HomeMy WebLinkAbout2015-01603 - windows � CITY OF ORONO * 2 0 1 5 — PJ 1 6 0 3 *
� 2750 KELLEY PARKWAY pATE [ssUEn: 12/30/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4040 DAHL RD
PIN : 07-117-23-1]-0021
LEGAL DESC : P[RATES COVE
: LOT 017 BLOCK 001
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 17,500.00
NOTE: REMOVE AND REPLACE(8)WINDOWS IN HOUSE AND GARAGE. SEE ATTACHED PHOTO.
APPLICANT PERM[T FEE SCHEDULE 325.24
STATE SURCHARGE(VALUATION) 8.75
HAMEL BUILD[NG CENTER TOTAL 333.99
18710 HIGHWAY 55
PLYMOUTH, MN 55446- Payment(s)
(763)478-6601 CHECK 42522 333.99
Minnesota State License#: BUIL-20631040
OWNER
LEPPLA, MR& MRS JOHN
4040 DAHL RD
MOUND, MN 55364
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 Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permi[s. All provisions of laws and ordinances goveming this type of work
shall bc compied with whether or not specified herein.This permit will
expire and become null and void if construction au[horized 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 after work has commenced. ��- ��"�
The applicant is responsible for assuring all required inspections are / ��,U"x
requested in conformance with the Sta[e Building Code.This permit may be �k
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By Signature Date
CITY OF ORONO * z 0 1 5 - PJ 1 6 0 3 *
2750 KELLEY PARKWAY DATE ISSUED: 12/30/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4040 DAHL RD
PIN : 07-117-23-11-0021
LEGAL DESC : PIRATES COVE
: LOT 017 _�001 �
PERMIT TYPE : ADDITION DEL/$��R �`�
\,_i`,�",
PROPERTY TYPE . RESIDENTIAL , ,;;.--
, ,� �� _��.;
CONSTRUCTION TYPE : ADDN/�ODELI�IR c��c._ _,
ACTIVITY : 434-R��NTIAL
VALUATIOI�I : $ 17,500.00
NOTE: REMOVE AND REPLACE(8)WINDOWS IN HOUSE AND GARAGE. SEE ATTACHED PHOTO.
APPLICANT PERMIT FEE SCHEDULE 325.24
STATE SURCHARGE(VALUATION) 8.75
HAMEL BUILDING CENTER TOTAL 333.99
18710 HIGHWAY 55 Payment(s)
PLYMOUTH, MN 55446- CHECK 42522 333.99
(763)478-6601
Minnesota State License#: BUIL-20631040
OWNER
LEPPLA, MR&MRS JOHN
4040 DAHL RD
MOLJND,MN 55364
AGREEMENT AIYD SWORN STATEMENT
The work for which Ihis permit is issued shall be performed according to
the approved plans and specifications,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 rype of work
shall be compied with whether or not speci6ed herein.This 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 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.
