HomeMy WebLinkAbout2010-01130 - windows CITY OF ORONO PERMIT NO.: 2oio-oii3o
� 2750 KELLEY PARKWAY
� ORONO, MN 55356- �ATE [SSUEn: 1U22/2010
, 952 249-4600 FAX: 952 249-4616
� ADDRESS : 117 CHEVY CHASE DR
P[N : 36-118-23-41-0014
LEGAL DESC : HILL O'WAY MANOR
: LOT 009 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILD[NG -UNDEFINED
VALUATION : $ 10,746.00
NO'l�E: REPLACE(6)WINDOWS INTO EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 206.50
PELLA WINDOWS& DOORS STATE SURCHARGE(VALUATION) 5.37
15300 25TH AVE N. - SUITE# 100
PLYMOUTH, MN 55447 TOTAL 211.87
(952)345-6047
Minnesota State License#: 20165884
OWNER
ARTHUR, ALAN &CAROL
1 17 CHEVY CHASE DR
WAYZATA, MN 55391-
AGREEMEI�T AND SWORN STATEMENT
I'he work for�chich this permit is issucd shall be performed according[o
the approved plans and specifications,applicable City approvals,and the
S[ate Building 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 of laws and ordinances governing this type of wark
shall be compied�vith whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
conunenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at airy time after work has commenced.
The applicant is responsible for assuring all required inspections are
� requested in confonnance with the State Quilding Code.This permit may be
revoked at any time for due causa.
� �1,�tA.LQ '�, i i i i
Applicant Permi�ee Signature Date Issued y Si ture te
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCR[BED ABO
Nov-17-ZO10 02:42am From-CITY OF ORONO +9522494616 T-638 P.002/002 F-076
Clty of Orono - .
Building Perm�t Application for Infiernal Work
(windows, doors� sidi�g, re..roof, etc_)
MsllingAddress' Permitnumber. �/D-D//„3 ,
O.�0�� PO Box 66 �
crystat 8ay, MN 56a2s.0066 bate received: / d
,a SIlB6f Add/�ess' Received by:
� 275�Kelley Perkway � Pian revi�w fee:
�� og�� . Orono,MN 55356 �
ToTdl Fe9: a fl, � �
Main� 952-2�9-a600 Fax: 962-249�6�6 wvuw.si�4,mn.us . .
Thls applfca�on forrn musT be compl�ted in full and ell r�qulrcd infnrmation must bs submlttod.�_. . _ .�
, • � Incomplete appllcations wil!be returned. (P/ease prin!) , ,
GEN�RAL INFORMATION: ' /'� _ � , .
..:�' �
^`�ta.b-�e�ress�. ,.. _., l��— -�1�-y�-----�- �1�*--. .
Will this b�a Parade of Homes, Remodelers 5ho�vcase Mome or other Display Home, Yss���. �� 0�No
� 1f yes,a speaia!avsnt psimlf Js requ�red wlth Polica oepertment and Clty Councll approvel 60 days prJor tc the evant. Shuftle bus sarvica wld ba
reqvlrod�nloss appli�cant damonstrafas su{ficJe�!on�slfe pbrkinA is avalleble. Non•ae�mrrrea evenfa v�nU nar 6a a�rowed.
GONTRACTOR!APP4.ICANT INFORMATION: � •
Name, � , Jo-d� � F/el*f Jnn�s
State�icense# Pella Windows &Doors R,�� k - a��'7
Phone: 15300 25th Ave N. Ste I 00 _. � (aell)
Mailing Address: , plymout�Z,N�N 554q�7 Z�P_
Contact Person; I.ic#2016588�1 Ph. 763/745�1400 � �°'necwner �c���ona►
�mail and/or Fax: —
PROPERTY owN�R NFORmaTi w: , . . •. •
Name: �/G /1 � 1'��/ � � �
Phone(day): ' �/� 4� B�• �� �' �
Addres5; /%��v �/S d 5 t �l'�. City: _ ZIP:
�mail andlor Fax �� �
PROJ�CT IN�ORMATION:
Typo Projeot' Any,earlh moven,ent may r�+quire
MCWD revlaw R�parmlt6 .
❑ poor(s) ❑Ramodal ❑�Nater pamape � .,
Minnehaha Creok WstE�rshed Aistrlat(MCVVD)
Window(s) Q Repair ❑Starm Dama�e '18202 Minn�,fonka Blvd
, • Deephavan, MN 55991
❑Slding ❑Restofatl011 ❑Other:(apocify) Phone= 95:!-491-U690 _ •
Faz� 9b2-�71•0682
Q �c�oof ❑Fi►e De aqe ,innNur- %�ha�ak-org . ,
OVerall Pro eot beacr7 t(on: G,� n / �/1 �d.7��1 i�� C
E�tlmated Constructlon Valuat7on of Projoct(exclu ing Iend) S /Q� 7 � L: ' . . .
App�ICANT ACKNOWLEDGEMENT:
• Agrees tn provide all Intormetion iequiretl or requesteo dy me 6ullding Dopanm�nt; '
■ Certifies that the Infiormatinn supPNed Is true end rnrrect to the bssf aP his/her knowled�e. The �ppllcant lecognizes that they
are solely responslble 1or submltting a oomplete application being awsra that upon fallure to ao sa, tne s�att nas no alternative
hut to rejeG R until it is complete; ,
• Samo or 311 Of ih0 ��format�on that vou are asked to provlde on thls appllcatfon is classlfted by Sta�e law as elther private or
coMldentlal. Prlvate data is information whlch ge�ertlly cennOt be glven to the pUbl�c but can be c�)ve� to the subject Of ttle
data. Gonfldentfel data Is Informatlon which Benerally cannot ba glven to eimer me publlc.of 2he suojece of tne data_ our
purpose and Intendsd use af Zhle fnfarmafion is to annually update our records and racord� of other govemmental agenc�as
_ required Dy law tf Xou rsfuse io suoplx tha InformaMon,the appllcation msy nof bv issued.
ApplicanYs Slgnature: _ �'l��- o� Date: ` (` ` 7 ( ��
X
Last UpOat�d: 06-04•200a