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Home My WebLink About2009-00844 (windows) 1 � CITY OF ORONO PERMIT NO.: 2009-00844 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssUEn: 1 U23/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3245 CARMAN RD PIN : 20-117-23-14-0010 LEGAL DESC : CARMAN COVE : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-LINDEFINED VALUATION : $ 200.00 NOTE: CHANGE OUT EXISTING BATHROOM WINDOW APPLICANT PERMIT FEE SCHEDULE 25.00 LAKE COUNTRY BUILDERS, LTD 339 2ND STREET STATE SURCHARGE(VALUATION) 0.50 EXCELSIOR, MN 55331 TOTAL 25.50 (952)474-7121 Minnesota State License#: 20349679 OWNER NIELSEN, JON& KIRSTEN 3245 CARMAN RD EXCELSIOR, MN 55331- 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 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 180 days at any time after 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 rexeked-at any time fo du�caySe. C . �� i / �-, ��'. � Ll��l, �-___--- �l�� ' `� i i �=��plicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1 � City of Orono Building Permit Application for Internal Work � (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: —dQ g,0,�\�� PO Box 66 , � , o\` Crystal Bay, MN 55323-0066 Date received: �I L�� , I I a � ��'�,'� �,�� Streef Address: Received by: �� '�n '� �'� G� 2750 Kelley Parkway Plan review fee: ��kESH��'� Orono, MN 55356 _ — Total Fee: p�� , � 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: � ��/ S ( ;�: ��ti� Ct \ -�ti 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 i!1 be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will nof be allowed. CONTRACTOR/ ,PLICANT INFORMATION: Name: �c:� ��:��f�'� �1.� ;�c��i� c� i'1 State License# Expiration Date: Phone: ��I� _ 4'�:��.. (��( l (office) �� `_�.� . '� `l�/`f�- ` I� I �'" =�t��J (cell) Mailing Address ��' �� S- � � Ci, : .f �, � .- ZIP: ;�� ;" Contact Person: =j��,n.� �� ,1�„v��,,-� Applicant is: Contractor, / Homeowner (Circle One) Emailand/orFax: <;c,;., , , y c - ��' r,� � co� n �,' ,. � �f��.� � PROPERTY OWNE INFORMATION: �� r Name: �� .,� � �l'��-c� !v � ��✓� Phone (day): `� �� t - -^� z( Address: 3 � �( 5 C� c.-��v,��. � Y �� .. d City: �U{L'c:tit�] ZIP: S 5 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(� ❑ 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.minnehahacreek.orq Overall Project Description: (:,l ?�� L t � `'�,:,� � �r"S�j lil-� ��1��t,1-� ��` �< <1 c� i,' Estimated Construction Valuation of oject(excluding land)�.� C�C; 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 su I t information,the a lication ma not be issued. i � r' � / ` �r ` Applicant's Signature: «r� L l22 � Date: !�� Last Updated: 05-04-2009 � DAT TIME v CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED �� PERMIT NO.��Q'�o8�� COMPLETED ADDRESS 32TS CLu-F'Y�C�,. IZ� OWNER CONTR. �fCI�l.d TELEPHON E NO. ��2- COS S ��Z-- � DESCRIPTION �L��. � ❑ FOOTING ❑ MEC ANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINA� ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � j d /� �. � ❑WORKSATISFACTORY:PROCEED L� �CPROJECTCOMPLETE v W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT 0 CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��CITATION ISSUED ❑ INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on ite: inspector. � White Copyllnspector's File Canary CopylSite Notice