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Home My WebLink About2015-00425 - windows ,, � CITY OF ORONO * 2 0 1 5 - 0 0 4 2 5 * 2750 KELLEY PARKWAY DATE ISSUED: 04/14/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 744 BROWN RD N PIN : 34-118-23-12-0005 LEGAL DESC : REG. LAND SURVEY NO. 1275 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-LINDEFINED VALUATION : $ 6,900.00 NOTE: REPLACE(2)WINDOWS INTO EXISTING OPENINGS. APPLICANT PERMIT FEE SCHEDULE 154.89 STATE SURCHARGE(VALUATION) 3.45 HAMEL BUILDING CENTER 18710 HIGHWAY 55 TOTAL 158.34 PLYMOUTH, MN 55446- Payment(s) (763)478-6601 CHECK 41 S 18 158.34 Minnesota State License#: BUIL-20631040 OWNER ML STEIL,TM SCHULTZE/ 744 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 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 rype 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 a[any time for due cause. ,� f��1�.s" ,� i l.S Applicant Permi ee Signature Date Issued Signature Date . . City of Orono Building Permit Application for Maintenance / Replacement I Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �- �:�A\\ MailiPO Bo�r66� Permit number: �S ^ � O�V� \ 1 Crystal Bay, MN 55323-0066 Date received: �l —� �j ( � � Street Address: Received by: 1 i�F ,�i 2750 Kelley Parkway Plan review fee: `��C.S H��% Orono, MN 55356 �� Total Fee: l�� J Main: 952-249-4600 Fax: 952-249-4616 ti+,�srai.c:.o!ono r�r:_�,c � / This application form must be completed in full and all required information must be submitted. Incomplete applications will be retumed. (Please print) GENERAL INFORMATION: Job Site Address: 7 �1 /��'«^� ��, � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes No ff yes,a specia/event permit is required with Police Qepartment and City Counci!approvaf 60 days pnor to the event. Shuttle bus service wil!be required unless applicant demonstrates sufBcierrf on-site parking is available. Non-permitted events will not be a!/owed. CONTRACTOR/APPLICANT INFORMATION: Name: ��rrr�"< ,6vic-/'i-�-�< G`,'"��`�- State License# ��'�3�i�/p Expiration Date: a3 �� a",•� Lead Certification Number: y�,�� ,��v7U —/ Expiration Date: p-� � �� — (for work on homes fhat were constructed prior to 1978 Phone: (cell) �6i�) C�� -- �So G (office) �7�s� %-��"—��-c � Mailing Address: /�%��v ��.,� s-s- City: �y,,,,�,,�,.� ziP: �-�-yyG Contact Person: ,�f�.�'- /3, �;<<f„y��,�,,, Applicant is: ontrac o / Homeowner (Cirole One) Emailand/orFax: ,«�<<:��„f�i✓ ,� �i�rr.-.-,rz./3.-.<�,-- C�'et---%T'rL. . �c�--�_ PROPERTY OWNER INFORMATION: Name: �f� _�d�.�y .S��r��.jz c< Phone(day): ��'s'1� �/y9 —c3s�G Address: -7 yy ��,�� ,,� c��: �ze �r��=�� ZIP: s'�`3 f� Email and/or Fax: PROJECT INFORMATION: Overall ro�ect description: Type of Project: Any earth movement may also require ❑Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�pennits: ❑Re-roof,asphalt ❑ Repair ❑Storm Damage ��nnehaha 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 indow(s} �nn,vv�r.�;�innenahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 6�va 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 hislher 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 agenaes required by law. If ou refuse to su 1 the information,the a lication ma not be issued. ApplicanYs Signature: .� /S��.,��..��---- Date: fy �� , --� Owner's Signature: Date: Last Updated:03/06/2013 �°" `} _ �.�, r`"" ;� i3 a� t � '.f' =�� ,�� `�9� �, � ,. " il �, _,:. -- _i __,_. , ^. _ ,,, � . ,. __—_-------" ,�- . . - .: _ _ ,� � � � / � � � �f A^ � :. � . .:: �� . . � � . ,. , ...._....� . �--�:..� . . .., .� , ..:'S �"' � < /L�! ".♦, -_ __"� � ��f ,. , �� a� '� ,�r � --T� ��i,c�w i r i i u,��I�4.� a J I + _�J�q t '�s�u � � ' = � ' I. I I� u��+��I�ll�ll I��I II � � � � � � � �� i i ��' � �' s � s i "s�'F � ��t �� -. - �� ,;, o �. � � ' z� ,�. ._ Ilj �°#� � � .;} . :�;� .. . ,,�.> ,. �_r, - . .:, . � - . .. .�,�, .. ,. . : � . _ __ - . ., "'-' ... �" '. , . ;F..'.._ .y. ...,...--',' _: . .. . .. . _ , -.-.., ; . .. ... . ...�� . '. ;f.... . .. - . 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