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Home My WebLink About2014-01030 - siding e � CITY OF ORONO * z 0 1 4 - 0 1 0 3 0 * 2750 KELLEY PARKWAY DATE ISSUED: 09/16/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : �1250 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 . $IDING� ° � �,�S �C�t cr ��Y"��,i� -�i{'�l C VALUATION : $ 24,997.0� NO�CI:: RI;SIDING HOMG. REMOVAL OF EXISTING APPLICANT PERM[T FEE SCHEDULE 413.00 STATE SURCHARGE(VALUATION) 12.50 THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00 2690 CUMBERLAND PKWY, STE 300 30339- TOTAL 427.50 (763) 542-8826 Payment(s) Minnesota State License#: BUIL-20268257 CHECK 69148 427.50 OWNER ETAL, ROBERT DONGOSKE 4250 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfonned 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 Cor additional or relaCed work which requires scparate 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 thc State Building Code.This permit may be revoked at am time for due causc. . ` C / / / d,1�V i� i � Applicant Permitee Signature� Date � Issu By Signature Date � t ��'%1" '2014%THU Ol : i'� ��'I FAX No, 952 854 4909 P, 002 � �- , � City of (Jrono BuiMd�ng Permit App[ication fior In#ernal Work (windows, do�rs, siding, re-roof, etc,) Mailing Address: _ .�,0,�. PQ BOX 66 Permif numt�er: _ O ^ (� CrySial Bay, MN 55323-0086 Date received: ( '��i'�^;. ., ,., ''`�'`�-• a, Streat Add�esS: Received by: :' �;st� � ��'��] c~ 275o Kau�y Parkway Plan reviewfee: '�'i �i��Ki'N1' �J ��g��s�pg„9 Oronp,MN 55356 ! WM�otal Fee: � �� Main: 952-249-4600 Fax: 952-24�-4696 www.Ci.UrUno.mn.us � This appfication form must be com�leted in full and aEi required information must be suhmitted. Incomplete applications wlll be returnad_ (Please prini) CENERAL 1NFORMATIpN�� 5� �U � ` � � � � � � /��1�� Job Site Address: l� Will this he a Parade of Nomes, Remadelers Showcase Home or other Display Home? Yes No !f yes,a specia!event perm/t Is reqcdrsd witn Poi;ce oepartment and Gity Councll approva/BO days prior to the evant. snutt/e 6us se�vlce wll!be required un/ess app/Icant dBmonstratas sufflcient onsrte perking is available. Non-parmltlAd ev�nts will not be s/!oY✓ed. CdN7E�ACTOR/APPLICANT WFORMATIQN: qs Q��ys • G u V 7 Name: state �icense# �` �__ T�TD At-r�ome Seivice, Inc, �'-q d, Phone: � 2690 Cumberl�,ncl Pkw�, Ste 300 rn_ ceil) Mailing Address: _ ,A��ta, CxA 30339-3913 Z�P Contact Person: Lic#CR268257 Ph. 763/542-8826 �omeowner (Clrcle One) Email and/or Fax: PROPERTY OWNER INF M'�jT�IQN_ /'� Name: �� IJ l✓ O n {){J ��. Phone(day)� ` RS� '7? - ��l M Address: O � ! � � Q �G Q�, City: / 1 � `�n � ZIP: J�S� 4 y Email and/or Fax PROJECT INFORMATiON: " Type of Project: � Any earth movement may require j MGWD review&pennits ❑ Door(s) ❑ Remodel � ❑Water Damage f ! � Minnehah�Creek Watershed District(MCWD) ; ❑Window(s) I ❑ Repair ❑Storm Damage 1 s2o2 Minnetonka Blvd � Deephaven, MN 5539Z �Siding ! ❑ Restoration i ❑Qther(speClfy) Phone� 952-A�71-0590 l ' Fax_ 952-471-0682 ❑ Re-ro0f ❑ Fire Damage wv�nn�. ehahBCfeek.or Overafl Project Descrlption: � ! �� Q /J') ,P �1 Q p y7 � �� n � Estimated Construction Valuation of Project(excl diny land) $ � [� � 9 'r ,�, APPLICANT ACKNOWL�DG�MENT': • Agrees to provide all inforrnation required or requested by the Buifdiny Dep�rtment; ; + Certifies that the information supplied is trUe aftd COrrect to the best of his/her knowl�dge. The �pplicant recognizes that they ale solely