HomeMy WebLinkAbout2010-01209 - addn/remodel/repair � " - CITY OF ORONO PERMIT NO.: 2010-01209
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 12/29/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1925 CONCORDIA ST
PIN : 18-117-23-14-0014
LEGAL DESC : FAGERNESS
: LOT 013 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 125,000.00
NOTG: SI?PERATE PI;RMI"1'S R�QUIRGD: PLUM131NG,MECHANICAL. ELEC"I'RICAL(STATE)
FIRG DAMAGE RES1�ORA'I�ION-DGMO INTERIOR
APNLICANT
SERVICG TEAM OF PROFESSIONALS PERMIT FEE SCHEDULE 1,206.75
6615 141ST AVE NW STATE SURCHARGE(VALUATION) 62.50
RAMSEY, MN 55303- TOTAL 1,269.25
(763)753-8080 PAID WITH CC# 7058
Minnesota State License#: 20301371
OWNER
KONAT, THOMAS
1925 CONCORDIA ST
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
fhe��ork tor�chich this pennit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
Slate Building Code. 7�his permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. nll provisions of laws and ordinances goveming this type of work
shall be compicd with���hether or not specified herein."This pennit will
expire and become null and void iY construction authorized is not
commenced widiin 180 days of the date of issuance,or if constniction is
suspended tor a period o(180 days at any time a�ter work has conunenced.
The applicant is responsible£or assuring all required inspections are
requested in conformance���ith the State Building Code.This permit may be
revoked at any time for due cause. ����
����� C�--�- l 1 / �l l � � 2.1L � l /v
Applicant Permitee Signature Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
12/27/2016 11:25 7637532595 STOP y;l , � ( �` i , PAGE 01/01
. •, - 1 j ��`.
� �,.�,1 � i;:,..��
s._., ! ,�%� ��' (,.,,� i
Cit of Orono ,V q��� °��"� ° �� �����i� � �
Y ,
Building Permit Application for Internal Work
windows, doo�s, sOding, re-roof, etc.)
_ � Mailin Address� ' ;'
� �~ PO Box 66 ,,. ;;�?�;,��'!.
� � F'ennit�lu,'ttrb�r �'
„�:
� F!�: :
� � Crystal Bay, MN 55323-006B �,batn Cqc�5lv.ed.:. . �:.:.. . ���:.
,� '�
,.,�, �, Sfreef/lddress: I�eCelVed by � �
� � � . 2750 Kelle Parlcwa � � ,, "'
Y Y I�I�n PgVi�Vv.f��, , ' ' ,�
��fe Orono, MN 55356 ` ���
Tatal Feec.. ,�/�
, . ..,�... �' „
Main: 952-249,4600 Fax; 952-249-4616 w�nn�v.ci.orono_mn.�c ,. l;"'-��..
.
This application form must be complel'ed in full and all required information must be submitted.
Incomplete applfcatlons will be�eturned. (P/oas0 print)
GENERAL INFORMATION:
Job Site Address: � �,5� ������'�r���n�► S�" . Ca(b� . r'r��
Will this be a Parade of Homes, Remodelers Showcase Home or other Dispfay Home? Yes o
If yes,a speclal evenl parmif i9 repuired with I'olice I�epertment and Clty Councll approva160 days prla fo the av�nf. Shuttlo bus serv/cs wlll be
requlred unless appllcanf demonstretes su�cient on-site perking is avAilAble. Non•permifted events wlll not be allowod.
CONTRACTOR/APPLICANT INFORMATION:
Name: _�r_v��c�¢ I��S ).� 7ro��1wr+�a�J
Slate License# 7 03��3'� � Expiratfon Date: __3�31- � 1
Phone: - o'Ffice , - cell
Mailing Add�ess: S i ��� Ci ZIP: 3
Contact Person; �'`�art,l� ��er���,,�- Applfcant fs� ontracto / omeowner �circre one�
Email and/qr Fax: _(YvaR,l�6� �h,p,� „c�,,n �ia.,� -�U,,3?�'SL,�.�y�-,S'
IPROPERTY OWNER I FORMATION:
Name; �" �m ��� n I�� i
Phone(day): _ _
Address: '�,'Z,7�� � ���� ��g�_Z,Q,, Ci�y: ,{�v�Javy�) Zlp:
�mail and/or Fax
PROJECT INFORMATION;
Type of Pro�ct: Any earth movement may require
MCWD reviaw&permits
i 0 Door(s) ❑Remodel ❑Water Damage
Minnehaha Creek Wate�shed Dlstrlct(MCWD)
❑Wlndow(s) [] Repair ❑Storm Damage 18202 Mlnnetonka Blvd
,,,_/ Deephaven,MN 55391
❑Siding �Restoratlon ❑Other:(specity) Phone; 952-�471-0590
Fsx: 952-471,0682
❑Re-roof ��re Damage wuvw.minnohaha�[oek.o[a
Overall Pro ect Descroptlon: '
Estimated Construction Val tion of Project(excluding land) $
APPLICANT ACKNOWLE EMENT:
• Agrees to provide all information required or requested by the Bullding Depertment;
• Certifies that the Information supplied is t�uo and co�r@ct to the best of his/her knowledge. The appllcant recognlzes lhat they
I are solely responsible for submitting a complcto application being aware that upon fallure to do so, the staff has no alternaGve
but to�eJect it until it is completa;
I • Somo or all of ihe InTor tlon that you are asked to provide on this application is classlFled by State law es elther private or
confldential. I�rivate da is information whlch generally cannot be given to the public but can be givvn to the subject oi the
i data. Confidential data I Iniormation which generally cannot be given to elthe�the publlc or the subject of the data. Our
I purpose and Intended uso of this information is to annuelly update our records and records of other governmental agencies
re uired b law. If ou reiuse to su ly the infarmation, the a lication ma not bc Issuod.
nppllcant's Signature: ����c C Dato: ��_� ">_ LL
l.est Updeted; 0�04-2008
�� rD/��� TIME �
CITY OF ORONO CALLED IN �
INSPECTION NOTICE G� SCHEDULED — ! '�
PERMIT NO�D/D����Q / COMPLETED
ADDRESS ���5 d-<<? S�
OWNER TELEPHONE NO. � S
CONTRACTOR
�: DESCRIPTION � -�n S �(aa '�' �'^'
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
o � ' � � N C� ������t. �j ��Z��� i= —
� /� S 'i�, � C::_.i S�P cJ
� l 1.� f �'�, � � f� C���F✓�
O
�
W � .
Q - _ •.�:C� �l >� N S �,,; �3 .�� ��+�C�
� � ^� �.' � c<a •-� %v�J ��tJ�
� l C::',Gl c� S GC.�r. ri/'a,..� � �{ � �Q 'i
W �.� ��,� r� � �
� �> ,-�t�� .-�. -v�- rl
� -
a
W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� '�ORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CI�RRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46�0
OwnerlContractor on s� e: �
Inspector. �✓ ,� ��
White Copyllnspector's File Canary CopylSite Notice
i�- -I\r".j
S YAC -V ttJ -
lz,-
ce,
Lo L";Zj-
czj.
r -v o
............ - ........ ..... ............. ... .... ... ....... ........... .........................................
Aty *- C -
"Aim,