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Home My WebLink About2010-00955 - windows � � �` CITY OF ORONO PERMIT NO.: 2010-00955 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE �SSUEu: 10/08/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 4175 FOREST LAKE DR PIN : 07-117-23-11-0006 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 007 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOIY TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 4,144.00 NOTG: (4)WINDOW REPLACEMENTS IN EXISTING OPENINGS APPLICANT PERM[T FEE SCHEDULE 118.00 THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 5.00 2690 CUMBERLAND PKWY, STE 300 30339- TOTAL 123.00 (763)542-8826 Minnesota State License#:20268257 OWNER THEISEN, T& S 4175 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT I�he work tbr which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and thc 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 compicd 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 l80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requcsted in conformance with the State Building Code.This permit may be revoked at any time for duc cause. �� /Ll � l /lj �� Applicant Permitee�ignature Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. i � . City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) -- Mailing Address: Permit�umber: 0�� 'U�� i �,_, ,.�`� �� PO Box 66 � Y � �� Crystal Bay, MN 55323-0066 Date received: �0� /� ; 0 Q�,� I,� ��,�,�� ,_ �,'� StreetAddress: Received by: �� f��+�'-�`';'�� 2750 Kelle Parkwa ��, ��..��.,.`�� Y Y Plan reviewfee: ��t tii`F:��r�� v% Orono, MN 55356 ��`�kESHo�`':, —__— 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: �� 7 S �� r� S ` 4 "'� r`' �l V�' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the evenL Shuttle bus service will be repuired unless app/icant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: THD At- Home Services Inc. �'d�� Jo�f State �icense# ?690 Cumberland Pkwy, Ste 300 4 Sa y5 - �b y ? Phone: cell Mailing Address: Cumberland Office Park ZIP: Contact Person: Atlanta, GA 30339-3913 lomeowner (Circle One) Email and/or Fax: Lic#20268257 Ph. 763/ 542-8826 PROPERTY OWNER INFORMATION: Name: Q ��`t Q 1 5� n Phone (day): �j S 7 7 � - 8 1 _/ Address: �(! 7'S o I A - /' Cit : �0 U/� Cl ziP: S S 3�y Email and/or Fax 5� �� 7 a • 7 $ l g PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review& permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) �Window(s) Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www.minne ahacreek.or Overall Project Description: w r n ('� /�( Cl I'� 1 n S �� L Y t S 1� � a �I n >�� S' Estimated Construction Valuation of Project (excluding land) $ � / Y y APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; _ __ _ — — --- -- — — Certifies that the information su �ied is true and correct to the 6est of his/her knowled e. Tfie a licant-teco-nires that-t e - • PP 9 pP J Y-- -- 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 b law. If ou refuse to suppl the information,the application ma not be issued. Applicant's Signature: �� Date: � � L 5 ` � � l Last Updated: 05-04-2009 DAT TIME D' C Y OF ORONO CALLED IN INSPECTION N TICE O��CHEDULED PERMIT NO COMPLETED ADDRES OWNE TELEPHONE NO.��,�i- T"7a-7�y CONTRACTOR >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � o �- � �- ��,� � � „ � �/�� r�c� �. � 0 � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED '� SUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �QSZ� 249-46QQ Owner/Contractor on site: Inspector. / / �" � � /�� White Copyllnspector's File Canary CopylSite Notice