HomeMy WebLinkAbout2010-00871 - windows E • • CITY OF ORONO PERMIT NO.: 2010-00871
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/2U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 4750 CREEKWOOD TR
PIN : 30-118-23-33-0003
LEGAL DESC : PAINTERS WOODS
: LOT 001 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : W[NDOWS
ACTIVITY : O/S BU[LDING -UNDEF[NED
VALUATION : $ 24,000.00
NOTE: RF,PLACG WINDOWS AND DOORS ON BACK OF HOUSE [NTO EXISTING OPENINGS.
APPLICANT PERMIT FEE SCHEDULE 398.25
THERRES CONSTRUCTION STATE SURCHARGE(VALUAT[ON) 12.00
2521 WILSH[RE BLVD
MOUND, MN 55364- TOTAL 410.25
(612)250-6180 95249
Minnesota State License#: 20514566
OWNER
JELLISON, MR.& MRS.
4750 CREEKWOOD TR
MAPLE PLAIN, MN 55359
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State E3uilding Code. This pernlit is tor 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 Ihis type of work
shall be compied with whether or not specified hercin.This permit will
expire and becomc 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 atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at ny tim�'for due cause`
<' , �/ �� L t� � /C� l:,Z l �c: l l
Applican ermitee Signature Date Issued By 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.)
Mailrng Address: Permit number: ���b— Od��
O�,�,�.0 PO Box 66
Crystal Bay, MN 55323-0066 Date received: /�
,� �'�'���" �_ Received by:
��G�;�, �, Street Address:
�'.F, �� °s^ Gti 2750 Kelley Parkway Plan review fee:
t`9kESH04'� Orono, MN 55356
Total Fee: ,(�j D, �S
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: �
Job Site Address: �J s�� - �T—��� 'T��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes '�f No
If yes, a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-sife parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: '�� � '
State License# �r�/ �i �"-�,�,, Expiration Date: � ,/
Phone: G� I z - 2 5`z� --i.� i �c� office cell
Mailing Address � � c.c� �' ;,�'_ �-✓i�,r.,c,� Cit : �,-�„ . ZIP: .S 5-3 �
Contact Person: �,rz�,�-�s � Applicant is: Contracto; / Homeowner (Circle One)
Email and/or Fax: �,s z - �{�,� - �� S� -
PROPERTY OWNER INFORMATION:
Name: '].�c�,,� � S_,�-c.,e 5
Phone (day): �3-Z.— �.J y`t — Q ? S-c:
Address: � � �-c3 ���_.t;�,� '��,.,;�' City. �.�u�-.-� ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: 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
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage www.minnehahacreek.orQ
Overall Project Description: �' � ' �,�,"i� �
Estimated Construction Valuation of Project(excluding land) $ 2 �p� cu
APPLICANT 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 information,the a lication ma not be issued.
�
ApplicanYs Signature: 1�� ����/�(�/L- Date: -Z� ��'
Last Updated: 05-04-2009
DATE TIME �
CITY OF ORONO CALLED IN `�'"
INSPECTION NOTICE SCHEDULED �bS-'�O _2��
PERMIT NO.aO/O—� 7� COMPLETED
ADDRESS 'Z'7�O � � r
OWNER TELEPHONE NO.��Z �SO �o�BU
CONTRACTOR ���� ��f •
>; DESCRIPTION ��� �����ws �"d0"dl''S �n ���
�
lt� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WAIL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
�
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED � ❑ 13SUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. �, f � ��-�� ��;��
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