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Home My WebLink About2010-00370 - windows � CITY OF ORONO PERMIT NO.: 2010-00370 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 05/20/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2967 CASCO POINT RD PIN : 20-117-23-31-0064 LEGAL DESC : REG. LAND SURVEY NO. 1470 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 12,000.00 NOTE: RGPLACE DOOR/WINDOW UNIT AND SIDING ON 3RD FLOOR GABLE END OF EXISTING fIOUSE. APPLICANT PERM[T FEE SCHEDULE 221.25 ROZEBOOM, MR. & MRS. STATE SURCHARGE(VALUATION) 6.00 2967 CASCO PT RD TOTAL 227.25 WAYZATA, MN 55391- PAID WITH CC# 4649 OWNER ROZEBOOM, MR. & MRS. 2967 CASCO PT RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be performed according to the approved plans and specitications,applicable City approvals,and the State[3uilding Code. This permit is for only the work described and does no[grant permission for additional or related work which requires separate permits. All provisions oY laws and ordinances governing this type of work shall be compied with whether or not specified 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 for a period of 180 days at any time after work has commenced. The applicant is responsibl Yor assuring all required inspections are requested in con rmance ith the State Building Code.This permit may be revoked a a�• e or d cause. c�'l 2� l � �i a�� ,/(� Applicant Permitee ignature Date Iss y Signature Date SEPARATE PERMITS REQU[RED 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: OQ �—l/v �v 0,� PO Box 66 , Q � O Crystal Bay, MN 55323-0066 Date received: �p�Q � y��;`�. . �I �m=4;;;�. �, Street Address: Received by: ,, � � � �ti 2750 Kelley Parkway Plan review f e: � ° . t`�kEsxo4`'� Orono, MN 55356 � Total Fee: � " � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us p�a 7•0�5 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: � ' 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 �equired unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: - Name: State License# Expiration Date: Phone: (office) (cell) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER IN�2NjQT��N�.�� Name: '� � Phone (day): Address: p Cit : ZIP: �S Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require � ( ) 0 Remodel MCWD review&permits Door s ❑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 �Re-roof Fax: 952-471-0682 ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: s '�r � Estimated Construction Valuati n of Project(excluding land) $ Qp � , � 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 the information, the a lication ma not be issued. �� ApplicanYs Signature: Date: �'J � �p Last Updated: 05-04-2009