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Home My WebLink About2011-01273 - windows CITY OF ORONO PERMIT NO.: 2011-01273 .. 2750 KELLEY PARKWAY � ORONO, MN 55356- oATE IssuEn: 10/19/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 825 BROWN RD S PIN : 10-117-23-21-0008 LEGAL DESC : CARRIAGE HILL : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : WINDOWS VALUATION : $ 31,267.54 APPLICANT PERMIT FEE SCHEDULE 488.25 C3 CONSTRUCTION SERVICES, LLC STATE SURCHARGE(VALUATION) 15.63 5227 OAKLAWN AVE EDINA, MN 55424 M[SC FEE 0.00 (952)927-4800 MAIL-IN FEE 0.00 Minnesota State License#: BC295942 TOTAL 503.88 PAID WITH CC# 9560 OWNER PARADISE, MARTIN&BRIDGETT 825 BROWN RD S LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The tiork 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 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 period of 180 days at any time after work has commenced. The a li�ant i responsible for assuring all required inspections are r uested'n n ormance wi[h the State Building Code.This permit may be voked a any i e for due cause. � LO i l i 1l �./1'l�� l l� l Appli ntPen ee Signature Date Issue By Signature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ' City of Orono Building Permit Application for New Structures or Additions ��_-- Mailing Address: jg,0,�� PO Box 66 Permit number: �O :\ O\`�, Crystal Bay, MN 55323-0066 Date received: � �� Received b a A j ,�' Street Address: y �� r -,:. � .�, �� ti�'� 2750 Kelley Parkway Plan review fee: ��kESH�g/ Orono, MN 55356 - - 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: Qrj � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No lf yes, a special event permit is required with Police Department 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: C� C�I4 T2U�T�' ON- — Ll_L State License# �_��L�Z Expiration Date: 1 Phone: q'Sz-�J'�-�yp,p(� (office) 6�z_�p3-yqyq (celq Mailing Address: SZ2, p City: — 1�{� ZI : S Z, Contact Person: p Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: pC�� C,�,��L . Cpvv� PROPERTY OWNER INFORMATION: Name: �"�l Cl-�AEL � 1�,0.i 121 LI�'1 -t-�2-N��N'(�C;Z Phone (day): 6lU- 2�J�3Q3f3(o Address: z S Cit : pp,� ZIP: Email and/or Fax MPL..w��a2ivnrv fJ�Z Ac��... • co►� ARCHITECT/ENGINEER INFORMATION: Name: (� ,(� Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction �Single Family with �Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer �Other: (specify) WIN vW ❑ Multiple Family/Condo ❑Warehouse M�— ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.m i n nehahacreek.or Estimated Construction Valuation (excluding land) $ 26 , Last Updated: 4/26/2011 � - 19- �,� ` STRUCTURE INFORMATION: � 1. Structure Dimensions 1. Structure Dimen ions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15�Story = ❑ Other(please specify): e. 2"d Story= f. 'h Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ ❑ Permit A lication ❑ � Pro osed Buildin Plans ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ '� Surve meetin all re uirements ❑ 1� Stormwater Pollution Prevention Plan ❑ Hardcover Calculation s ❑ Se tic S stem Site Evaluation Re ort ❑ �, Access Permit ❑ � Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other APPLICANT ACKNOWLEDGEMENT: Agrees to provide all information required or requested by the Building Department; Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; 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; Acknowledges the Escrow Agreement is completed and signed; Understands 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 annuaily update our records and records of other governmental agencies required by law. If you refuse to supply the information, the application may not be issued. Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: � Date: 0 � Last Updated: 4/26/2011 -20-