HomeMy WebLinkAbout2015-00445 - doors CITY OF ORONO * Z 0 1 5 - 0 0 4�
2750 KELLEY PARKWAY DATE ISSUED: 04/17/2015
ORONO, MN 55356-
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(952) 249-4600 FAX: (952) 249-4616
ARGRESS : 925 BROWN RD N
pIN : 27-118-23-34-0001
LEGAL DES� : iJNPLATTED 27 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 1,000.00
NOTE: INSTALL 9'W X 8'H GARAGE DOOR ON A DETACHED GARAGE(NEW DOOR)
ON DETACHED ACCESSORY STRUCTURE
APPLICANT PERMIT FEE SCHEDULE 43.30
STATE SURCHARGE(VALUATION) 0.50
REITAN,GREG TOTAL 43.80
925 BROWN RD N Payment(s)
LONG LAKE, MN 55356- CREDIT CARD 8474 43.80
OWNER
REITAN,GREG
925 BROWN RD N
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for onty the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming 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 I80 days at any time afrer work has commenced.
The applicant is responsible for assuring a11 required inspections are
reques d in conformance with the State Building Code.This permit may be
revo at any time for due cause.
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Ap li nt ermitee Signature Date Issued By Si nature Date
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
/�O� Mailing Address: Permit number:
O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
� � Street Address: Received by:
ti G� 2750 Kelley Parkway Plan review fee:
F Orono, MN 55356
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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: � /, �
Job Site Address: �� � �-'C'�Rn ��cx�� /V .
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 approva160 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 I APPLICANT INFORMATION:
Name: �!�-t'�l �c�' �� T�-�*'C�-
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) .; — 5�' �� ., (office)
Mailing Address: �' City: ZIP: S � -
Contact Person: Applicant is: Contractor / omeowner sc���ie o�e�
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: ��y� �_
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description� c✓ $�f� �«. �c - �a�l�l�zr���
Type of Project: Any earth movement ay also require
�oor(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
❑ 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(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project (excluding land) $
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 infor tion is to annually updat our records and records of other governmental agencies required by law. If
ou refuse to su I the ' ormation, he a licati ma not be issued.
Applicant's Signature: � � ✓ Date: ��
Owner's Signature: Date:
Last Updated:January 2015