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Home My WebLink About2010-00157 - windows CITY OF ORONO PERMIT NO.: 2010-00157 + � � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 03/18/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 965 EDGEWOOD HILLS RD PIN : 02-117-23-14-0001 LEGAL DESC : REG. LAND SURVEY NO. 1098 : LOT 000 BLOCK 000 PERMIT TYPE : M[NOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS tY'•{ib�t�� c-1-� 8i��t�3 VALUATION : $ 70,000.00 NOTE: REPLACEMENT OF DOORS,WINDEOWS AND SIDING APPLICANT PERMIT FEE SCHEDULE 831.75 JAMES PATSCH CONST INC. STATE SURCHARGE(VALUATION) 35.00 3427 HUMBOLT AVENUE S TOTAL 866.75 MINNEAPOLIS, MN 55408 (612)527-01 I 1 PAID WITH CC# 8239 Minnesota State License#: 4290 OWNER CUSICK, MR. & MRS. THOMAS 965 EDGEWOOD HILLS RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT Thc work for which this permit is issued shall be peribrmcd 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 relatcd 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 applica responsi for assuring all required inspections are re uested n c rmance ith t State Building Code.This permit may be re ked t y e for e cau � � � i i cant ee Signatu Date Issued By S'g ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO . - City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) �0�, Mailing Address: Permit number: /�v ,�j� PO Box 66 .il� O \ Crystal Bay, MN 55323-0066 Date received: � s� Received by: � �'�.��.'�' s.�I StreetAddress: '" �''� �' � 2750 Kelle Parkwa �`' o~ Y Y Plan review fee: L�kESHo4'� Orono, MN 55356 - Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This app�ication form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: / Job Site Address: � �W�p� � � Will this be a Parade of Homes, Remodeler howcase Home or other Display Home? ❑ Yes o lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLI ANT INFORMATIO : � Name: � L- S r State License# E piration Date: ?j �� Phone: — S office - s Z cell Mailing Address: Cit : ^ S ZIP: s p Contact Person: Applicant is: ontracto / Homeowner (Circle One) Email and/or Fax: ' S e�/' `, , PROPERTY OWNER I FORMATION: Name: �p� � Phone (day): S2- _ 2 � Address: � � Cit : ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require �oor(s) ❑ Remodel MCWD review 8� permits ❑Water Damage ,�Window s Minnehaha Creek Watershed District(MCWD) ( ) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Sidin Deephaven, MN 55391 g ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 ❑ Re-roof Fax: 952-471-0682 ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: e U �,�5 ` _Estimated Construction Valuation of Pro�e t(excluding land) $ "70, OD� Gt�xi�y�ac�q� �� 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 info ion is to ually update our records and records of other governmental agencies re uired b law. If ou refu e to su the information the a lic tion ma not be issued. ApplicanYs Signature: Date: Last Updated: 05-04-2009 ��/ , � , / �� DATE TIME `� CITY OF ORONO CALLED IN � �L' INSPECTION NOTICE SCHEDULED ��LZ� � PERMIT NO.��(%�1' ��I C� 7 COMPLETED a��REss ��L�� c_✓�C�l c_� �C�,�'i�� i�/.S OWNER TELEPHONE NO. �/%.� -�J�� '��z CONTRACTOR "�-J�t��'?'�_') ��Q--�S��-� ��. � DESCRIPTION I �,�._.L_I'L'1��`t-c.� ��'k'��-1 � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTI�FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU•.j�YES_NO /\ � COMMENTS: � � � W a � J O � � O � W � Q � Z W � W � � d � ❑WORK SATISFACTORY:PROCEED OJECT COMPLETE W ❑CORRECT WORK 8 PROCEED J ISSUE CERTIFICATE OF OCCUPANCY � �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 4 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. ' White Copylinspector's File Canary CopylSite Notice