�-� � , ���
Applicant Permitee Signature Date Is Signature Date
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� � City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�—�A, Mailing Address: Permit number:
;/ i��`YO PO Box 66
r�
' Crystal Bay, MN 55323-0066 Date received:
1 � Street Address: Received by:
� � � 2750 Kelle Parkwa
'`y :/ Y Y Plan review fee:
`�c� , �.`-' Orono, MN 55356
��SHv�
__ Total Fee:
Main: 952-249�600 Fax: 952-249-4616 'wwv�r.v ci.o�:����:.; :nn.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: �'�`nt�'r7" r� = v�� - //� -.1-3 _�i _ ��:� �
Job Site Address: %/ �'p .����Z �a`✓��J , /�-i t-�v!�� �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes (�lo
If yes,a specia/event permit is required with Police Department and City Council approva!60 days prior to the event. Shuttle bus service wil!be
required unless appticant demonstrates sufficient on-site parking is available. Non-permitted events wi11 not 6e albwed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �i,m.t-C ��%c-��.v� �:���`�`�'�
State License# ���'�3'i� i� Expiration Date: �3 �� ��;;�
Lead Certification Number: �.�� ���v7c� ;2 Expiration Date: G� � _��,;
(for work on homes that were constructed prior to 1978
Phone: (cell) �6i� ) ��� -- �S-G G (office) �j�j) %��-C G� �
Mailing Address: /���v �,,, s-S.- City: ��yh,,�,,T,� ziP: s s-yy G
Contact Person: ,�F�� i3, ����f�f.���.f,,, Applicant is: ontrac o / Homeowner �c�rc►eo�e�
Email and/or Fax: ,�-�i<<�/�i�vE'�%✓ ,L'L'� /f.-r.-�-�z/3.:��,o..-- G c.�-._frrx_ . f�-----�_
PROPERTY OWNER INFORMATION:
Name: �'i�-c% L f,��� �
Phone(day): 9 s"�c - y-7�Z - s-y s�i
Address: %� yo �,�� ,l1�,�-r� CitY: �'��,,.,!� ZIP_ .SS� S G y
Emaif and/or Fax:
iPf�-+-+vs-rc f iP�/'�r�s'Gr` �fj! /�-'�o�����e7�... �f r/
PR�I IC�`T IAIC/1�MAT1/'1W. rl.,,....n .........,a.�..,.,,�:
tlOn: �/� � G=�.rJ i �Ts�i�f.v rS -i°!� ,9�z.� s':r,N�� s",zr <�f,,.,^-L_�
rYF Any eaRh movement may also require
❑ � �e Damage
MCWD review&permits:
❑ ( L�� `c;� � ; , orm Dama e Minnehaha Creek Watershed District(MCWD)
` ��� 9 18202 Minnetonka Blvd
❑ � ' � � ater Damage Deephaven, MN 55391
`' � �` --F=-- „ � �;'. � � � �) Phone: 952-471-0590
❑ ' � her: s ci Fax: 952-471-0682
_ ��'�-��:z � L �1`�;��r�c� � ��t , �,v,a,��:�.�r:irnehahacreek.orq
Es1 ` `� uding land) $ /7�, Sov
AP
• �d by the Building Department;
• �ect to the best of hislher knowledge. The applicant recognizes that they are
ion being aware that upon failure to do so, the staff has no alternative but to
• :o provide on this application is Gassified by State Iaw as either private or
ally cannot be given to the public but can be given to the subject of the data.
iot 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 agenaes required by law. If
ou refuse to su 1 the information,the a lication ma not be issued.
Applicant's Signature: ��.� /S�,�,.I..GG�.-- Date: �� �:� �S
Owner's Signature: Date:
Last Updated:03/06/2013
DATE
CfTY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. 0�0l�- olbos COMPLETED .� -a 7- /?
ADDRESS '�'� 4� �•
�NNER TELEPHONE NO.
CONTRACTOR ��'�N�l �� '��r
� DESCRIPTION �rKdv� 2�;0/•
t~y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q��LNAL ❑ WATER HOOK-UP �.EOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? OlMN9UCOMiRACTON TO MEET Y�OU:_IfEB_NO
� COMMENT'� p��,K�t ��cP�� �le� � �'q���� 4
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� ❑WORK SATISFACTORY:PFiOCEED �?ROJECT COMPLETE
W ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUWINCY
0 O CORRECT YYORK,CAII FOR REINSPECTION TEMPORARY
V BEFORE CdVERiNa PERMANENT
❑CORRECT UNSAFE OONDITION WITHIN H��• ❑p►{OTO TAKEN
INSPECTOR WILL RETURN ❑qTATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION RE(]UIRED.CAIL TO ARRANGE ACCESS.
ceN ror a,e next inspection 2a nours in advance. (952) 249-4600
Owr�erlContractor on site:
Inspector:
YYhite CaPYAnspector's FII� Camry CopyfSlM Notie