responsible for Submitting a Complete application being aware that UpOn failUre to do so, the staff has no alternativA but to rejeCt it Until It is COrrYpleie; � Son�e or ali of the information fhat you are asked to p�vvide on thls application is classified by State law as either private or conffdential. Private data is inforrnatiol� whlch generally c2nnot be given to the public but can be given to the subject of the data. Confidential data is information which gensrally cannot be given to either the public or the subJec[ o{ the data. (�ur purpnse and intended use of this information is to �rtnually update our records and records of other c�ovemmental ayencies re uired b faw_ lf ou refuse to supply the information,the appfication may not be issUed. Appficant's Signature� ��✓ �► �—�- p�t�; ( l �r ( � y Last Updated: 05-U4-2o09 � �� City of Orono Building Permit Application for Internal Work �f��dows, doors, siding, re-roof, etc.) — Mailing Address: c ��9 Permit number: � �v�,�`��\ J�P � 5 ��I"t PO Box 66 /j� �A� Crystal Bay, MN 55323-0066 Date received: 1� 1� 1�� ,n;"�',�'�• '.._ �.��fl��t Address: Received by: ��' � �' ��. ' `�' 2750 Kelley Parkway �' ','�'- �!� a ~� Plan reviewfee: t�y��f�,��grpZ`gr�� Orono, MN 55356 :�.IfESH�,-� `- 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. (P/ease print) GENERAL INFORMATION�� O �� r t l /�� C Job Site Address: S -t' � Q � ,� �J Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes,a special event permit is requi�ed 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 INFORMATION: 9S��3yS • 4 � Y 7 Name: State �icense# THD At- Home Service, Inc, o di Phone: 2690 Cumberland Pkwy, Ste 300 (cell) Mailing Address: Atlanta, GA 30339-3913 ZIP: Contact Person: Lic # CR268257 Ph. 763/542-8826 lomeowner (Circle One) Email and/or Fax: PROPERTY OWNER INF MATION: Name: �0 h Q 0 n 0 S �-Q. Phone (day): QS'a �l'� 7 - S/y Address: Y e'Z 5 � o /'t � � Q �L �� c�t : /'') o ,►n d ZIP: 's S 3 L x 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 �Sidin Deephaven, MN 55391 � g ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 l Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www. innehahacreek.or Overall Project Description: � � � p /?') ,e 0 � b 0 Y�7 / n Estimated Construction Valuation of Project (excl ding land) $ � t�� Q 9 7 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 annualty update our records and records of other governmental agencies re uired b law. If ou refuse to su pl the information, the a lication ma not be issued. ApplicanYs Signature: ��-� v � Date: l � �j [ � 7 Last Updated: OS-04-2009 �f � GIII/ D T TIME � CITY OF ORONO CALLED IN INSPECTION TIC SCHEDULED PERMIT NO. - O COMPLETED ADDRESS 5��0 ��1-Q-�-� ��'.�-�i 'C.�i4,f�� OWNER TELEPHONE NO. ��70��7''3 CONTRACTOR �- ,�c � r�� DESCRIPTION ��-�� N ;��'�'�� l� ❑ FOOTING ❑ DEMO-FINAL ❑ SE IC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUN TION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RAD N SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ F MING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W S BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O � t � � O � W 2 Q � �_ W /� � vv v w � J d W ❑ RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � CORRECT WORK 8 PROCEED ,rJ ISSUE CERTIFICATE OF OCCUPANCY W O RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 ho rs in advance. 952 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice