HomeMy WebLinkAbout2013-01167 (windows) � � CITY OF ORONO * z 0 1 3 - 0 1 1 6 7 *
2750 KELLEY PARKWAY DATE ISSUED: 1 U01/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3420 BAYSIDE RD
PIN : OS-117-23-13-0012
LEGAL DESC : AUDITOR'S SUBD. NO.203
: LOT 020 BLOCK 000
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 3,275.00
APPLICANT pERMIT FEE SCHEDULE 103.25
STANDARD WATER CONTROL SYSTEMS INC STATE SURCHARGE(VALUATION) 1.64
5337 LAKELAND AVE N
BROOKLYN CENTER, MN 55429- MA1L-IN FEE 2.00
Minnesota State License#: BC001522 TOTAL 106.89
PAID WITH CC# 2666
OWNER
MILESKI& APRIL NEWTON, BLAIR
3420 BAYSIDE RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work Cor which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State[3uilding 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 afrer 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,slue cause.
/Vl (�.(�Y � � / /
Applicant Pe mitee Signa ure Date Issued y S� ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A UE.
10/30,/2613 11:57 7635371882 STANDARD PAGE 02
City of Orono
Building Permit Application for Maintenance I Replacement / Renavatian
(No structural expansfon. Oniy windows, doars, siding, re-roof, etc.)
���0 Mailrnq Address� Permit number: �{ " D ���
PO Box 88
Crystal Bay, MN 55323-0086 �ate�eceived: ��'3 —
Street Address Recaived by;
� � 275p Kelle Parkwa
�- Y Y Plan reviaw fae:
`�� �u Qrono, MN 55356
�K�SF�°� Totel Fee; �D� g�
Main: 952-249-4600 Fax: 952-249-4618 n .mn.
This application form must be completed in full and all raquired information must be .
Incomplete applicatlons wlll be returned. (Please print) �D�• l'i(�
GENERAL INFORMATI� ' ,�� ,� I � -1
Job 8ite Address: ��� G�
Will this be a parade of Homes, Remod�l Showcase Hvme or other Disptay Home7 Yes Nb
!f ye9,a specia!event permit!s repulrOd wlth PollCe Dep�rtment and City CounC�!approva160 deys prior to the e�Or+t. Shunle bus servlce will be
required unless epp�iCent demonstrates sufflcfent on-site parking;g avaflable. Non-permitted events wi!!nOf be alfowed.
CONTRACTOR/APPLICANT INFORMATIC�N:
Name, �- �. � �UVltv'��
5tate License# C (�jp��� Z Expiration Date: I
�ead Gertificatipn Number: y�q.� -� �C.{3(�� � Expiration Date' S�
(for work on homea that were canatructed prlor to 1978
Phone: (celq (offic�)
Mailing Address: City: ZIP;
Contact Person; Applicant is: Cantractor / Hnmeowner �c�►a•on.�
Email and/or Fax�
PROP�RTY OWNER INF�RMA`�ION:
Name: ���t� 1�'l.�c ��SKl
Phon�(daY) T �c�� �11
Addres5: 1� Vy-�� City: ZIP:
�mail�nd/or Fax'
PROJECT INFORMATION: Overal! ro'ect descri tfon;
1`ype of ProJeCt: Any earth m�vement may alea requlre
Q Door(s) �7 Remodel ❑ Fir�Dama�e M1��Wp revlew�permlta:
�Re�roof, p�phalt ❑ Repair �Storm Damage Mlnnehaha Craek Watershed District(MCWD)
16202 Minnekonka�1vd
�Ra-roaf, cedar ❑ Restoration �Water Damege Deepheven, MN 55391
❑ Re-roof,other(apacliy) ❑Siding ❑4ther: (specify) Phona: 952-471-0590
Fax' 952-471-0882
�Window(s) w. innehahacreek.o
Estimated Constructlon Valuation of ProJect{excludfng land) $ � �.
APPLICANT ACKN�WtEDGEM�NT;
. Agrees to provide all information required pr requested by the 8uilding Departmsnx;
. Certifies that the information suppliad is true and correct to the best of hia/her knowledge. The applicant racAgnizes that they are
solely responsible for submitting a Complete application being aware that upon failure to do so, the staff has no alternetive but to
rej�ct it until it is campl�te;
+ 5ome or af1 af the information that you are asked to provide an this appllcation is elasaified by 8t8t8 Isw es either private or
cunfldentlal. Prlvate data is ir�formation wnich ganerally cannot be given ta the pu�lic but cen bc given to the subject o}the dat�.
Conildentfel data Is information which generally cannot be glven to either the public or the subJect of the data. Our purpose and
intended use of this infnrmaUon is to annually update aur records and records of other gpvernmental agencies required by 1aw. If
ou refusa to su I the informgtion the IiCatlon ma not b�issued.
