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Home My WebLink About2010-00169 - siding 1 ' CITY OF ORONO PERMIT I�O.: 2010-00169 2750 KELLEY PARKWAY ORONO, MN 553SC- DATE ISSUED: 03/25/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 945 COX FARM RD PIN : 27-118-23-33-0015 LEGAL DESC : SHADOWOOD FARM : LOT 003 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : SIDING ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 55,000.00 NO"CE: REPI,ACF,ALL WINDOWS AND SIDING APPL[CANT pERMIT FEE SCHEDULE 719.25 HOME VALUE IMPROVEMENTS STATE SURCHARGE(VALUATION) 27.50 13756 REIMER DR MAPLE GROVE, MN 5531 1- TOTAL 746.75 (763)425-9500 Minnesota State License#: 20464927 OWNER SANFORD, MATTHEW 945 COX FARM RD LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT 7�he work for which this permit is issucd shall be performed acwrding to the approved plans and specifications,applicable City approvals,and the S[ate Building Code. This permit is for only the work described and does not grant permission tor additional or related work which requires separate pennits. 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 fo a period of 18 ays at any�time after work has commenced. The applica t is responsib f suring all required inspections are requ i onformance t t�ie State Building Code.This permit may be rev �ed any time t�r e ause. (j`� � -y�c �� 2 �� !� � r- icantPermitee Signature Date � � � �� Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. _ ' City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �C� /C;— � , g,0,�-`�,\ PO Box 66 Q s\ O`, Crystal Bay, MN 55323-0066 Date received: /[� l,� ��';r`�:�::� �,i! Street Address: Received by: �`.�, �1`�;,;!„ ��i 2750 Kelley Parkway Plan review fee: � r��/ Orono, MN 55356 � ESFi�4' -- Total Fee: �//,/,,�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us `r� This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATIC�V�C � Job Site Address: �( J DX �/�1(�/Yl �pf}Q Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Departmenf and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-srte parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFOR ATION: Name: IJGt,� /'V�/�G h'j.�� State License# '7 Expiration Date: ' — — /Q Phone: — office) S ` S cell Mailing Address: '� Cit � ZIP: $ '/ Contact Person: ' Applicant is: Contract / Homeowner (Circle One) Email and/or Fax: $ .�� , �v� PROPERTY OWNER INFORII/IPTION: , Name: A��-f'1 r., !' �.n � Phone (day): Z. � 'T — Z2 Address: Q�./ �.1 Cit : Q/�61.�^c� ZIP: SS35(� Email and/or Fax PROJECT INFORMATION: Type of Project: I Any earth movement may require MCWD review& permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) �Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd � Sidin Deephaven, MN 55391 g ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire D mage wwv��.minnehahacreek.orq Overall Project Description: q,�� ( � �p�,s' � �•�� (o Estimated Construction Valuation of Project(excluding fand) $ S's� pp� APPLlCANT 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 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 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 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 records of other governmental agencies re uired b law. If ou refuse to su I the inform ' n,the a lication ma not be issued. ApplicanYs Signature: Date: �� 7 — �(� Last Updated: 05-04-2009