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Home My WebLink About2011-01319 - doors � � • ' CITY OF ORONO PERMIT NO.: 2011-01319 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUE�: 10/25/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 509 FERNDALE RD N PIN : 36-118-23-13-0011 LEGAL DESC : FA[RWAY VIEW : LOT 000 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL COI�ISTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 17,500.00 NOTG: REPLACE 5 PATIO DOORS APPLICANT PERMIT FEE SCHEDULE 309.75 ULTIMATE EXTERIORS OF MINNESOTA LLC STATE SURCHARGE(VALUATION) 8.75 425 1 OTH ST NE MILACA, MN 56353- TOTAL 318.50 (888)360-6633 Minnesota State License#: BC489489 OWNER SUTTON, GEORGE& KATHY 509 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AND SWORN STATEME1vT The 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 permfssion for additional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 for cause. � �O / Z5 / // / / ' ant Permitee Signature Date Issued By S� ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . . � � City of Orono ��3� � Building Permit Application for Maintenance / Renovafion (windows, doors, siding, re-roof, etc.) Mailing Address: / �v�,� PO Box 66 Permit number: Q 4 � Crystal Bay, MN 55323-0066 Date received: ��`��,r i Received b �a ,,�, s, Street Address: Y� �'�,n g �t a�'�, �ti 2750 Kelley Parkway Plan review fee: t'�tfESHo�`� 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: Q � Q� ,� d.,,�,( � �� .j �,.r.�-� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No lf yes,a specia/event permit rs required with Police Department and City Counci/approva/60 days prior to the event. Shuttle bus service wrl/be required unless applicant demonstrates sufficienf on-site parking is available. Non-permitted events wil/not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��-�-� �_ x-�-�� `o .- � c�� -�� State License# c < < ��`� �� -/ Expiration Date: `� --'3� _ �� Z Lead Certification Number: �� -� � 3 -z � _ � Expiration Date: ��, ry�� (for work on homes thaf were constructed prior fo 1978 � Phone: ��1S - �(c b =- 6 fo�� (office) � �-j2 c�7 - Z �Z,— �.0 �G. (cell�� 5 Mailing Address: � � � -��— � � City: � r� ZIP: r c��_ � � � Contact Person: �,� ,� � d-� �..z.� Applicant is: n ractor / Homeowner (Circle One) Email and/or Fax: -- PROPERTY OWNER INFORMATION: Name: �`�t�._., �.- ��m �� q S.,-N� .-. Phone (day): (o f � 2 2v - S`�c�� Address: �Or -('s�,-- , C �_ -�(Z�.. � �-/ City: �G.y,pr�� ZIP' SS 3`� 1 Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require oor(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt ❑ Re air Minnehaha Creek Watershed District(MCWD) p ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other s eci Phone: 952-471-0590 ( p fy) � ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 .S p`-E, �: �� www.minnehahacreek.orq Overall Project Description: `'��p��. � ,P � �� .�,� `.t �, a,,r. � Estimated Construction Valuation of Project (excluding fand) $ , 7 �p c.� 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 alternafive but to reject it until it is complete; • Some or all of the information that you are asked to provide on this applicafion 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 lication ma not be issued. ApplicanYs Signature: _ - - Date: l�•� 2-�~- r � Last Updated: 08-09-2011