Applicant's Signature: �ate: /�Q
Owner'a Signature: , Date:
Last Updated�03I0812013
10/3e/2013 11: 57 7635371882 STANDARD PAGE 03
. .. , �
S'��1NpAR�` �11VATL� ���IxRO�, �YSTE��, INC.
5337 Lakeland Avenua North • Crystal, Mlnnesota 55429 � www.standardwater,aom � Fax(763)637-1 ggP
M�NN�AP�Ia �'T',pAUI. 6URN8VILLE 9T.A4auo DULUTH ROCHEBT@R OUTaTATE AE8 Ml]INEB
(763)697�4p (6d1J 7�$$Q1 (9C�2)804-4107 (3fdD)262�D760 (E1B)7T7-149b (SO'�28frB64p
S�fl)�-� (616)�Ea�QaeB
•� Wlndow S ratem 7'o Be lnatalled�a Involrq N ���',�4-( Jdb Slte A�. 7�I L� t`�..`Date ��'' w
Name �` � ` � �+C Nama
Addreap G ?0 a.l� w m Addra�e
c�ry C� �' i�'1�t/, Z�a�.�6 c�y �
P
Homa Phpne( ) Homr Phong( )
Work phone ( �b3) g�-�"� — �j� �'j Wo�k Phone ( )
Sipnd��d Nleter COntrol Sysbm�,Ina.wlll'lumlah all hbor�np mataisl�lar work u�pscllbd.Insulhllon Qwr�nt�rd to p��opfo�fl�d
� �nd cnmpletsd In�wqticnlMnllks irunn�r.:1t fe Hte propsrty q�rr1�C�rsepqnilbllfly to h�v�c�N�61y pnqsMrminwd�nd Inform th�oont►Rctur
wh•n propsny Ile.(.)■re laaetsd,Atry 4oets rylpulHnp fl�oln�ub�aqusnt dl�putee roladep tq wlntlbw wRll�t)�nor4aorimenl nasr or on
ad�ao�nf p►oputle�aro 1h�rppOrlplbtllly of thr,prppprly 0µry�ef,Includf�y but not IImIMd to d�ny oosts rol�tad ta aurv�y�,wrl�no��,
�ubwqu�r►tly medfylnp,nmovinp end q1 nllooa4lnp�ny pert ot or all of wlnqpMr and/or wlqdow Ywll m�arid ana aqn�iruCdan eo�b.
!n th�wanl unMresea6l�oortdltlon�niqqfr�eraw ta woNc�t job�la I�br th�n�ntldp�ted,awnvr rt►ust ellaw work araw to conNnu�
Workfnp with no Int�rruptlpnr unGl��4b I�flnl�fNd,un111#0 oih�Pwf�s tpsollbd.
Atry�uD�equent amla�wlb to ndd�M for wark ar Inwpaatlan wlll bu don�tlurfnq norm�l bu�In�a�hoyP�,M�F,A�ni tp 3pm,
Own�r Ir n�poo�IDle ror In�tallallon of�molu�tor It nquln0.
SPECII�ICATIpNB-qlppRAM QF AREA T0,B�BLRVICED
.-.,,r . .
Fal�atlon Daoalptlon qnd Thlckne�,0laak pirtfenolon�and Fxhtlnp
• Windowf•1 oppm��s�y RaFER To�rt�oM�q woRK&M��t'te)
He�dN�s}R�qulrotl 1 � r �
1� � � IN1'�RIOR Ftn�ehl�Q MetM� f J� �
{/�, a� INT�fildFl Obalniatlane
�r"� � � BXTkPIIOR Flnl�Mnp M�b►lal ��
� �CI�f11CR ObNruallonR
�XTEp10R 4nlda�nd landscapl/np�Oaecrlpdon ,,,,��'�P /Q A,A.did
� Bo111yp�IContlMan� _f��
Tb bo InatAUod andib►pPho�ed:P�AM� WE INClUD�O
C Cl OLABS BLOCK WINDOW(8)( )P�tym
�` ❑1MIh Vvmr( )WItM7ut WnSa( �
' ��j��d R G �l�+ �EpR�68 WINDOW(e)(�_}
FRONT �Manufaquror anmar lyp��✓e�„ �t� _
�1 Modsl and Slzo �r�� ��Y ?r�,. /
PAYMENT T�RMS �-EaRe$a wir�oow weu.ls)c�.,..)
