HomeMy WebLinkAbout2013-00205 - windows � CITY OF ORONO * Z B 1 3 - B 0 2 0 5 *
• 2750 KELLEY PARKWAY DATE ISSUED: 04/02/2013
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 25 BROWN RD S
PIN : 03-117-23-21-0001
LEGAL DESC : LTNPLATTED 03 1 17 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 14,929.00
NOTE: 2 WINDOW REPLACEMEN'I'S IN EXIS'I'[NG OPENINGS
APPLICANT pERMIT FEE SCHEDULE 265.50
PELLA NORTHLAND STATE SURCHARGE(VALUATION) 7.46
15300 25TH AVE N. -SUITE# 100
PLYMOUTH, MN 55447 MAIL-IN FEE 2.00
(952)345-6047 TOTAL 274.96
Minnesota State License#: BC645090
OWNER
POWERS, SUSAN
25 BROWN RD S
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 permi[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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with�he State E3uilding Code.This permit may be
revoked at any time for due cause.
�ytitk�(,t�, (/� i i i i
Applicant Permitee Signature Date Issued By Sig ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
1 ,
� � City of Orono
Building Permit Application for internal Work
(windows, doors, siding, re-roof, etc.)
- - Mailing Address: Permit number:
.c�,0 1�� . PO Box 66
�
�;��' V��� Crystal Bay, MN 55323-0066 Date received:
� ��R�,.S� �; ,,�� StreetAddress: Receivedby:
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��,� ,�,�p+� ������� �ti��' 2750 Kelley Parkway Plan reviewfee:
`�l l�,i;�1 rv >% 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. (Please print)
GENERAL INFORMATION:� S � Q�'p(,J/1 I�Oa Q�
Job Site Address: �E./
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes,a specia/event permit is required with Police Deparfinent 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:
Name: 9S� $Y S •4 o y 7
State License # Pella Northland o ��
Phone: 15300 25th Ave N. Ste 100 (cell)
Mailing Address: PlymOuth, MN 55447 ZIP:
Contact Person: Lic# BC645090 Ph. 763/745-1400 �omeowner cc���ie o�e>
Email and/or Fax:
PROPERTY OWNER j�OR�IIATIOfI: � �/O
Name: / '1/ �/14'[. � TT
Phone (day): � •�3 ' y ,,/ /'O /� 0
Address: � 'S' $. f`b bJ!I l� Q V City: � ZIP: SS3 S L
Email and/or Fax
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PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review & permits
❑ Coor(s) ❑ P.2model ❑ Water Damage
Minnehaha Creek Watershed District(MCWD)
Window(s) Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage www.minnehaliacreek.or
Overall Project Description: ��,,��n (�(d�,y �o p 4 u Msn S //� Q k� S /n 9' O�t� �� ¢ s
Estimated Construction Valuation of Project (excluding land) $ �Yy q'2 9'
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
re uired b law. If ou refuse to suppl the information, the application ma not be issued.
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ApplicanYs Signature: �' S � Date: ��� 8 ! �3
�
Last Updated: 05-04-2009
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.�'3'u�.�o.� COMPLETED /� - �%-/
aG�r-cr�:�6 'l .�'� S
ADDRESS �� a�-�.��
OWNER TELEPHONE NO.
CONTRACTOR ����� ��'rz5�'lQ"�
�: DESCRIPTION ��� �>� ����
�
4� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORE/WETLANDS
�
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
Z"g"G�._ ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. OLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTFiACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED �ROJECT COMPLEfE
W ❑CORRECT WORK 6 PROCEED ❑ 1 SUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
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
OwnerlContra tor on site:
Inspector. ��
White Copyllnspector's File Canary CopylSite Notice