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Home My WebLink About2013-00795 - chimney repair ,� � CITY OF ORONO * 2 0 1 3 - PJ 0 7 9 5 * 2750 KELLEY PARKWAY DATE ISSUED: 08/13/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 25 BROWN RD S PIN : 03-117-23-21-0001 LEGAL DESC : UNPLATTED 03 1 17 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CHIMNEY- REPAIR ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 12,090.00 NO"I�I:: REMOVING FLUI�i'I�ILES AND INS"1'ALL[NG STAINLESS STEEL LINER. APPLICANT PERMIT FEE SCHEDULE 236.00 NICK RICHARDSON STATE SURCHARGE(VALUATION) 6.05 4179 149TH AVE NW ANDOVER, MN 55304- TOTAL 242.05 (612)207-8619 PAID WITH CC# 5822 Minnesota State License #: BC183369 OWNER POWERS, SUSAN 25 BROWN RD S LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for��hich this permit is issued shall be performed according to the approved plans and specifications,applicablc City approvals,and the State Building Code. This permit is for only the work described and does not gran[permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this typc 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 Ihe State Building Code.This permit may be revoked at any time for due cause. •��,��/ 1� /�,-ol 3 �� / �� / I Applicant Permitee Signature Date Issu B Si nature Date Y� & SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , City of Orono � Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: � ,�• � 7� PO Box 66 Crystal Bay, MN 55323-0066 Date received: �J� � Street Address: Received by: y�, � 2750 Kelley Parkway Plan review fee: L Orono, MN 55356 ��'�BSHO�� / ��D� 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: Job Site Address: Lt; �j ��-�,,,�, (Z� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No /f yes, a special event permit is required with Po/ice Department and City Counci/approva/60 days prior to the event. Shutt/e bus service wi/l be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �,��, ��,,��..��Y, State License# ��-�� Expiration Date: �� Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (��Z�7--��\� (ottice) �E;�- y z� - ��,�,�� Mailing Address ��(� \�:��, �� ,,�,, City__��1,�, ZIP: ��„� Contact Person: �,� Applicant is: � / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: �, ��,�� 1�� Phone (day): �� {,� .Z� . �� Address: '15 S C��,�.� ' �. City: �� ,.�,� ZIP: S S�'3S � Email and/or Fax: , PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt �'�tepair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding �Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) C=��r�.�� ,� 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 information is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the infor i ,the a licatio not be issued. Applicant's Signature: 6 Date: Owner's Signature: Date: Last Updated: 03/06/2013 5�� D 9T TIME J CITY OF ORONO CALLED IN � ! INSPECTION NOTI E /J SCHEDULED — — lO. OO PERMIT NO.�/�/��DD�`7�COMPLETED ADDRESS aJ� /�C� � OWNER TELEPHONE NO. � 76� y$ Z �205 CONTRACTOR �/Q-C,� ��C�t�(i ��.�1 . — /V[C�- ,�C:�=a�.rn >: DESCRIPTION r �� ❑ FOOTING ❑ PLUMBING FINAL `��LO�N ❑ EX AV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � ❑ LAKESHORE/WETLANDS Q ❑ FRAMING ❑ MECHANICAL FINAL/['`r Gp�i ir-�'❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIF'�EP��, r� R, SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP -��u"� �ROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT Q ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL J ❑ PLU RI S AL ❑ FOUNDATION/REMOVAL � OWNER ONTHACTOR TO MEET YOU:�YES NO � COMMENTS: � W a � J O a � O � W � Q � Z W � W � � d W @J�SRKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� Z49-46QQ OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice