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Home My WebLink About2009-00280 - windows � CITY OF ORONO PERMIT NO.: 2009-00280 ; 2750 KELLEY PARKWAY ORONO, MN 55356- DATE 1ssUEn: 06/08/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2475 DUNWOODY AVE PIN : 20-117-23-22-0014 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 006 BLOCK 008 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-LTNDEFINED VALUATION : $ 4,955.00 NOTE: (1)WINDOW REPLACEMENT IN EXISTING OPENING. APPLICANT PERMIT FEE SCHEDULE 118.00 THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 2.48 2690 CUMBERLAND PKWY, STE 300 30339- MAIL-IN FEE 2.00 (763)542-8826 TOTAL 122.48 Minnesota State License#: 20268257 OWNER VICKERMAN, DAVID&V[CKI 2475 DUNWOODY AVE WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT "Che work for which this permit 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 for additional or celated work which requires separate permits. All provisions of Iaws 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 timc for due cause. l�%�y`'"___ � / / Applicant�Permitee Signature Date Issued�3y gnature �ate � SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. � � Total Fee: $ Date Received: Entered By: Permit#• CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (p/ease pr�nt all informatio�i) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle o�ze) OWNER OR ONTRACTOR JOB SITE ADDRESS: a�� s �U �w o o � t, �C. ZIp; �S�J � � Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO Ifyes, a special event perntit is required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus seivice will be required unless applicant demonstrates sufficient on-site parking is available. Non-perniitted events will not be allowed. NAME OF OWNER: �n U l(� V( L j(�( {'I�Cr � PHONE: (hoine) �� - �L j � J (work) MAILING ADDRESS: /Z��$ D U n w�o C(S/CITY:C.JC/�!�ZG�a ZIP: S S 3 4 / THD At-Home Services, Ine. CONTRACTOR 2690 Cumberland Pkwy, Ste 300 _PHONE: �f S7 3 U S� L D�/7 CONTACTPERSON: _ Cumberland Office Park AGER: �bt[, Q �(41r nfl�S MAILING ADDRESS: Atlanta, GA 30339-3913 ZIP: STATE LICENSE: #_ Lic#20268257 Ph. 763/ 542-8826 DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) '—� Any earth movement may require MCWD review and permit�! PROPOSED WO�(describe in detai�: � L.,1 �/1 C�o W (�{ A1 1 !�n � S t d1 �' 1 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � � � � I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATiJRE: lG-- DATE: � � � 7 31 .�. � Sec.13AA R[GH'I'S OF SUI3JF,CTS OF DATA Suhd.1. Type of data. The rights of individual on whom die data is stored or to he srored shall be as set forth in this section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use ofthe requested data�vithin the collecting state agency,politica]subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known conseque�nce arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized b}�state or federal law[o receive the data. This requirement shall not apply�vhen an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax o�roqertv tax refund instructions instead of on those fomis. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and�vhether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disdosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individuai suhject ofthe data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturday�s,Sundays and legal holidays,if�mmediate compiiance is not possible. If'the cannot comply with the request within that time,he shal I so inform the individual,and may have an additional five days within which to comply with the request,excluding Samrdays, Sundays and legal holidays. Subd.4. Procedure�i�hen data is not accurate or complete.An individual may contest the accuracy or completeness ofpublic or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bclieves the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagrcement is induded with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",�ve would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you i'urnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusa] may require that the City deny the permit or license. 3. The informatio❑ may be shared �vith other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. T!'� �j c h � /1 �C. First Middle Last ll :�� a u �c n s.��u � ��r�ss �j�vu/'�lln �� 0 C��y State Zip Phone I understand my rights as stated above. �— Sign re 3? �� TIME � CITY OF ORONO CALLED IN � INSPECTION NOTI E SCHEDULEDS-Co�' _.�� PERMIT NO. ` �Q COMPLETED ADDRESS OWNER CON . 4T`� TELEPHONE NO. 3 Z— O S � DESCRIPTION ��ndOG� ` �n� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. oA fi�� ►'�o o� �C. ��f�1 e,e.....�e-r�'r' '' c�� ,ef' ��ra..fi f�eG. � � C�:��t.; j��.. t�r W � Q � Z W � W � � d � ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED �, SSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: � Inspector. � White Copyllnspector's File Canary Copy/Site Notice