HomeMy WebLinkAbout2016-00422 - siding CITY OF ORONO * z 0 1 6 - 0 0 4 2 z *
� 2750 KELLEY PARKWAY DATE ISSUED: 04/25/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2760 COUNTRYSIDE DR W
PIN : 04-117-23-12-0011
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 003 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : O/S BUILDING-LINDEFINED
VALUATION : $ 15,000.00
NOTE: NEW SIDING ON FRONT OF HOUSE
APPLICANT PERMIT FEE SCHEDULE 278.77
STATE SURCHARGE(VALUATION) 7.50
STERN,JON&MOLLY TOTAL 286.27
2760 CO[JNTRYSIDE DR W Payment(s)
LONG LAKE,MN 55356 CREDIT CARD 7872 286.27
OWNER
STERN,JON&MOLLY
2760 COUNTRYSIDE DR W
LONG LAKE, MN 55356
AGREEMENT AIYD SWORN STATEMENT
The work for which this permit is issued sha11 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 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 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
requested in conformance with the State Building Code.This permit may be �,/�
revoked at any time for due cause. Y
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Appli ant Permitee i ature Date Issued y Signatur Date
, City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number: � �� z
PO Box 66
Crystal Bay, MN 55323-0066 Date received: �-
� �
Street Address: Received by: �
ti�, G� 2750 Kelley Parkway Plan review fee: �
t �, Orono, MN 55356
�kESHO� � �� . ��
Total Fee:
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: � � v � � �
Job Site Address:
Will this be a Parade of Homes, Remodelers Showcase Ho or other Display Home? Yes No
If yes, a special event permit is required with Police Department and City Council approval 60 days prior 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/APPLICANT INFORMATION:
Name:
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) (office)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: � �
Phone (day): _ � 3_
Address: J City: (�f'(� ZIP: ��j�S
Email and/or Fax:
,� ,
_�`� � I
PROJECT INFORMATION: Overall project description: ! /1 , — T��'v.1 �'� !� ���5 �e
Type of Project: - ny e h movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage `�MCWD review 8�permits:
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ 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) $ — 'rl
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 annually update our records and records of other governmental agencies required by law. If
ou refuse to su I the information,the a lication ma not be issued.
ApplicanYs Signature: ��L�i. Date: �... � — �(f/
Owner's Signature: Date: �— ZS\— �lf
Last Updated:January 2016
•
DATE TIME f
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. X11 COMPLETED - /f/-/i
ADDRESS (27,U Cace.44-7.,rdQ a ,ar- Lr/ -
OWNER 3e0N- r,1 (TELEPHONE NO.
CONTRACTOR
E DESCRIPTION Re- 502-0
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
d ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
"7 ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
• 0 FRAMING ❑ MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UPOLLOW-UP
Y ❑AS BUILT-SURVEY 0 SEWER HOOK-UP ❑ OUNDATION/REMOVAL
d
0 DEMO-SITE 0 SEPTIC INSTALL
OMINERICONTRACTOR TO MEET YOU:_YES_NO
COMMENT'S: Pero/1:r- h (a.— (47/c0 Z— C-4.iC �orcc
O. ((4dI J /d 4r -t r
j Permit has expired per MN Building Code Sec. 1300.120 subp. 11
Expiration, no record of a Final inspection.
aC
CC
W 0 WORK SATISFACTORY.PROCEED 0 PROJECT COMPLETE
CC0 CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.I BEFORE COHERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR 0 CITATION ISSUED
o INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next Inspection 24 tours In advance. (952) 249-4600
OwneHCorrtra site:
Inspector: ' ~ ~
Whits Copyllnspsctoes FIN Canary CapYISIM Nonce