The URL can be used to link to this page

Home My WebLink About2014-01006 - windows 1 ' CITY OF ORONO * 2 0 1 4 - 0 1 0 � 6 * 2750 KELLEY PARKWAY DATE ISSUED: 09/09/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4250 FOREST LAKE DR PIN : 07-117-23-12-0022 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 000 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 6,205.00 NOTE: REPLACE(S)WINDOWS INTO EXISTING OPENINGS. APPLICANT PERMIT FEE SCHEDULE 147.50 STATE SURCHARGE(VALUATION) 3.10 THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00 2690 CUMBERLAND PKWY, STE 300 TOTAL 152.60 30339- (763)542-8826 Payment(s) Minnesota State License#: BUIL-20268257 CHECK 69092 152.60 OWNER ETAL, ROBERT DONGOSKE 4250 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be pertbrmed according to the approved pians and specifications,applicable City approvals,and the Sta[e 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 oi'the date of issuance,or if construc[ion is suspended for a period of]80 days at any time afrer work has commenced. The applicant is responsible for assurinc all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �Y�o...� c,J ��- � Applica t Permitee Signature Date Issucd y Signaturc Date f � �;Ity OY IJf OiIU 275U Kelley Parkway Oro�io MN 55356 95�-249-46(i0 Rec:eipt No: 3.011738 Sep 9, 2014 F1der-Jones Previous Balance: .b0 Permits 2014-01U06 a25U Forest 14�7.50 lake Ur 1(:l 1-32530 Mechanical/ieptic/Other Permits PZ014-010U� 4250 Forest 3.10 Lake Dr 101-20802 Due t�:� govts-St�te Per�mits P2014-U1006 4250 Forest 2.00 Lake Dr 101-34440 Bldg Permits-mail in fees Tota1: 152•60 Check Check No: 69U92 152.60 Pay�r: Fltler-Jones ii�tal Applied: 152.60 Char�ye Tendered: .00 09/05/�014 01::;fiPM . ` City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: ;;:¢,�,�:'\ PO Box 66 !-� �AV Crystal Bay, MN 55323-0066 Date received: i. ; I Received by: ��,� ,�� r�: �.;� StreetAddress: \�`�l ��'��'��G//� Oro�no, MN 55356 aY Plan review fee: ��kEs H�4:� �-_ _- 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:Y 2 �.O �O �.� ST Job Site Address: � !� �lL !�/�I1�C�, 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 event. Shuttle bus service wi/l be required unless applicant demonstrates su(ficient on-site parking is available. Non-permitted events will not be al/owed. CONTRACTOR/APPLICANT INFORMATION: Name: �1 S? 3�l j'. G t9y 7 State �icense# THD At- Home Service, Inc, � Phone: 2690 Cumberland Pkwy, Ste 300 (ce��) Mailing Address: Atlanta, GA 30339-3913 ZIP: Contact Person: Lic # CR268257 Ph. 763/542-8826 lomeowner (Circle One) Email and/or Fax: PROPERTY OWNER FORMATI N: /� Name: � o b� /' /.�O /� � S��L Phone (day): 9 rs a y 7 ? • �Y� / 'I 0 U n � ZIP: s�3 � Address: � $ O O/'d � � Q � L D/�. Cit : Email and/or Fax 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.minnehahacreek.orq Overall Project Description: (,�� p� /` Q �'/ C) I n Estimated Construction Valuation of Project (exclu ing land) $ (a a O . 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 re uired b law. If ou refuse to suppl the information,the a lication ma not be issued. Applicant's Signature: ' � `�� Date: j [ � ` ! � Last Updated: 05-04-2009 � /�� y�� DATE TIME �y( CITY OF ORONO � CALLED IN INSPECTION NOTICE SCHEDULED �2 i� PERMIT NO. - ,(� COMPLEfED ADDRESS '��D �Ore S-f f��_ OWNER TELEPHONE NO. ��07`2S�q-o � CONTRACTOR �Y�(1 i--�— �; DESCRIPTION �� .-�-�o�. � /Y�6�-P�� 4� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � O POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAIV � FOUNbATION/REMOVAL Z OWNERICONTFiACTOR TO MEET YOU:_YES LL_NO � COMMENTS: � � � a � W/NKJow ►'e�0�e.+tc.r�s � S�s.t� SiZ,�_T_ j � 0 eac�St/� OO_�S. - >. � � eJ�L�e✓io i'S 4 r e I►�te� C� � /�DL� GA.4�iLe� W � ��'��les �lrrt t, ' �awt2 p wnQ✓ SL�4��S �/�� Q / 2 S✓1�..1 r'�KlLr•t�ib/ R45• �'h•s�✓u?� 7� /Ks�%�i!/f-1 oG� WS�dl�_.ri�4.cr� — �x�-e,.co� -yb 6-Q c��lk��) °� ��.� j�.,�.'� ' t�a.-..s�t J�I� � � ❑WORKSATISFACTORY:PROCEED �ECT COMPLEfE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. all forthe next inspection 24 hours in advance. (952) 249-4600 Ownerl ctor on site: �7 L��'►�� Inspector. White Copyflnspector's Ffle Canary CopylSite Notice