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Home My WebLink About2015-00813 - windows , CITY OF ORONO * z 0 1 5 - 0 0 8 1 3 * 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1761 CONCORDIA ST PIN : 17-117-23-22-0017 LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK : LOT 011 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 9,826.00 NOTE: REPLACE(6)WINDOWS [NTO EXISTING OPENINGS APPL[CANT PERMIT FEE SCHEDULE 201.36 STATE SURCHARGE(VALUATION) 4.91 RENEWAL BY ANDERSON MAIL-IN FEE 2.00 1920 COUNTY RD C. WEST ROSEVILLE,MN 55113 TOTAL 208.27 (6l2)502-4777 Payment(s) Minnesota State License#: BUIL-BC 130983 CREDIT CARD 8788 208.27 OWNER HOLSTE, D HOLSTE& M 1761 CONCORDIA ST 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 gran[permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 applican[is responsible for assuring all required inspections are requested in conformance with[he State Building Code.This permit may be revoked a[any time for due cause. � �Glti C�G�� -� � 1��.� �J` Applicant Permitee Signature ' Date [ ued By Signature Date � City of Urano Buiiding Permit Applicatian far Maintenance / Renovatian (wirtdows, doors, siding, re-roof, etc,) �� Malllp0 BWc 6fi• � I Permit number� �Q��-U � � � Crysf21 Bay, MN 55323-0066 Date received: �o —�.3 � � Sfreet Address: R�ceived hy. G� 27'50 Kelley Parkway Pian review fe�: __ �� Orona, MN 55356 Q Totai�e�: � U. � Main: 952-249-4600 Fax: 952-249-4616 www_ci_arono.mn.us 7'his applicatian form must be comple�ed in full and al1 r�quired informatfon must be submitted. lncompl�ts applicatidns will be returned. (Please prinf) GENERAL INF4RMAT10N: Job Site Address: I�'�� C o�Car cl�c,,, . �-(-��,� Wili thls be a Parade ot Homes, Remodelers Showcase Home or other blspEay Mome? Y�s No X yna,a specia/event pe�T»Pt!S r6qulrgd wlth Pollce Depa�rnent and City CounaY spprovgl 80 days prlor to tire event. Shuttle bus servicc>w!!I be iequlred unfess applicant demonstn�f6s suH7clent pnsfte parking is available. Non-p�J'mftted 6v9nts wlJl not 8e alfowed. CONTRACT�R/APPL.lCAN71N�'QRMATIQN: Name: 1�-� � 'Av��xSer.7 __. _ State l.icense# C.��0�$ � _ Expirati�n aate: '��3� .� -- Lead Certificatian Number: �j��.ag3 �� Expiwation Date: 4I t5 (1br wor�c on homes that w�Cons#ruct�ad pr,f'or to i978� Phone: 1D51� o�(�y-4 0$$' �ityAh (ofFlce) � (cell) - Maiiing Address: �• •• WES�{' City. � � ZIP� �S 1 � Contact Person: Appllcant Is: n r r / Homeowner (c��a ona� EmalE and/or Fax� PROPER7Y OWNER INFQRMATIQN: l, Narne: �L G��!: [� ►1 C>>��`�.. , Phone(day): '�. � - d p Address: �S; City' ZIP: Email and/or Fax �� T PROJ�CT IN�ORMATiON: Type nf Projact: Arry earEh movement may requi�+e ❑ Door(s) ❑Remodet ❑Fire Damage M�p��F��^its: Mlnnehaha Creek Watershed Distrtct(MCWD) ❑Re-roof,asphalt �Repair ❑Siorm Damage 18202 Mlnnetonke Bl�d � R�roof,ceder ❑Restoration C]Water Dam2ge Q��p��v��.MN 5539� phone_ 952-471-0590 0 R�roof,other(spectfy) ❑Sldfng [�Other. (sp�cify) Fax: 952r471-0fi82 indaw(s) wrwv.minnehehacreek.or� dverall Project Descri tion: 0. '� p W� � .� �l`Q� Estlmated Cvnstructinn Valuation of Project(exciuding land) � � $a QC) 0 � APPLICANT ACKNOWLEDG�MENT: • Agrees to provide all information raquireti Ot'requested by the Building Departm�nt; • Certi[ies that fhe Infarmatlan supplled Is true and carrect to the best af hfs/har knowledge. The 2pplic8ni recagnlzes fhet they are salely responsible for subm�tting a comp[ete applicatlon being eware that upon failure to do so, the siaff has no altemative but to re)ect it unbl it is oomplete; . Some or all ot the IMprmation that you are asked to provide on !ltis applicafion is c[essrffed by State faw as either prtvate or confidenti�l. Pn"vate data Es Infarmatlon whiah generally Ca�not be given to the public but can be give� ta th� Subject of ihe ciata_ Confidential deta is information which generally c8nnot be given to efther the public or the SubjeCt of the data. Our purpose and lntended use pf 4hls lnformatlon is to annually update our recorr�s and recards of other govemmen#af agencies re uired b law. If u refuse to su I the informatian,the a €ication ma not be Iss�ed. An�lEcant's Slanature: Date: ��'`�� j� � . - Y �� DATE TIME ITY OF ORONO CALLED IN INSPECTION N ,TICE �� SCHEDULED � - BS __�� PERMIT N COMPLETED ADDRESS � �/� � ��✓� /'�1J�� . OWNER TELEPHONE�� IS�� CONTRACT�R � � DESCRIPTION �� -� � l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDAT N WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADO LAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FR ING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W S BUILT-SURVEY ❑ SE ER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ PTIC INSTALL � OWNERICONTRACTOR TO MEET YOU: YES_NO F=-=_=_-=_=_ v�, COMMENTS: � W C � J O ). � O � W � Q � 2 W � W � j d W O WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou advan � 2� 24 - QQ OwnerlContractor on site: Inspector. White Copyflnspector's File Canary Copy te Notice