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Home My WebLink About2016-00592 - chimney repair CITY OF ORONO * Z 0 1 6 - 0 0 5 9 2 * � • � 2750 KELLEY PARKWAY DATE ISSUED: OS/3ll2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 77 FERNDALE RD N PIN : 36-118-23-44-0006 LEGAL DESC : ALLO-RAE TERRACE : LOT 002 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CHIMNEY-REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 4,000.00 NOTE: REBU[LD CHIMNEY&REPLACE CAP APPLICANT PERMIT FEE SCHEDULE 108.38 PLAN REVIEW 70.45 SELA ROOF[NG&REMODELING, INC. STATE SURCHARGE(VALUATION) 2.00 4100 EXCESIOR BLVD ST. LOUIS PARK, MN 55416- TOTAL 180.83 (952)915-7227 Payment(s) Minnesota State License#: BUIL-BC1050 CHECK 37038 180.83 OW1vER KNABENSHUE, PAUL&ALYCIA 75 FERNDALE RD.N 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 l80 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 appiicant is responsible for assuring all required inspections are requested in conformance with the S uilding Code.This permit may be revoked at any time for due se. _ ��,�� f�C� �� 7 ��7 I � � � App icant ermitee Signature Date Issued By Signature Date City of Orono B�ilding Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) O Mailing Address: 1� ��-. � l �_� . �- � PO Box 66 ( � Permit number: _ r" ` ' -� --- � Crystal Bay, MN 55323-0066 `�"` Date received: : " � � � � v Street Address: Q�`�J�I�� Received by: ' �� 2750 Kelley Parkway '�� Plan review fee: "' F��t(� � �<k_1 '`� � �� Orono, MN 55356 qkESH�� Total Fee: / �/� �'� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 6 U This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION:� � ,n^,/�� A � Job Site Address: �� Y 1(/l�(/1, �\/ Will this be a Parade of Homes, Remodelers Showcase Home 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 se i e will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFO ATION: Name: State License# Expiration Date: � Lead Certification Number: Expiration Date: (for work on homes fhat were constructe prior to 1978 . � Phone: (cell) (office) � � Mailing Address: City: N,�s ZIP: Contact Person: Applicant is: C ntracto / Homeowner (Circle One) Email and/or Fax: � PROPERTY OWNE�RMATION: V L V lX/ Name: Phone (day): (,Q�Z ' I - �Q( � Address: �1_��j( (,( � � City: D(��,{� ZIP: � � � Email and/or Fax: PROJECT INFORMATION: Overall project description: b � � � 1 -" r � � Ul Type of Project: Any earth move nt may also require ❑ Door(s) MCWD review&permits: ❑ Remodel ❑ Fire Damage ❑ 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 �O�her: (specify Phone: 952-471-0590 �l ,�n '„ / Fax: 952-471-0682 ❑Window(s) � ►��1. www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 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 i r is to annually update our records and records of other governmental agencies required by law. If ou refuse to su the inform io ,the lication ma not be issued. Applicant's Signature: Date: � Owner's Signature: Date: Last Updated:January 2016 �� j j � � �� ^ � � � ,-� � � �- � � -�`. � � � � � � � .� � � � _ � � �� . �, _ � � � �J �� -��- � ^ � ` Q — � � � S S� � � � -' ,� � � � �.ss � S �.,` C� � .� � .� _,. � = 5 � � � � - � � 5 �? � � S � �' ~ '�. � ,,�r.� � v� -�., � (V R�i � , C, '�'� 5' S � � �, � `� f� N ,._ ., � ' � � � � � � � � N t�.r � � � � d .. _ _ ___ � � c � � -�- C�' `� c-� � � � � � R � `n � � v � � � � � � m o � � 3 � � �o co � . � � �. � � � A a �' I 1 �• � 1 � j � � �. Q a � � 1 (� � � �� . O �� : �. � � , � � '- � f� �Q `� ✓ •/`-'� ` DATE TIME CITY OF ORONO CALLED IN _� INSPECTION T C � SCHEDULED , _1��.�C PERMIT NO. °� ��'� COMPLETED ADDRESS -� __7 �'_.t � � ��'1��t. �� C� '" OWNER TELEPHONE NO. � �� CONTRACTOR `� � DESCRIPTION ��r � � '� � lV ❑ FOOTING ❑ DEMO-FINAL ❑ SE C FINAL/C�/�`/�r� Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/ LLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL � Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS��j� � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT ! /i �� Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ PTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: — , a �<CS• r''lt r w�r!Qy �'�lJ�c. i --� 'r�,O�C� � v Cd� � �.. • � - ;SiDG�k G�r�S��s ,vraa�oc g — O / �+ W l�� C Q Gf�� !J��r� Sa��iZ�} fi4'Ge4 H�C�G� � �`1��l/lcv - Q Z /c L'S�6-F k��lL �cPrQca�3 ��i��c � � a � � j ('}� �'1��[ti �1- �Gr`�r L` �iilrcl�Q d W� ❑WORKSATISFACTORY:PROCEED �i?'4�ROJECT COMPLETE W }�66RRECT WORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY O��O CORRECT WORK,CAIL FOR REtNSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector.��7'� White Copyllnspector's File Canary CopylSite Notice