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Home My WebLink About2010-00943 - windows CITY OF ORONO PERMIT NO.: 2010-00943 ., ' 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 10/04/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1 165 BROWN RD S PIN : 10-117-23-24-0020 LEGAL DESC : UNPLATTED ]0 1 17 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 8,000.00 NOTF.: REPLACE WINDOWS AND DOOR INTO EXISTING OPF.,NINGS \ APPLICANT PERMIT FEE SCHEDULE 162.25 NIELSEN, ERIC P.O. BOX 54 STATE SURCHARGE(VALUATION) 5.00 CRYSTAL BAY, MN 5532r TOTAL 16725 PAID WITH CC# 2237 OWNER NIELSEN, ERIC P.O. BOX 54 CRYSTAL BAY, MN 5532:r 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 E3uilding Code. This permit is(or 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 specitied herein.This permi[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 � e � f 180 days at any time after work has commenced. The ap cant i esp nsible for assuring all required inspections are reque ted i nf ance with the State Building Code.This permit may be revo a y ' e for due cause. /� / � / / v /� � � Applicant Permitee Signature Date issu I3y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono `� '� � � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: o��/�— �0,�. PO Box 66 � �� Crystal Bay, MN 55323-0066 Date received: ��''� Received by: (,� ��:��,+' � Street Address: �,�, � °>� �ti 2750 Kelley Parkway Plan review fee: ��kESHOg'� Orono, MN 55356 Total Fee: �(��. a5 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: ' �J� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ill be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT I ORMATION: Name: ��L ( �(.5�� State License# Expiration Date: Phone: (office) (cell) Mailing Address: Cit : Contact Person: Applicant is: Contractor OIYI@OWtlef �Circle One) Email and/or Fax: t ��l,` �j �j��cL—�� 0�1�.(a4� (.� - �-01� PROPERTY OWNER INFORMATION: Name: �(Z-1�— � I �L`� ��'-� Phone (day): �, I2 • 7`�d • -�S��S L" f Address: _�k r,'�- City:C�`�.5` � �i�yZIP: S53Z� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits �Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ��Window(s) �tepair ❑ 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.minnehahacreek.orq Overall Project Description: ��(,�� pp �� p�D w;�DpvJ y � �ocN�-. Estimated Construction Valuation of Project(excl d niu g 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 informati nerally cannot be given to the public but can be given to the subject of the data. Confidential data is info io wh�ch g erally cannot be given to either the public or the subject of the data. Our purpose and intended use this ' forma�on i to annually update our records and records of other governmental agencies re uired b law. If ou ref se to u I t in rmation,the a lication ma not be issued. ApplicanYs Signature: Date: < � - � - `� Last Updated: 05-04-2009 �-- ✓ � ATE TIME CITY F ORONO �LLED IN l� �� INSPECTION NOTICE �CHEDULED � ��.�� PERMIT NO. / - �9� COMPLETED ADDRESS � � OWNER _ � e' T LEPHONE NO CONTRACTOR (l/` ��✓�� : DESCRIPTION � � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � w a � � O � � O � W � Q � Z W � W � � d W� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ RRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner/Contractor on site: Inspector. ��,�/ � �, �J� White Copyllnspector's File Canary CopylSite Notice