The Owne� �Apraeo o pey Cont�ctar m sum eia lo�iowe �.Menufaaluror�ntl/or'fyQe���pr,h�r�r�� ��-��
A.Pr�e 1��1 L9lL� � i ai7 �y.Motlrl�nd 8ix� `
B,Other \1 (�U"+' ;� � �w�ntlow W+11 Gr�ln�p�By�t.m
C.Ot11BY � r d � ���u Md Rommn DM ltld OIh1f PIN�ItOtl Deba1�
� + � ��xpe�ipr Trim Around Wlndow ���("�
W.Prinalpa,l BalanCe $� � ��� �
$ � -� .,
E.Down Psyment W��(' � 1[16�C �:..�' "'� r
F. Unpald Balance 5 �� __
�Carh upon oompleilon
❑Ta Be Finqnoed.
p Vls� - MesteroaM - 4lwover Cerd
Not�:AII flnanoinp muet be approveQ 7 days or more prior to Inetdllstlon dllte.
BUY�RS Rl(iHT TO CANG�L. if th1N eqrsement wes sallalt�d ei your rnoltlenca end yau do not went ths qaoda�nd wrvles�,
you m�y cano�l thls edreement by m�►Illnp�notlo�io tho�eller. Ths notle�may�ay ihat yau da not vrrM ihe poad�or
wrvicee end mwt ps m�llsd b.ton mltlnlaht oi the thlyd bu•Ins■i dey after you slpn Ihls�pnement. Th•notior mu�t bs
mailed M:Standxrtl Wrtar Control By�tem�,lna.,6987 Lakoland Avenus North,Cryrtal,Mlnneaat�d0428.
ACG�P'rANCL�OF PROP08A�
I hRVp o4refu��y read both the front end tFto baak of�hla Apreemenf wnci tho 4VInd6W Inatalletion WOYkBhAAte end aN nf the pdCes�
apaciFlCatlon8 antl ConditlOne,The terme on boih e1d98 Of thla Agreemant and the Wlndow In�taHatfon WOrkeh9ate are B4tieftatOry
' and are heraby accepted.Ally devlAtlqn from the drewlnq andlo�Spectn�atlans abov9 wlll reeult fn an exlra charpe.Yau 4re eutha�lx9tl
to da ihe work ao epeClfled.I Apr!!e to meke payment aa oudlned abqve.
Dete � ,,,�1��Owner OAte_.__. -
Balee Ra Owner .,.,,,,. , �a�� ,._ ---
' R�v.08l10 MMINEBQTA BUILDINO CONTRACTOR UGEN86 NO.1K¢4 •Copyrlpht 1G77•�OtQ SWGBM�,Ina,
I , ,,,,,.. . „ , . . ,_ . . , ., ., . . .. . .. ... .. . .. .. . „
, 10/3�/2013 11:57 7635371882 STANDARD PAGE 04
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STANDARD WA'�,�R, f�ONTROL SY�'1"'�MS, INC.
5337 Lekeland Avenue North, CryStfll, MlrtrteSptfl 85429 800�978-7867 763-537-4849 www.alandardwot�r,r�m
GLASS B�QCK OR�GR�SS WINDUW INSTAL.LATIQN W�RKSM�ET
Customer Namc��Q ► � � I ` � 5 � I 7ob Site Number � Datc d j�
�G�--� �—�-�•�1_
;
Job Address � `� �'_�City�rC� z�P����„��
nror�oa�no�
E1IIa�IN9 OP�MIN9 �� �� �
�1 ( If Present )
� � �i d`
9B p�
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Glase Bla�k Window(s) ____ �f ____
Pattern,�.�„_,__,��__---- ��. _�^---
Egress Window(s) _�__ Qf ____
Manutacturer_1��G_�-a"_�'�Lti�_��.1_
MOd91#---���_-----__...__.�.�_—
Window Well(s) _�_ of .�.�__ �"f r� r
Type & slze__�'����.�.��-------- �!
Exlsting window openina? Yes�No__
Header Requ(red7 Yes� No__
Load Be�ring WaU? Yas,,�No__
Foundation Qasaription _„��Q�,i� ___
. �lack Dlm, H_�J_W--��'— p--��
Inst�N Window WQII �raln? Yes„�Np__
Draintilv Avail�ble 1or praln? Yea,� No__
�
F�oan
rvot�s: ____---__�__�._____
----------------�_�.__.�_____�,�_--------�..�_____�.—____.�--_------
_��..�.��..�----,��.��___�----------.�._...____�--�—�----------_�--___—=— ---� .^------�-�--
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Homeowners signature_��_r_---__.�.��._-----___�..�_Sales Rep signatur�m.,.._ ���:��.,
a�canyr��n�w��•zoodswcsMainc.
