HomeMy WebLinkAbout2009-00594 - windows CITY OF ORONO PERMIT NO.: 2009-00594
� 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 09/16/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1913 FAGERNESS POINT RD
PIN : 17-117-23-23-0009
LEGAL DESC : FAGERNESS
: LOT 017 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 14,000.00
NOTE: WINDOWS&SIDING
APPLICANT PERMIT FEE SCHEDULE 250.75
STOVERN, BRANDON STATE SURCHARGE(VALUATION) 7.00
1913 FAGERNESS PT RD TOTAL 257.75
WAYZATA, MN 55391
PAID WITH CC# 2467
OWNER
STOVERN, BRANDON
1913 FAGERNESS PT RD
WAYZATA,MN 55391
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
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 fo,i.dtte�au�. �, �
--� , ���� T' /C
. r' U
- 5 >� - -`" -� l l 6 / U G ,�--�-�k, U�jl � �+ ''
Applicant Permite ignature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, City of Orono
. Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.) ,
/�� Mailing Address: Permit number: �—
.,��� PO Box 66 - �
i�Q,.� 0\ Crystal Bay, MN 55323-0066 Date received:
�i � �i
I a � � ;4.�7. s. ' Street Address: Received by:
��'�n � '�"� ti��� 2750 Kelle Parkwa
t , � �� / Y Y Plan review fee:
`�kESH� Orono, MN 55356
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:
Job Site Address: n f , � �. �' �
� l �� �CCC1E�hC � �C��� K�,� �
Will this be a Parade of Homes, Rem delers Showcase Home or other isptay Home? ❑ Yes o
/f yes, a specia/event permit is required with Po/ice Department and City Counci/approva/60 days pr�or to the event. Shuttle bus service wi/l be
required unless applicant demonstrates sufficient on-site parking is avarlabfe. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name:
State License# Expiration Date:
Phone: office (cell)
Mailing Address: Cit : ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFOR ATION:
Name: (�rc�,��r, :��UPrh
Phone (day):
Address: /q/ � r-�,�ie,,hc rS /��. / r,� City: �r<<��ti� ZIP�S,S�� /
Email and/or Fax �LFDLT�2(c� f��w�ct, l.ce�ti,
PROJECT INFORMATION:
I Type of Project: ' Any earth movement may require R,
� MCWD review & permits
❑ Door(s) ❑ Remodel ❑ Water Damage
Minnehaha Creek Watershed District(MCWD)
�Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Sidin �;L: ( ���'"� Deephaven, MN 55391
� g� ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 ,�
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage i www.minnehahacreek.orp
Overall Project Description:
Estimated Construction Valuation of Project (excluding land) $ j�l *� .,y
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
I
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they i
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
re uired b law. If ou refuse to su I the information,the a lication ma not be issued.
� � _.__ .
� `'�S
Applicant's Signature: � Date: ' �� ;�,�.
Last Updated: 05-04-2009