HomeMy WebLinkAbout2013-01125 - windows � , CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 3 - PJ 1 1 2 5 *
DATE ISSUED: 10/25/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 980 COX FARM RD
PIN : 27-118-23-33-0012
LEGAL DESC : SHADOWOOD FARM
: LOT 009 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 9,697.00
NOTE: REPLACf?5 CASEMEN"I�WINDOWS IN EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 191.75
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 4.85
10751 EXCELSIOR BLVD
HOPKINS, MN 55343 MAIL-IN FEE 2.00
(952)277-1600 TOTAL 198.60
Minnesota State License#: BC239369 PAID WITH CC# 3989
OWNER
WILLSON, CHRIS & SARAH
980 COX FARM RD
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEME1vT
The work for which this permit is issued shall be performcd 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 governin�this type of work
shall be compied with w�hcther 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 applicant is responsible for assuring all required inspections are
requested in conformance wi[h the State Building Code.This permit may bc
revoked at any time for due cause.
�l�l Z.5/ � ��>�,,�,�� l(� l d�l
npplicant ermitee Signature Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
♦
City of Orono
Buiiding Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. 4nly windows, doors, siding, re-roof, etc.)
MailingAddress: Permit number: a� �3��l�
� Cry sal Bay, MN 55323-0066 Date received: /0 '� -�3
Street Address: Received by: `
;, �" 2750 Kelley Parkway Plan review fee: •
�'t L� Orono,MN 55356 �,Z `!7Q(,���
'�'��sNo�`�` TotaEFee: �9$, �D �
Main� 952-249-4600 Fax: 952-249-4616 www ci.orono.mn.us
l"his application form must be completed in fuil and all required information must be submitted.
Incomplete apptications will be returned. (Please print}
GENERAL INFORMATION��D �D� �a�� �OQ „p
Job Site Address; �t
Wiil this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes .�No
!f yes,a specia!event permil is requi2d with Police DepaNment a�td Crty Council approva160 days priorto the evenf. Shuttle bus service will be
required unless appllcanl demonstrates sulficient on-site parking is available. Non-permitted events will not be alfowed.
CQNTRACTOR/APPLICANT INFORM ION:
Name: ��.{� S .
State License# ��Qj 3(pg Expiration Date: f �q=
Lead Certification Number: �f�_ �(p�Q�r-'-/ Expiration Date: 0.23 /S
(for work on homes thaf were constructed prior to 19 8
Phone: (cell) (offce) 9J�a`0?7 -�(D �j�
Mailing Address: d'�,�/ s��y City: ZIP: Q
Contact Person: Z 5��y„� Applicant is: on r / Homeowner �ci«�e on��
Emai! and/or Fax: C �. ' �Y,�� . �
PROPERTY OWNER I FORMATI N:
Name: �GJ{�' S G{,/�Q�1 /l�
Phone (day): , ;L
Address: D � Q`'yy� OG� City: ���, ��!(.Q ZIP: 5jr�j�L
Email andlor Fax:
PROJECT INFORMATlON: Overall ro'ectdescri tion:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire bamage MCWD review&pertnits:
❑ Re-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven,MN 55391
❑Re-roof, other(speclfy) ❑ Siding ❑Other:(specify) Phone: 952-471-0590
Fax: 952-A71-0682
�Window(s) ��CCCS�YY1�Qt�tfS www.minnehahacreek.orq
Estimated Constre�ction Valuation f Project(excluding land) $ 7
f�? �-X[�Sfl•n5 O�iYk�s.
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Depariment;
• 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 intormation which generally cannot be given to the public but can be given to the subject of the data.
Confidential data is information which qenerally cannot be given to either the public or the subject of the data. Our purpose and
intended use of fhis information is to annually update our records and records ot other govemmental agencies required by law. If
ou refuse to su I t inform tion, lication ma not be issued.
t
•ApplicanYs Signature: Date: d ��- ���
Owner's Signature: Date:
last Updated:03/06/2013
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. 0�/3 ' D!/�S COMPLETED / '/o�"��
ADDRESS 9gd �� �''�''� �
OWNER TELEPHONE NO.
CONTRACTOR �"�e�''c/` ��d'S- L,�,.��r
�; DESCRIPTION ,�1��iG�� ��,[� ` -
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
� O INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Z
Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ��OLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVEfi REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTFiACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 2a hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice