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Home My WebLink About2013-00658 - doors r � CITYOFORONO * 2013 - 00658 * 2750 KELLEY PARKWAY DATE ISSUED: 07/17/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 255 CRLSTVIEW AVE PIN : OS-117-23-14-0021 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT 004 BLOCK 002 PF,RMITTYPE : MINORALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIV[TY : O/S BUILDING - UNDEFINED VALUATION : $ 1,416.00 NO"f(:: RL PI,ACG PATIO DOOR APPLICANT PERMIT FEE SCHEDULE 57.50 DENNIS SARELL CONSTRUCTION INC STATE SURCHARGE(VALUATION) 0.71 1 1368 RED FOX DRIVE MAPLF GROVE, MN 55369- TOTAL 58.21 (612) 723-235� Minnesota State License#t: IR665951 OWNER RF.]MAN, STEPHANIE 255 CRESTVIEW AVE LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT i�he work�br which[his permit is issued shall be performed accordin�to die approved plans and specifications,applic�ble Cit}�approvals,and the State Building Code. 'I'his permit is f�or only the work described and does not grant pem�ission Ibr 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 specitied herein.This permit will expire and become null and void if construction authorized is not commenced ti�ithin 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. I�he applicant is responsible for assuring all required inspections are requested� conformance��ith the State Building Code.'i�his permit may be revuke at• �y time tbr ue cause. � � � C��/� �� / � �� App icant Permitee,ignature Date Issu By. ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ' ' City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: — �O(p PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: � �' 2750 Kelle Parkwa yF Gti Y Y Plan review fee: t �, Orono, MN 55356 �KESHOI� Total Fee: �g �/ 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: ��S �("��P�i/i �(x'� � 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 Department and City Council approval 60 days prror to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLI NT INFORMA�N: 1 Name: � �o'1nI� S Ci;�C'�� 5�1�i,�.e �i�l1 �C State License# - Expiration Date: - ' �- �-�/�/ Lead Certification Number: /.� � -, ��-r'j S -- Expiration Date: �� a.�/ y (for work on homes that were constructed prior to 1978 Phone: (cell) �'a. — ��-- �/" (office) Mailing Address: � , �l �� City:�j/I� � :;; :iz ZIP: � �y�'� Contact Person: ' � ,^ j .,�vl l Applicant is: ori rac / Homeowner (CircleOne) Email and/or Fax: j� S--fiS ��'1 �' � � r a �v • Cc,�t PROPERTY OWNER INFORMATION: Name: y�}'�.DI-�or��C' �rC/Yt�L1 Phone (day): �'S-a, _ y-7�-- a� 7- O Address: O�.,f'S" Cres fv��z.� �` City: � �j,n� ZIP: �5��-� Email and/or Fax: �� PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require �Door(s) � Remodel ❑ Fire Damage MCWD review&permits: ❑ 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(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq . � Estimated Construction Valuation of Project(excluding land) $ 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 infor ' n is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the ' fo ation,th lication ma not be issued. ApplicanYs Signature: �----- Date: �r- � "� 3"C� �� Owner's Signature: Date: Last Updated:03/06/2013 DATE TIME ✓ CITY OF ORONO ALLED IN 7-/7/3 INSPECTION NO ICE �/) �-j SCHEDULED 7.��r�/3 PERMIT NO. ��3 —` "�"� OMPLETED ADDRESS �� C-� � OWNER TEL HONE NO��a -7�-3-�35 CONTRACTOR �� : DESCRIPTION - � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ 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: � W a � J O � � O � W � Q � Z W � W � � � ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOUPS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contractor on site: Inspector. � ,�� White Copyllnspector's File Canary CopylSite Notice