HomeMy WebLinkAbout2012-00515 - addn/remodel/repair - CITY OF ORONO * 2 0 1 2 - 0 0 5 1 5 *
, • 2750 KELLEY PARKWAY DATE ISSUED: 06/1 U2012
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1935 CONCORDIA ST
PIN : 18-117-23-14-0013
LEGAL DESC : FAGERNESS
: LOT 012 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPA[R
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 750.00
NOTE: FIXING SMALL PORCH ROOF&REPLACING A ROOF VENT
APPLICANT PERMIT FEE SCHEDULE 34.75
MIKE HEIDERSCHEID STATE SURCHARGE(VALUATION) 0.38
47045 CEDARCREST TR
RUSH CITY, MN 55069- TOTAL 35.13
(763)862-0616 PAID WITH CC# 4066
Minnesota State License#: BC521605
OWNER
SUNHI& STEVEN SCHUSSLER, RYAN
1935 CONCORDIA ST
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
fhe 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 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 applicapt is responsible for assuring all required inspections are
reques[�dzi nformanc�,y.vith[he State Building Code.This permit may be
revo ' � ��'"`a�1Ue cause.
f . j���.—____.._.�.r._�._.. / / ��j
;+ �� (',�/yt C-L� r�i' l � l �—,
Ap�I'�c P litee Signature Date � Is ued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
06/11/2012 13:58 FAX I�001/001
City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, sidin , re-roof, etc.)
—�� Mailing Address; Permlt number, a0�a- - �OS/5
0.�,�,�0 PO Box 66
Crystal Bay, MN 55323-0066 Date received: ���� /?i
s, Str�et Address: Received by:
��, ' � 2750 Kelley Parkway Plan review fee:
$ Orono, MN 55358
� H�
—•— Total Fae:
Maln� 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
Thls appllcation form must be completed in full and all required information must be submltted.
Incomplete applications will be returned. (Please print)
Job Slt�e Address�ATION: �� S
� �,. � .�S ��y/
WIII thls be a Pa�ade of Homes, Remodelers 8 owc sa e Home ar othe�Diaplay Home� Yes � o
!/yss,a speciel s►rent permit la requlred with Pollce Depe►tment end Clty Cflunci!epprove160 deys prior to the event. Shutfle bus servica wil!be
requiiad unless appllcant demor�st�afes sulBclent on-sif�parking ia avelleble, Nony�ermifted evenfs will not De ellowed.
CON7RACTOR I APPLI AN INFOR TI
Name: ,�.d � :J
State License# Explratlon Date: /;
Lead Certification Number: Expiration Date;
(foi woik on homes that woere co�structed pdor to 9978
Phone: -8 ' (o�ce) (cell)
Mailing Address: � . ¢-� ,� Cit : �; ZIP: S rj (� `�
Contact Person: , �� , , �e�,� �.,� Applicant is; Contra / Homeowner (Clrele Ona�
Email end/or Fax: ;- �51,�,�,,' ,1.. r,,,�i; ,� . �o w�
PROPERTY OWNER INFORMATION:
Neme: ,
Phone(day):
Address: City_ ZIP:
Email andlor Fax
PROJECT INFORMATION:
Type of ProJecL Any earth movement may requlre
MCWD review 8 permita:
❑Door(s) ❑ Remodel ❑ Fire Damage Minneheha Creek Watershed District(MCWD)
❑Re-�oof,asphalt ❑Repair ❑Storm Damage 18202 Minnetonke Blvd
❑Re-roof,cedar ❑Restoration ❑Weter Demage Deephaven,MN 55381
Phone: A52-471-0580
�e-roof,othe�(specl ❑Sldlnp ❑Othe�(specify) Fax: 952-471-0682
p www.minnehahacreek.or�
���v�.y���►�{�. IC.ao ❑Window(s)
Overall Pro ect DescrlpUon: � � � t
Estlmated Constructlon Valuatlon o roJect(excluding land) $
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provlde all inFormatlon required or requested by the Building Department;
. Certifies ihat the informatlon supplled ia Uue end conect to the best of his/her knowledge. The appllcant recognlzes that they
are solely responsible for submilting a complete applicetion being ewere thet upon feilure to do so, the staff has no alternative
but to reject It untll it is complete;
• Some or all of the information that you are asked to provide on thia application is classified by State law as either private or
confidential. Private data is information which ge�erelly eannot be give� to the public but can be given to the subjed of the
data. Confldential data is information which generally cannot be given to elther the public or the subject of the data. Our
purpose end Intended use of thia information is to annually update our records and records of othe� govemmental agencies
re ulned b law. If ou refuse to su I the information,the a lication ma not be issued.
ApplicanYs Signature: �,��/,� � Date: —�/' ��
LaslUpdaled; 08-08-2011
� ' �
� ATE TIME
� (,� �t � � 2-
CITY O ORONO �LLED IN �
INSPECTION NOTICE ` ,, SCHEDULED `y< <a-I I a- I l . v O
PERMIT NO. �l n I��W-��5 COMPLETED
ADDRESS l� � � C C��C G� ✓c� r � S�t
OWNER TELEPHONE NO���������
CONTRACTOR ��� 1 � ��� d e�sC h � i
� DESCRIPTION �'1 �- ' ���'� �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAI
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
� ❑ PLUMBING RI ❑ SE' TIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COM1fAENTS:
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W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 U CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on site:
Inspector. �
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