HomeMy WebLinkAbout2012-00752 - windows ` CITY OF ORONO * 2 0 1 2 - B 0 7 5 2 *
2750 KELLEY PARKWAY DATE ISSUED: 08/02/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 350 CRESTVIEW AVE
PIN : OS-117-23-14-0057
LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK
: LOT 000 BLOCK 006
PERMIT TYPE : M[NOR ALTERATIONS
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 2,770.00
NOTF.: REPLACE 10 WINDOWS IN EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 88.50
WINDOW WORLD STATE SURCHARGE(VALUAT[ON) 1.39
221 1 1 1TH AVE. E.
#130 MAIL-IN FEE 2.00
ST PAUL, MN 55109- TOTAL 91.89
(651)770-5570 PAID W1TH CC# 0074
Minnesota State License#: BC356847
OWNER
STEPHENS III ET AL, W[NFIELD R
3770 BAYSIDE RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORIY STATEMENT
The work for which this permit is issued shall be perforrned according to
the approved plans and specifications,applicable City approvals,and the
State Quilding 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 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 oC 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 with the State Building Code.This permit may be
revoked a[any time for due cause.
�i�'1/�.-�-� �- / / / /
Applicant Permitee Signature Date Issued By g ature Date
SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED AB E.
, � City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, sidin , re-roof, etc.y
�O� MailiPO Box 68 . Pemllt pumber: � Of o2 � �� 5�
0 � Cryatal Bay, M N 55323-0066 Date recelved:. —2� `��
Street Addresa; Recelved by; �J
� 2750 Kelley Perkwey pf�n�review fiee;
����N Orono, MN 53356
Total Fee: �( �,gj�
Mairt: 952-2�9-4600 F�t; 952-249-4616 mt�m.ci.orono.mn.us r•�
Thls applicatlon to�rn must be wrnpleted in full end ell required informativn must be submitted.
Incomplete appllcatlons wlll be returned.. (Please print)
GENERAL INFa,RMATION:
Job Slte Addresa: 3��_Gr� (�c��/ ��i
WIII thls be a Parade of Homes, Remodelers Showcese Homa or other Dlsplay Home4 YeB No
If yee,e specieU�vent permit is iequirod with Pofice Depertment an0 Ciy Counci!epprvval 60 deys prior tv the event 3huttle bus service will be
r�qu�red unless applioeni demonstrates aufficlent on-shte perkln�la evAllabls. Nan-perm/tled eventa wlll not be al/owed.
CONTRACTOR/APPLICA T IN ORM TION:
Name: G,/c^;�p� �'�r�(,�j
State License# F�cplratlon Date: j ��
Lead Certlflcation Number, � , � ��h ,( Expiration Date;
(for work on h�mea th�t were conatructed prlor to 49T8
phone; , �, ,p� (offlce) (cell)
MaIIIngAddress: ��� � � City� •�J'IP: U
Contact Person: , ,Applicant is; ontract / Homeowner � (C�ro�o Ono�
Email andlor Fax: ,� w� r,.,i„ { , ,�_ � � � _ _ •� q�
PROPERTY OWNER INFORMAT�N;
Name: 1�1, ,�.• ^-�� �S
Phone (day): �(�_-_. ���- � j� /
�_77/� ��_S, �
Address, !� f�J City; �•,,� l�,. �.G ZIP: �,�,���
Email and/or Fax
PROJECT INF RMATION;
Type oT ProJect; Any earth movement may requlre
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD revlew&perml�s:
Minnehaha Creek Watershed District(MCWD)
❑ Re-roof,Ssphalt � Repair ❑3torm Damage 18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Resto�atlon ❑Water Darnage beepheven, MN 55881
Phone: 952-471-0590
❑ Re-roof, other(�peclty► ❑ Sldlnp ❑ Other: (specify) Fax; 952-471-0682
�Wlndow(�) www.mi nnehahacreek.ora
Overall Pro)ect eacrlptlon: '.�,� �,U rn t�S in P�f'�S• �' G��
Estlmated Ccnstructlon Valuatlon of Pr ct excludln lend S '��
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all Informatlon required or requesied by the Buildina Department;
. Cerllfles that tha Informetlon supplled Is trua and correct to the best of hls/har knowledge. The applicant recognizes that they
aro •olely�responelble for aubmliting e complete eppllcatlon being awaro ihet upon failuro ta do ao, the staff has no alternative
bu!to reJept It untll It Is complete;
� Some or all of the infvrmation thal you are asked to provide an this application is classified by State law as either private o1'
confidenti8l. Private daia is informaiion which generally cannot ba given to the public but can be given to the subject of the
data. Confidential data is inf�orm�tion which generelly cennot be piven to either tha public or the aubject of the date. Our
purpose and intended use of this informetion is bo ennuelly updai� our records and records oi vth�r governrnental agencles
re uired b law� If au refiuse io su I inform 'on,the a li iion ma not be issued,
Appllcant's Slgnature: ~F� ' Date: ����"��-
Lest Updated: 08-09•2011
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