HomeMy WebLinkAbout2012-01033 - addn/remodel/repair �
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CITY OF ORONO * z 0 1 z - 0 1 B 3 3 *
2750 KELLEY PARKWAY pATE tSSUE�: 10/16/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2700 ETHEL AVE
PIN : 20-117-23-24-0013
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 002
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/ REPAIR
ACT I V ITY : 434-RESIDENTIAL
VALUATION : $ 1,680.00
NO'I'E: INSTALL(3)WALL ANCHORS IN SOUTH WALL OF MECHANICAL ROOM-(3)CONCRE"I�E PATCHES INTO GARAGE FLOOR
AN D
TUCK POINT IN JOINTS WHERE CONCRGTE HAS FALLEN OU"1'.
APPLICANT PERMIT FEE SCHEDULE 64.00
JESSE TREBIL FOUNDATION SYS INC. STATE SURCHARGE(VALUATION) 0.84
60335 U S HWY 12
LITCHFIELD, MN 56387- MAIL-IN FEE 2.00
(320)974-8729 TOTAL 66.84
Minnesota State License#: 20446489 PAID WITH CC# 3188
OWNER
MORRIS, DEBORAH
2700 ETHEL AVE
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
fhc work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and [he
State Building Code. This permit is for only the work described and does
not grant pennission 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 specitied herein.This permit will
cxpire and become null and void if construction authorized is not
commcnced 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 Ihe State Building Code.This permit may be
revoked at any tim�for due cause.
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Applicant Permitee Sign• Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
OC�-I�S-�"a12 21:07 FROM:TREBILFOUNDATION SYS 3205938720 T0:19522494616 P.2�3
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� Cifiy of Orono �� ����� r����� '��e
Building P�rmit Application for Maintenance / Renovation '�a r`' -�6-' z
(wlndows, doors, slding, re-roof, etc.)
Mailing Address: p�rmiC number; o��/o�-�/U�
I Og,O j�O PO Box 66
Cryatal Bay, MN�5323�0066 Data received: ���6��
� ' Str�et AddreSs. Rocolve.d by,
G� 2750 Kelley P�ikwdy PI8r1 fCVlBw('eC:
I � �.� Orono, MN 55356 � /
! �� Totel Pee; /,�� �L�
Mein, 952-248�4600 Fax: 952-249-4616 www.cl,orono.mn,us Y 1
�� This application form must be completed in full and all required informetion must be submitted.
Inoomplete appllc�klon�wlll ba retumod. (Plaasa p�nt)
GENERA�INFORM4TION:
JQb Slte Address: V�
VI'lll thls be a Parade of Homes.Remodelers Showcasa Homs or other Dlsplay Home? Yes No
� Nyat,a spedal e�renC pem►�Is ispuWd wRh Pollce Depa�trnent and C!!y Councll approva180 deys pibr to the ovsnt. Shuttb bu9 esMc+e wlll bs
roqui�ed unless eppllcent demonstretes 8uflsc�ent orrslte parking.ls avaUabls. Non-pem►lftsd susnts wlll nof bs elbwed.
CQN7RACTOR/APPLICANT INFORMAt10N:
N�e' ��Q�.a�.T('�� �i����-i�r� ���n
Spte �icense# b� y y.������ �— Exp�retion Dete: �_3 I� 1�
L ed Certification Number. y��-_ , ,� a�q_ � Explration Dete: 3_ ��_����
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(tw worfr on homos LhBt were consbuc[�ed prlor to 1878
P�one; ���_ ��� _ (o�ce) (ceU)
MPiling Address: City: �� ZIP: �'
CQntect Person: L�����Qp �a,a�� Applicsnt is: ra / Homeowner �c��i.o�.�
Email end/or Fax: � rn�n � S1��P�r��ma v��� ,C��C't.1. ......�.�.� .�s�Q:�.��'i� — �7�
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P�tOPERTY OWN6R INFORMATION: .
