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Home My WebLink About2013-01131 - siding � CITY OF ORONO �" * 2 0 1 3 — 0 1 1 3 1 * 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4025 DAHL RD PIN : 07-117-23-14-0002 LEGAL DESC : UNPLATTED 07 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPF. : SIDING ACTIVITY : O/S BUILDING - UNDEF[NED VALUATION : $ 3,000.00 NO"TL: RESIDING APPLICA1vT PERMIT FEE SCHEDULE 88.50 MIDWEST EXTERIORS PLUS STATE SURCHARGE(VALUATION) 1.50 6451 SYCAMORE CT. N. TOTAL 90.00 MAPLE GROVE, MN 55369- Minnesota State License#: BC010277 OWNER JOHNSON&JODI QUAM-JOHNSON, DEAN 4025 DAHL RD MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT The��ork for which this pennit is issued 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 ibr additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specitied hcrein.'I'his 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 ar[er work has commenecd. The applican[is responsible for assuring all required inspections are requested in conformance wi[h the S[ate Building Code.This permit may be revo ed a ny time r due cau e. � �u� a 3� /� � /D ��3 � �App ntP' mitee Signaturei Datc Issu� By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER TNAN DESCRIBED ABOVE. � City of Orono Building Permit Application for Maintenance / Replacement / Renovation �No structural expansion. Only windows, doors, siding, re-roof, etc.) '�O �' Mailing Address: a��7J �� / �� PO Box 66 Permit number: (' 1 Crystal Bay, MN 55323-0066 Date received: `0�j�3 � � Street Address: Received by: � yf �� 2750 Kelley Parkway Plan review fee: Orono, MN 55356 ��kfSH�� ,r�1 -_.� " Total Fee: ��, �/�/ Main: 952-249-4600 F�: 952-249-4616 vv��n�v_ci ur�no mn us This application form must be completed in full and all required information must be submitted. Incomplete applications will be retumed. (Please print) GENERAL INFORMATION:�� l �3� Job Site Address: \� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No !f yes, a special event permit is required wrth Po/ice Departmerrt and City Council approval 60 days prior to the event. Shuttle bus servi e will be required unless applicant demonstiates sufficient on-site parking is available. Norrpermitted everrts will not be allowed. CONTRACTOR/APPLICANT INFORMATION: � Name: �k LOYS S State License# Expiration Date: 3� 3� �� Lead Certification Number. � -�-� 3v3�{� � Expiration Date: � � /s^ (for work on homes that were constructed prior to 1978 Phone: (cell) ��- p'a '/� / ,� � (office) �j(�j 3 — �a7��(oG/(o Mailing Address: (0 5� �Q G City: Q ZIP: 5S3 Contact Person: Applicant is: ontra tor / Homeowner �c�«ie o e� Email and/or Fax: PROPERTY OWNER INFORMATION: Name: [�Q� d.. ��(,U �OLinScSY) Phone (day): S2, _ r�3� Address: p .1�„ City: {�(�(,�/t� ziP: 55 3 6 � �KI Email and/or Fax: PROJECT INFORMATION: Overall ro�ect descri tion: Type of Project: Any earth movement may also require ❑Door(s) ❑Remodel ❑Fire Damage MCWD review 8� permits: ❑ Re-roof,asphalt �Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 e-roof,other(specify) �Siding ❑Other: (specify) Phone: 952-471-0590 � � Fax: 952-471-0682 ❑Wndow(s) ;��wU✓minnehahacreek orq Estimated Construction Valuation of Project(excluding land) $ 3 oDo, o c� 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 a ally update our records and records of other governmental agencies required by law. If ou refuse to su I the i rmat on,t li n ma not be issued. ApplicanYs Signature� ' Date: U"�-3 —�,� Owner's Signature: Date: �� V J _ ATE TIME CITY OF ORONO CALLED IN — INSPECTION NOTI Jv `�I SCHEDULED �f� PERMIT NO. co ereo ADDRESS � ' � � OWNER TELE ON NO. �Z 7�Z—�F"7�� CONTRACTOR � Ul� r � DESCRIPTION -� v � � ❑ FOOTING ❑ PLUMBING FINAL ❑ XCAV/G ADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESH RE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 'jREE OVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT Q ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HAFD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � ��-4 � W a � J O �. � O � W 2 Q � 2 W � W � � d W� ❑WORK SATISFACTORY:PROCEED iOJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RE7URN ❑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�0 OwnerlContractor on ite: .. Inspector_ _�/l �� White Copyllnspector's File Canary CopylSite Notiee