HomeMy WebLinkAbout2014-00187 - doors �
- � CITY OF ORONO * z 0 1 4 - 0 0 1 S 7 *
2750 KELLEY PARKWAY DATE ISSUED: 03/06/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2715 COUNTRYSIDE DR W
PIN : 04-117-23-12-0019
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 004 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING - UNDEFINED
VALUATTON : $ 988.00
APPLICANT PERMIT FEE SCHEDULE 41.25
STATE SURCHARGE(VALUAT[ON) 0.49
SCHERER BROS LUMBER MAIL-IN FEE 2.00
10751 EXCELSIOR BLVD
HOPKINS, MN 55343 TOTAL 43.74
(952)277-1600 Payment(s)
Minnesota State License#: BUIL-BC239369 CREDIT CARD 3989 43.74
OWNER
WILSON, MARK& KIRSTIN
2715 COUNTRYSIDE DR W
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifica[ions,applicable City approvals,and [he
Statc 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 whe[her or not specified herein.This permit will
expire and become null and void it�construction authorized is not
commenced within l80 days of the date of issuance,or ir construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in contbrmance with the State E3uilding Code.This permit may be
revoked at anv time tbr due cause.
�►�1.�-(.�C � / /
Applicant Permitee Signature Date Issued B ignature � � Date
City of Orono
Building Permit Application for Maintenance / Replacement i Renovatio�
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
�,(�J1 j PO Sox 66
� Crystal Bay,MN 55323-0066 Date received;
Received by:
Street Address
�' ,� 2750 Kelley Parkway Plan review tee:
y� c? Orono,MN 55356
Iq'CESNO�� Tota1 Fee:
Main: 952-249-4600 Fax: 952-249-4616 www ci.orono.mn.us
This application form must be completed in full and a!I required information must be submitted.
Incomplete appticatlons will be returned. {Please print)
GENERAL INFORMATION: � �de D�c v� ,�� JP.c
Job 31te Address: o`Z 7��2 ����Yy S v-'�-- —
Wilf this be a Parade of Homes, Remodefers Sho case Home or other Dlsplay Home? Yes No
!f yes,a speclal evenl permrt rs required with Pofice Department and Crty Councif approva!60 days prior to the evenl. Shuttle bus se ice wifl be
required unless applicant demonstrates su�cienf on-srte parking is availabfe. IVon-permitted events will not be allowed.
CONTRACTORlAPP CA TINFORMA710N:
Name: C���Y-e-1� {�'O�. l.�-YV� Cd
State License# (p� Expiration Date:
Lead Certification Number: �"�a(p�(jS-1 Expiration Date: f
(for work on iromes that were constructed prior fo 1978
Phone: (cell) (o�ice) 5a-v�7� ' (o
Mailing Address: ��� Ce Sia V � Cit : ZIP:
Contact Person: � vt }��lNiO Applicant is: C�ntracto / Homeowner �ci.�ie o�.j
Email andlor Fax: .� (,°, . CD�Yt
PROPERTY OWNER INPORM TION• .
Name: �l,V� l D
Phone(day): •b � ZIP:
Address: e �/Q City: V71(/J p rJ'
Email and/or Fax:
PROJECT INFORMATION: 4verall �o'ect descri tion:
Type of Project• Any earth movement may a�so requlre
' MCWD review&pertrzits:
�Door(s) ❑ Remodel ❑Fire Damage
i Minnehaha Creek Watershed District(MCWD)
❑Re-roof,asphatt ❑ Repair ❑Storm Damage 1g202 Minnetonka B1vd
❑Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven,MN 55391
F'hone: 952-d71-0590
❑Re-roof,other(spsclfy) ❑Siding ❑Other: (specify) Fax: 952-471-0682
❑Window{s) www.minnehahacresk.ora
Estimated Construction Valuation of Project(excluding land} S
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Depa�tment;
• Certifles that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are
solely responsible for submitting 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 ihis application is ciassified 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 tha subject of the data.
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and
intended use of this information is to annually update our records and recor8s of other governmental agencieS required by law. If
ou refuse to su I the information,the a licatiop ma not be issued.
ApplicanYs Signature: �d Date: �«'
Owner's Signature: Date:
Last Updated:03/06l2013
S �D&TE� TIME �
CITY OF ORO CALLED IN GD^
INSPECTION NOTIC SCHEDULED S-
PERMIT NO.-� -��87 MPLETED
ADDRESS a7 �-
OWNER�/f-�L� � ��NiT P NE NO.
CONTRACTOR��J�.� �-�S•
� DESCRIPTION - �L:�t� L%��
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAM ❑ MECHANICAL FINAL
0 ❑ TREE REMOVAL
Z ❑ IN LATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ ADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ MO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI Q SEPTIC FINAL ❑ FOUNDATION/REMOVAL
? OWNERICON7RACTOR TO MEET YOU:_YES_NO
v�i COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ,
O CITATION ISSUE -
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 ours in adva . 52) 249-4600
OwnerlContractor on site:
Inspector.
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