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CITY OF ORONO * 2 0 1 3 — 0 0 5 5 0 *
2750 KELLEY PARKWAY nATE �ssuEn: 06/21/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 60 CRYSTAL CREEK RD
PIN : 33-118-23-33-0008
LEGAL DESC : CRYSTAL CREEK
: LOT 002 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 20,850.00
N01'E: WINDOW REPLACLMENT
APPLICANT PERMIT FEE SCHEDULE 354.00
SUNDANCE EXTERIORS STATE SURCHARGE(VALUATION) ]0.43
105 W. 23RD ST.
HASTINGS, MN 55033 MAIL-IN FEE 2.00
(612)419-1085 TOTAL 366.43
Minnesota State License#: 20383035
OWNER
MYHRE, PETER& SHAWN
60 CRYSTAL CREEK RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issucd shall be performed according to
the approved plans and specitications,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 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 l80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer 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 any time for due cause
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Applicant Permitee Signatur Date � Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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From: 06/21/2013 11 :06 #711 P.001/001
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City of Orono
Building Permit Application for Maintenance / Replacement I Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�O�O Marlrng Address: Permit number: D — �
PO Box 66
Crystal Bay,MN 55323-0066 Date received: �o�/
Street Address. Received by:
� � 2750 Kelle Parkwa
yF G. Y Y Plan review fee:
�,� �, Orono,MN 55356
kFSH�� � / _/.i/�
Total Fee: iofo �f�
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 prinf)
GENERAL INFORMATION: ( �
Job Site Address: �-r/ � �'�� �'�� L- ��� ��L_�'�G�
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? Yes No
!f yes,a special event permR is required wifh Police Department and City Council approval 60 days prior to the event. Shuttle bus service wil!be
required unless applicant demonstretes su�crent on-site parking is available. Non-permitted events wilf not be allowed.
CONTRACTOR/APPLICANT INFORMATION: , f (�
Name: � J D�5 U 1/�. I t vIn��cQ —�i�L•
State License# G-- 3 S Expiration Date: � /S
Lead Certification Number: Q- �- �p,��e{ _ � j- bOZ7 Expiration Date: /z
(for work on homes ihat weie constructed prior to 1978
Phone: (cell) �ptZ-c���.-�p�� (office) (��I-�-{�o-3 Ya o
Mailing Address: l d� S,��e6 f 2-� ��` S�t City: ��-���S ZIP: �j S�3 3
Contact Person: ��� �,,,�.�. Applicant is: Contractor / Homeowner �c��i.o�e�
Email and/or Fax: �rv�a,rw,� �&,a,�ce-�xtFr � c.r g . ��
PROPERTY OWNER INFORMATION:
Name: �h q�r �.� f�
Phone(day): q S Z - �-gy_Z��c�.
Address: (p� �"�,7 Sy,� � ( �r�t� r-��s City: ZIP:
Email and/or Fax:
PROJEC7 INFORMATION: Overall ro eci descri tion:
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 DisUict(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-<171-0682
�]Window(s) `���`7�- �'S�� www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ 2D�gsZ�
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Cehffies that the information supplied is true and correct to the best of his/her knowiedge. 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 inforrnation 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 gene Ily cannot be given to either the public or the subject of the data. Our purpose and
intended use of this inform ion is to an all update our records and records of other governmental agencies required by law. If
ou refuse to su I th rma i the a ication ma not be issued,
ApplicanYs Signature: `�--Date: jO��Gl-1�
Owner's Signature: T' Date: �������
Last Updated:03/06/2013
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. �D/3-OoSS d COMPLETED �«"
ADDRESS �� C��sf� G C.-e �.f ,f��
OWNER TELEPHONE NO.
CONTRACTOR Sc�.tc�.E•��¢ �X�Cr�e✓s
j DESCRIPTION ���vt9ac.� IP�-� �-
�
� ❑ FOOTiNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP p PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. �FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector. ��+i �
White Copyllnspector's File Canary CopylSite Notice