HomeMy WebLinkAbout2009-00455 (Windows) . CITY OF ORONO PERMIT NO.: 2009-00455
2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISsuED: 08/10/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1432 BALDUR PARK RD
PIN : 08-117-23-43-0007
LEGAL DESC : BALDUR PARK
: LOT 007 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 7,425.00
NOTE: REPLACE LIVING ROOM WINDOW IN EXISTING OPENING.
APPLICANT pERMIT FEE SCHEDULE 162.25
PELLA WINDOWS& DOORS STATE SURCHARGE(VALUATION) 3J1
15300 25TH AVE N. -SUITE# 100
PLYMOUTH, MN 55447 MAIL-IN FEE 2.00
(952)345-6047 TOTAL 167.96
Minnesota State License#: 20165884
OWNER
NYQUIST, MR. &MRS.
1432 BALDUR PARK RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
[he 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 ar related work which requires sepaza[e
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 no[
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 cesponsible for assuring all requiced inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cau�e.
�,�'K.GI.�C� LK� l l l l
Applicant Permitee Signature Date
Issued By S� nature i Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO .
Total Fee: $ DateRe ved:
Entered By: Permi : 00 Q � 6 o Y 5 S�
CITY OF ORONO - BUILDING PERMIT A
All information must be submitted in full before plan review will be started.
(please print«l[information)
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THE APPLICANT IS: (circle oize) OWNER OR CONTRACTOR
JOB SITE ADD�SS: � � 3 a �3 a 1��f P�� � R� Z�: �s� 3� j
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YeS ❑ NO Ifyes, a special event per�nit is required tit�ith Police Department and City Council approval
GO days prior to the event. Shuttle bus service will be required unless applicant denionstrates
su�cient on-site parking is available. Non perrnitted events will not be allowed.
NAME OF OWNER: J a c k� ' /t/�U 15 (-' PHONE: (home) �f 7l-74 Y /
1(work)
MAILING ADDRESS: ��3 •� �j�?1 C��r Pk� CITY: �Q aTG► ZIP: `J � 3 g �
Pella Windows and Doors
CONTRACTOR: 15300-25th Ave. North, Ste. #100 'HONE: �Sa 3�S-�0�I 7
CONTACT PERSON: _ Plymouth, MN 55447 GER: S n�, � ����r J o�u s
MAILING ADDRESS: _ License # 20165884 ZIP:
STATE LICEN�E: # �63-745-1400 �ATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NANIE: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in cletai�: � 1 f`00 L.�! d�0(,v
�'rn(n� m���s in ��rr s-��n� ��� � n�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED D�TACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � � a 5
1 hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATLJRE: � DATE: � � � �
�
31
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Sec.13.Od RIGHTS OF SUBJECTS OP llAT�
Subd. 1. T}pe of data. The rights of individual on whom the data is stored or to be s[ored sha(I be as set forth in this section.
Subd2. Information required to begiven individual. An individual asked to supply pnvate or confidential dataconceming himselfshall be
info�med of. (a)the purpose and intended use ofthe requested data�viU�in the collecting state agency,political subdivisioq or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any kno�vn consequence arising from his supplying or refusing to supply
private or confidential data;and(d)Che identiry of other persons or entities authorized by state or federal law to receive the data. "I�his requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner_of revenue_may�lace the notice required under this subdivision in the individual income tux or nroperty tax refund
instructions instead of on those forms.
Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classi[ied as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shal I be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject ofthe data. The responsible authority
may require the requesting person to pay the actual costs of making certifying and compiling the co�ies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within 6ve days of
die dale of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannotcomply with the request
within that timq he shall so inform die individual,and may have an additional five days within which to comply with the request,exclud�ng Saturdays,
Sundays and legal holida}�s.
Subd.4. Procedure�a�hen data is not accurate or complete. An individual may contest the accuracy or completeness ofpublic or private data
concerning himself. To e�ercise this right,an individual shal I notify in writing the responsible authority describing the nature of the disagreement.The
responsible authority shall�aithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data ro be correct Data in
dispute shall be disclosed only if the individual's statement of disagreement is induded with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADViSORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that}�our request
for a permit or license rrom the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notitied that:
1. The information you f'urnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. Ifyour requested permit or license requires Council action to approve, some information may•become
public.
5. You have certain rights under M.S. 13.04(available upon request)to revie�v private data on yourself.
6. Your full name is required to process this application or permit.
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I understand my rights as stated ove.
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INSPECTION NOTICE SCHEDULED � �
PERMIT NO���—�O��COMPLETED
ADDRESS 3 LC�
OWNER�/��.�/l/G�1'�n�EONTR. Gv
TELEPHONE NO. ! SL �Z� 7Z�� �p/Z-3�0�-27Z�
� DESCRIPTION�����DG�s — ��— /�Sl�
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
,Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ OEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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GW ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED '�1SSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
OwnerlContractor on site:
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Inspector. l' �(�� _J� �
White Copyllnspector's File Canary Copy/Site Notice