, . . .. . . _._ , . . ,�. . . • .:, ,. . . • , , ..., „ , , .. ,., , , .. .. . ,., ,
10/3�/2013 11:57 7635371882 STANDARD PAGE 05
hnNHR$�QTq06Md741[►17Q� 1'1��'D�����'1�� �R�Rr��i �'ON��H�I�O�
� I�►9C7R & INC)USTFtY
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Construerinn Cadea and I.Icsn�inp�Wlafon I ir:analnp end Cerlificatlnn SoIViCBs 443 l.efflyslte I�oad N��.P�p�q.MN 651 S5
Weba}te: �ywsn!,dp.mn.novA�sldasn Fmsil: qll.Uconse�sla�emnus Phone� 85�.2yt.Sp3q
'fhis is�o ccrliry thut thp Ccrti�calC hdldrr is licc�nsrcl av a R FCIbf;NT1AL N[)#t,p11VG C.'QN'�'ttACT(1Ct;u tfyc Riale��(A1inncsota aud is in
co�npliancc wiih Uumnso�n 5�nn��cA'#2nH,RQS,nnd ritn�'�1ltlIQ PCSlf�C111IF1I I'GA�G5IB�C�cuntrttct or ufY'cr to contrltt�vi�h��i v�vncr to build
rccidcn{inl real cslate,�nd cou�rnct or offcr ta eo»�rnc�with an owner to ii7iprpvc rxisting resi<Iciitial r¢ul¢sta�e:pruvide�i th�
resppnsible iiidividu�l i�nt ell�imcs n QII�LIFYINCi f31.�II,�C1t nnd�3ic cerulicnte bolder m�i�ilatns complianco�vith{he requirCd�cneral
linbiltty insuranco,7nd wpi'kert'contpcnsaiion lowa.
l�l�enae : R��fDENTEAI�LDG CONT'HAC70R
Uc Number : BG0a1522 STANDARD WMTER CQNTRO�SYSTEMS INC i
EfloCtlV6 Dat• : q4/01/2q12 5337 �AK�LAND AVE N �
�xplreifon bate : p3/3�/2A1a gROOKLYIV C�NTER.MN 55A29 c
r
VERIFY UP•TO-pA'TE STATUS,BUND,AND INSt1FiANCE INFO AT www.dlLmn,aovlCCld/l.icV�rifv.aso (ENTER NUMB�q�,
I�WA� CONTRACTOR REGISTRATION CER�'I�tGA�'L
��������l.r StATE bF{t71NA AAT� f�SUELI: 10/1A/�411
�l��M��1 10WA WORKFORC� D�VEtOFMENT DAT�EXPIR��: iQ114/�p12
bIVISION QF LABOR SERVIC�S
.;Pr,r CbN7`RACTOF7 f2�GISTRATION R�C�IaTl3ATICIN NWMB�R: C1Q61�y
1 AQQ �ast(3rand Ave.
Des IUloineffi, IA 5Qa19,02Q9
PhOne(515)242 mm 5871
�,�,,,r�,,,..�.�. � ���'
S7ANC7/�RD WATER C(7NTFtOL
SY&T�MS INC Miahael A_ M�uro, �ammia�foner
633� LAKELAMD AV� N
CRYSTAL, MW 66428
Your certiflcale will be e�lorced for 1 year H yoU sre In complfence wllh ConlreGtor reglstra�lon,unemployment in5ursnCe,and workers compenmallon regul�tlons,
1=al�i(yfng any rocords may r�sult In rovocatfon ui your cerlitl�al�,$5qQ civil penalty,and aimineE proaecution.
1D: ID:
83rag5 ea�a99
STANDARD WATE GO LS SYS'f�MS INC MIKE NpGENSON
Cert111catloo.I.Ic se,oY Replttr�tian No e 8xplres Cert1(tatlon,Lic �e,or RepErtritlon N� e E�plrea
pwalling Cornrac Canlflaatlon OSi/22/1 Z pwalling Contract Queli(ier Certific�N 10�06l13
Wiscansin Dep��4ment of Camm�rae Wisconsin C��partment af Commerpe
St�n�turo:
SlpuMture;
. 10/36/2013 11:57 7635371882 STANDARD PAGE 06
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ACQRD 28(Y070I06) Th.ACORQ nRme�nd logo ero repi��m■rka ot ACORD
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.� "�<<�' � COMPLETED /�,�/`�/r!r
ADDRESS �>��w����� � �•
OWNER TELEPHONE NO.
CONTRACTOR �-�`�� � � - ��"
� DESCRIPTION �k���c=J �1
tU ❑ FOOTtNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORENVETLANDS
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O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q RADON SLAB ❑ WATER HOOK-UP ❑ PROGHESS
��� ❑ SEWER HOOK-UP ❑ COMPLAINT
J O DEMO-SITE O SEPTIC MAINT. �FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnedContractor on site:
Inspector. w—
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