOTAL 90.00 (612)616-4447 Minnesota State License#:20381410 OWNER ST'EPHENSON,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 period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested i •.n ,rmance with the State Building Code.This permit may be revok-. .t. ti . fo due cause. / / / z— App1i•.nt Permitee Signature Date Iss By Signature Date 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: a, I, ' ��.� I j�. ,0,e1--- , PO Box 66 0 N. Crystal Bay, MN 55323-0066 Date;received: / / /�-- a t)..!,.•, ,_47... Street Address: Received by.: �n ti ,, 'ii"'"gid' ~ 2750 Kelley Parkway Y Plan.review fee: qty �'� �� Orono, MN 55356 \ESH04 Total=Fee: . Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us V 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: '-+55 ) (,,Vol, ifsrio,- P(C1 C(' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 3No 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 I APPL CANT INFORMATION: Name: r PILI V►��vl Prvper17es State License # Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: 42 fZ.-C,gU,-Lf 4!'--1 7 (office) (cell) Mailing Address: 56, r s) , Poi f- L" City:/r - "4 ZIP: `537 Contact Person: , CJe 6.fP N el 9 ,.t Applicant is: ontra • / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require E Door(s) Remodel ❑ Fire Damage MCWD review&permits: ❑ Re roof, asphalt Minnehaha Creek Watershed District(MCWD) p ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd E Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) Phone: 952-471-0590 ❑ Siding E Other: (specify) Fax: 952-471-0682 E Window(s) www.minnehahacreek.orq Overall Project Description: ADD Q,4-rt.2.0c9 r--1 ( Gto�9 Estimated Construction Valuation of Project(excluding land) $ 3()vv 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 ipferfn. on i 0 annually update our records and records of other governmental agencies required b law. If you refuse to scii.•I e i dr - '•n,th- as•lication may not be issued. Applicant's Signature: J11111V Date: 7-/i. -/- _ Last Updated: 08-09-2011 Z TE TIME V CITY OF ORONO CALLED IN f— i. INSPECTION��T.,1ICS SCHEDULED /----2-e---P) PERMIT NO. --d•- 02 - 003D co PLETED ADDRESS V- 5 Myer Pl,q_r-f OWNER TE HONE . 2-- - (O-4` 41 CONTRACTOR V• Q,/l fP1± ¢-- •/ >; DESCRIPTION ltcl Lt. • ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Cl) 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS Q 0 FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL El FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO,^MEET YOU: �f ( YEES� NO // COMMENTS: l�U 5� /_ 2-9 R5 W O. CC O cE Z W z W 0 Lu ❑WORK SATISFACTORY:PROCEED kilROJECT COMPLETE W IDCORRECT 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 ❑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. L.4_i' , s zi �!S White Copy/Inspector's File Canary Copy/Site Notice D TE TIME V CITY OF ORONO CALLED IN I Z INSPECTION NocE SCHEDULED PERMIT NO. - Ot0 3 COMPLETED ADDRESS V 61 Pl aj "i OWNER TE HONE .Q' CONTRACTOR ° ► dfYt •�/ • >, DESCRIPTION W ❑ FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING W• ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 0 FRAMING ❑ MECHANICAL FINAL 0 TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL 0 PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR/TO,MEET YOU:_YES NO yo COMMENTS: (-U /tat - 279 R5 W O � AJ t A ii 12,2j +cc � C)I i7 s x1 '�S S WCC ❑WORK SATISFACTORY:PROCEED IROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U 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: Inspector. Lur 1/L1 e s White Copy/Inspector's File Canary Copy/Site Notice