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Home My WebLink About2016-00710 - exterior stone work �` CITY OF ORONO * 2 0 1 6 — 0 0 7 1 B * 2750 KELLEY PARKWAY DATE ISSUED: 06/22/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4225 FOREST LAKE DR PIN : 07-117-23-12-0025 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 003 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : UNDEFINED ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 11,000.00 NOTE: EXTER[OR STONE WORK PROJECT APPLICANT PERMIT FEE SCHEDULE 216.81 STATE SURCHARGE(VALUATION) 5.50 CONDOR F[REPLACE& STONE CO. MAIL-IN FEE 2.00 8282 ARTHUR ST NE SPRING LAKE PARK, MN 55432 TOTAL 224.31 (763)786-2341 Payment(s) CREDIT CARD 6743 224.31 OWNER ANDERSON,KENNETH 4225 FOREST LAKE DR MOLJND,MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according ro 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. l ,� 1 �,;�j � c <{ �:�_�.�` � <�._ � �_ c. c_��=,�t� �� , �z z , �c�, Applicant Permitee Signature Date Issued By Signature Date O 06-20-2016 09:46 Fax 5ervices -�19522494616 �3 � "� �- City of +C�rono Buildfng Permit Application for Maintenance 1 Replacement / Remodel — Residential ONLY �(i.e. windows, doors, sidinr�, re-roof, etc. - NO STRUCTURAL EXPANSf�N} . '� . ;� A -. MaNing Address: ! .. � �., ' �V��, PO 6ox&B � Permit number: -�C ;...��,.-�_�,___j — ,'� '1 Crystal Bay,MN 55323-0066 Dats received; _ � /�C, _�-�.� i � Received b _ ��-� � Street Address.y y Plan review fee: —� ��;� '� y, „ �� `�,r� 2750 Kelle Parkwa � !,a � �+ r`~r Orono, MN 55356 �w9lu`, � � ' � Total Fee� �Z C�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � .. _ _. _ ....._ �_ ----------_ __.... This application form rnust be completed in full and all required information must be submitted. - �� r�y� (� Incomplete applications will be�etumed. (Please print) '�`'��`�� /�� ZL GENERAL 1NFORMATION: w „ ,� , Job Site Address: �.�'�� .J�,.�_ "`�ti�,�_�V��r'��.�-�' _._��` _______._�_--.......__. -- - _--- Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes � Na /f yes,a specia/event permit ls requi�ed wrth Police Depertment and City Council approval BO days pnor to the event Shutt/e bus service w�q be requi�ed unless applicani demonslrates su�cient on-site paikiny is evailable, Non-permitted events will not be allowed. CONTRACTOR/APPL.ICANT INFORMATION: Name; � �� '�� '��.��w�..�� ....._ � -- State License# ��,�___� a�� Expiration Date: �';1 •'�fl ^�,q� ��'^' � � �� . -��-�,.7'� _ _ _. '-��...,.,,,,. _ — Lead Certification�Jumber. Expiration Date: (for work on homes that were const�ucted pr�ar to t978� '-- �,.T � - � ---- '.^ � Phone: (Cell) (ofiice) � 1 �' g�-(c� ��-,— .� _�, ,�_ �. . ....._ +.f . �,� Mailin Address ' � ,, y �'� � �,��. �M 1 ; ` .�,:�'�,� g �,`�t�, r ._. '� ��... _ ._ �it t 7� �..`�;'�,��" �.,.y ' � Contact Person . �� a�� ,�.�� Applicant is: � 'r�c3mr� h• Homecov+rr7�r (Clrcle One � ��~�� Email and/or Fax �� ..1(`_..�,`N,�,�..._�.�''-��"'�`�'� "�i-' . [...�,_u �.�?(�� PROPERTY OWNER INFORMATION: Name: ��_� ,a�;:�'�:'��,�.,,.�`��"��'" -_....___ , . . .. --- - -- Phone da � � �- � �� '��S ��.'�.� ��:,� _ _ �� ._C.:�.�t^�-��w.__ �. ��,..� _..��" _ C�ty: r...,� , ^� +.a Z I P: Address: y �~ __ C,� �'�-- -- __....._—. Email and/or Fax: __ __. __ ..._... ...... -- -- __ � � � �� 1� - . PROJECT INFORMATION: Overall rc�e�rt desc�i�tsc,rr1 _�� L��,� � � - C�'" ...... � ._.- Type of Project: Any earth movement may also req ire �Remodel MCWU review 8�permits: ❑Door(s} ❑ Fire Damage ❑Re-roof,asphalt ��Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑Restoration ❑Water Damage Minnetonka,MN 55345 ❑Re-roof,other(specliy) ❑Siding ❑Other. (specify) Phone 952-471-0590 Fax: 952-A11-0682 ❑Window(s} www,minnehahacreek.orQ __ __... — , .... .._...._. ...,, -- - _ , __ _ .. ... --- ' Estimated Construction Valuatwn of Project(excluding land) $ �"� � I,�� [:,;;,a APPLICANT ACKNOWLEDGEMENT: _ __._ _ _ .....--- -_._.., __ _ _- ----- • Agrees to provide all information required or requested by the Bwlding Department 1 • Certifies that the intormation suppliad is true and correct to the best of his/her knowledge. The applicant recognizes that they are ! soiely 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 camplete; • 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 gwen to the public but can be given to the subject of the dat8 , Confidential data Is information which generally cannot be given to either the pubhc or the subject of the data Our purpose and '; ;ntended use of this information is to annually update our records�nd records of other governmental agencies reqwretl by iaw. tf y�u�efuse to su�aply the infarn7G�Uon, the�a�xFifir ritir�i�m�y not be issued. _.. __ ---- --- ,....� � W ,�� " . � �.. ApplicanYs Sign�ture �.,,�'�__,_W...�,.' ""�' . Date. ---�i._ , �:;�... „ �� ' � � �,i � � �':•, �� ` � "� ,��` DaEe: �..� �"� .. Owner's Signature _.__-��-;�,',�,�"a"�� ' � �� "°`� � � Lasl Updaied:January 2016 ! � � � �z �c �C�r�� (k _ �: �� J � �� Gf��q /�j�� 11-�s�-�� `� r/ X �� J ,:;�s-�-�(� `�x�� Z.� b loc.�L �,��f��(/ � # � ��(s , !6" � ---< - , ' /� l ,_ � .�, , —� �; , � �� , 3 , „ � ,, ------------------ i � ; T � Z8� t-�Z' 1� I �i / � �{Z � ' � ; ,- i � I: ,�' ,, � 7, ; � ` �,- __ _ Y, _ _ , �`z._..___.__��{� - — . _ - 3�, ..,..,f� CITY OF ORQNd �� BU{LDiNG RE;R�J NEV6EW � INSPECTOa C.�_ DATE � ' 1 ` �� --P[�^�^IT NO.----�____ F'Pfi��1;'E7 A�:S!J��;ii�?=D ❑ A!'P�iOti'F��'!`d"i i i C�,��;��"T,O�lS�tS N�.._^� ❑ ��T tiPPR?Vr��---C��;�c�i��CY�r�'1��:;�;�T r"'�`CO�T(I't'.f`1S afv'{0�'ji:V.•i�'.`.OiC??T!D'l. f1��WC.'IS^i'c''i Ii2�••fl9 �.._,� IC '- . 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