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Home My WebLink About2011-01436 - windows CITY OF ORONO PERMIT NO.: 2011-01436 � 2750 KELLEY PARKWAY , ORONO, MN 55356- DATE ISSUEn: 1 U14/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2245 BAYVIEW PL PIN : 17-117-23-44-0028 LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B : LOT 026 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS VALUATION : $ 1,200.00 NOTE: EGRGSS WINDOW ONLY APPLICANT PERMIT FEE SCHEDULE 47.75 AFFORDABLE EGRESS WINDOWS STATE SURCHARGE(VALUATION) 0.60 6509 HORSESHOE BEND DR CORCORAN, MN 55340- TOTAL 48.35 (763)267-3891 OWNER SUMMERS, GINA 2245 BAYVIEW PL WAYZATA,MN 55391- 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 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 app►icant is responsib� r assuring all required inspections are requested in conformance w� Buiiding Code.This permit may be revoked atany time for e use. � '' � '� � �� /L / d"<..�i��c.-�C-� C�l-ytiC �� -� 7`� Applicant ermiJ.e�` ignatu� � Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono � , Building Permit Application for Maintenance / Renovafion �-, ' (windows, doors, siding, re-roof, etc.) Mailing Address: /'�v 0,� PO Box 66 Permit number: Crystal Bay, MN 55323-0066 Date received: O ��"��'r� O I Received b a � � : :�.,,_ s,� Street Address: y� �'� •'�'�,_ �ti� 2750 Kelley Parkway Plan review fee: L�sk ��4� Orono, MN 55356 Esxo Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This appfication 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: ��,,��'7 j�c_y' �;�,� i�� Will this be a Parade of Homes, Remodel rs Showcase Home or other Display Home? ❑ Yes .�}No If yes,a special event permit is requrred with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be required unless appJicant demonstrates sufficienE on-site parking rs available. Non-permitted events wil!not be allowed. CONTRACTOR/APPLICANT INFORMATION: � i Name: �1E-��.6 r. �-�s W,w,�v.,�s � -..�..f ��;.,r�>, " i�� State License# r�� c��U� E piratio Date: Lead Certification Number: Expiration Date: (for work on homes that were construcfed prior to 1978 Phone: �-�-jy�� (office) (cell) Mailing Address: �-s�n �u -c 15z-.� ( . Cit : .. f ZIP: � �( v L:.;,��r->---, S�3 %C� Contact Person: �� /l�d(G, Applicant is: Contractor Homeowner (Circle One) Emailand/orFax: \j,t�,,,,��c(� (,� v�.�,�,J_c�� :,::- _._____ / PROPERTY OWNER INFORMATION: Name: ' �� r�� i-•i-v�✓ln[1� Phone (day): j 'j Z - 7_7('� - 9�> � - Address � �' �, ,,,z� ��, � City: � �� ZIP: 5 j'��= � � v � Email and/or Fax � ' PROJECT INFORMATION: �1 � Type of Project: + Any earth movement may require ❑ Door(s) ❑ Remodel � ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair T,� ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration `� ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other s eci Phone: 952-471-Q590 ( p fy) ❑ Sid'ng / ❑ Other: (specify} Fax: 952-471-0682 Vindow(s) � , www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding landj $ - `= 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 submitfing 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 whic Ily ot be given to either the public or the subject of the data. Our purpose and intended use of this in ation is t nnuall update our records and records of other governmental agencies re uired b law. If ou refuse to I the infor ation fion ma not be issued. � /� , ApplicanYs Signature: Date: �/—��—�� Last Updated: 08-09-2011