N�me= _�P blo.�� �(Y1ron�l„�,�
Phone(dey): 1 I„�-,�3\ " I 1�3 1
A�dreas: c�l`I D� E`�-hp a �,� ��ty� , r t�C� ZIP: a� '`�J 3 �,
Email and/or Fax
PROJECT INFORMATION:
Ty�pe of ProJec� Any earth movement may raqulre
[�Door(s) Q Remodel ❑Fira Demege MCWD re�vl�w b pertnite;
Minnehahe Creek Watershed qistrict(MCWD)
[�Re-roof,esphalt Rapair ❑SDorm Oamage 18202 Minne�tonka Blvd
❑Re�roof, ceda� ❑Resroradon ❑Weter pamage OBepheven, MN 55391
Phone: 852-471-059a
[,�Re-roof, other(spac�y) ❑ 5iding ❑Other: (speciFy) Fex: 952-471-0662
� Q Window(s) �vu�nv,minnehahacreek.ora
Overall Pro eet Descrl lon:Z ', � ;
E�tlmatsd Constructlon Valuation of Pro ect(excludln land) S � 3 ` ��a�
ARPLICANT ACKNOWLEDGEMENT: �1�� � �� ��� I n'����
• Agrees to provlde ell infonnetion required or requested by the Building DepBrtment; g�,��,
• Certifies that tfia infoRnetion supplied is true and Co�reCt to the best of hlsR�er knowledge. Tho epplicant reoognl2es thet they
ere solely respor�sible for submitting e C�mplete epplication being eware t�at upon failure to do so, the ateH hae no alt�ametive
but to reJed ir until it ia complete;
� SOme or all ot the infonnatlon that you ere asked to provide on thls applicaaon is daeelfled by Scate taw as either private or
con6dential. Privete data is informetion which generally pnnot be given to the publlc but can ba given to the subject.of the
data. Confiderrtiel data Is InfOmlatlon which genefally cannot be given to aither the public or the eubJect of the d�te. Our
purpose end ir►tended use of titis infomlation is to annually update our remrds and records of other government8l egencies
uired b law. if u rofu8a to su I the informetlon tne e Ilcatlom m �ot bo issuaC.
Ap licant's Signature: L.�1,�. o OQ o . I,'� c n� � R��n� Date: I O _
L88 Updetad; 0&-09-2011 .
OC�-15-?�12 21:08 FROM:TREBILFOUNDATION SYS 32059387z0 T0: 19522494616 P.3�3
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Quality YVe Can Guarantee ForemE,n �.�
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,p►pproxirnate number of days for job com.pletion: � Xear Built: �,(:�
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Non-Refundab7�Dcposit $ G er One unt of b ��
I�ate � Check# Yes D No Pltiia ermit
O 1Xomeowner to get permit
Qu�pcioriry is to fix the problem with your foundation,that's what our customers rely on us Cor, Keep in mind th�t
we csan not be responsible for any finish carpentry,painting,paneling;etc,that may be necessary after our work is
Gompl�Ced,resse T�cbil Foundation Systems,Xnc.will noi be respnnsible far uny landscaping,rest�ding�r rc-coding,
unless otherwise noted on bid,
We will call "Gopher One" to have all public underground lines locaCed,!t you have private lines such as satelli�e dish
Gables,propane line,sprinkler systcm,etc.you are responsible for marking them.Jesse Trebil Foundaaon Systems;
Inc, will not assume responsibiliry iF there i.ti damage to private lines.If you live ar A rur�address,public lines will
on'ly be located to the pole or youz property line. Tf damage co any of[hesc lines in an area that was not marked
occurs,.you will be responsible�or all repairs, If your city requires outside engincaring,this quote may need to be
nwritten co meet their recommondstions, Any addiblonel fees i�cuned are not included�o thls bid�nd are the
Customer's responsibility.
T: Pa�men!l�� ue 0)1 COlflDleliO)!. 2q6 sur�h�rgr on 14aarort:ad/Nru/D/�rnver
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1�epresontAuve's Signature• Authoriaed Signature
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