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CITY OF ORONO * z 0 1 2 - 0 1 2 5 0 *
2750 KELLEY PARKWAY DATE ISSUED: 12/17/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 980 FERNDALE RD W
PIN : 02-117-23-44-0019
LEGAL DESC : COUNTRY CLUB ESTATES
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDINC - UNDEFINED
VALUATION : $ 9,973.00
NOTE: REPLACG(11)WINDOWS IN"TO[?XISTING OPENINGS.
APPLICANT PERMIT FEE SCHEDULE 191.75
APEX ENERGY SOLUT[ONS STATE SURCHARGE(VALUATION) 4.99
8400 NORMANDALE LAKE BLVD#920
BLOOMINGTON, MN 55431- MAIL-IN FEE 2.00
(651)688-2739 TOTAL 198.74
PAID WITH CC# 5542
OWNER
SAFAR,JACK& PAMELA
980 FERNDALE RD W
WAYZATA, MN 55391-
ACREEMENT AND SWORN STATEMENT
l�he work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and thc
State[3uilding Code. This permit is for only the work described and does
not grant permission for additional or rclated work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not speciticd herein.'fhis 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 afler work has commenced.
The applicant is responsible for assuring all required inspections are
requested in confomiance with the State Building Code.This permit may be
revoked at any time for due cau e.
^ � � � � / �� / � �
App ' ant Permitee Sig ature Date Issu [3y ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
To: Png`2 of 3 ZO'IZ-'1Z-'17 '17:SO:OZ (GMT) From: Apex Enargy Solutions
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C�ty af Orono
Building Permit Apptication for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
_ —�:`� Mailing Address: pEnnit nut�►ber, �� -- ��
� 0,�. PO Box 66
I,� � Crystal Bay,MN 55323-0066 Dat�receiVed_ �o�. � — r�-� `
(��� � Recei��ci by:
a � , ,� ,�J Street Addrsss:
`,'�'�, ' � G� 2750 Kelley Farkway Plan review fee:
?�.E$�o8�/ Orono, MN 55356
-_--- Tt�tal�e�: �j�,
Main: 952-249-4600 Fax: 952-249-4616 www.ci.or�no.mn.Us ���' �
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GEN RAL INFORMATION: /�
Jab iteAddress: q�0 F�QNDACE �io�Q GL���
Will is be a Parade of Homes, Remodeiers Showcase Home or other Display Home? Yes No
li s,a specia/everrt permit is required with Police Deparfinent and City Council approva/60 days prior to the event Shuttle bus service will be
required unless applicent demonstrates suffm.ient on-sife parking is available. Non-perm7tfed events will not be a/lowed.
CON RACTOR/APPLICANT INFORMATION:
Nam : �}PUt �ivfRby Sac��'c�s c��/Y1in:n,�w"''N-, .�',vt._
State License# S�P�C�/�C.r� ��rv'TXi�1e�¢ t�1c�Pf'idJ Expiration Date:
-----
Lead ertification Number: ��f/}��'� �i�y� �-/ Expiration Date: ,$' y' .7�/�'"
(f work on homes fhat were constructed prior to 19T8
Phon : �,a 1^Fr 8b'^ Z 73`� {office) �/2-`7/p-.7Sa?fd (cell)
Maili g Address: ��oo /Vo2�t�C� CRwf f3��a, S��" �r2n City: �vomi�6•rc.0 ZIP: ,s'yf�'7
Con �ct Person: C,:.�R�st'�Ay�,Q �tietc�i2 Applicant is: ctor / Homeowner (Circle One)
Emai and/or Fax: t�'fr�¢�. �Q l4r C� �r�ftct i�: �'�rK ��c': �S/�- 3oS � b�/S/
PRORERTY OWNER INFORMATIO�:
Name: ��t� Ftn,p F�na�cR�,c��
Phone (daY): �b5�- ��b�- ;��'] Cwoa�r�
Addr �SJ ,��'rtNL�C� �o.�G �i.�E3T C�tY� t7�1oND ZIP: ,��Q�
Emai�and/or Fax = _ _
PROJECT IfVFORMATION:
Type of Project: Any earth movement may require
❑Door(s) ❑Remodel ❑Fire Oamage MCWD review$permits:
Minnehaha Creek Watershed District(MCWD)
❑Re-roof,asphalt ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd
❑ Re-roof,cedar ❑Restoration ❑Water Damage Deephaven, MN 55391
Phone: 952-471-0590
❑Re-roof,other(specifyr) ❑Siding ❑Other.(specify) Fax: 952-471-0682
[�Window(s) www,minnehahacreek.oru
Overall Project Description: R�Pu�t. if wrruDc�:.s — F�Crs�rivi DP�i�vEs
Estimated Construction Valuation of Project(excluding land) $ �;y7�
APPUCANT ACKNOWLEDGEMENT:
• Agrees to provide alt 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 revognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staif has no altemative
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 hut can be given to the subject of the
data. Confidential data is information which generally cannot be given to either ths public or the subject of the data. Our
purpose end intended use of this information is to annually update our records and records of other 9ovemmental agencies
re uired b law. If ou refuse to su I the infonnation e a lication ma not be issued.
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Appli nt's Signature: ` f�'�-- Date:
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To: Pape'1 of 3 20'12-'I Z-'17 '17:50:02 (GMT) From: Apax Enargy Solufions
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Facsimile
Building Inspection/ Permits—
I To: City of Orono
Fax: 952-249-4616 Pages: 3 Pages Including Cover Page
�� Phone: Date: December 17, 2012
Re: Building Permit Application
� Urgent �X For Review � Please Comment � Please Reply � Please Recycle
Attached is a building permit application for window replacements at the Safar residence
at.980 Ferndale Road West. _
Please either call or email me with the exact arnaurtt of the permit. I can then provide �
you with credit card information or mail you a check. 7"his is the first contraet we've had
in your community and I recognize every community is a bit different when it comes to
the permit application and payment process.
Also,�re we required to stop by to retrieve the application or are you able to mail it to aur
company address?
Thank you and Merry Christmas!
Christopher M. Collar
t'hristo�her.c��ll ar;c��maii.com
612-710-7534
8400 Normandale Lahe Blvd. Suite 920
Bloomington, MN 55487
Phone: 1-651-688-APEX (27a9}
Fax: I-651-305-8151
/ � DAT,� T,1AAE , /
� CITY OF ORONO CALLED IN ���� � � � `� ��
INSPECTION NO I E SCHEDULED � -vU
PERMIT N0. � ��2 ��I 2� COMPLETED _y
ADDRESS `1 cY Q � r n��� ���
OWNER`����C -S�'�-e ���-r^�ELEPHONE NO.C� `-�'�� V`r� �
CONTRACTOR �� x ����� `�-'�d�'
>; DESCRIPTION ►"�`"�`�� ��n`'z�
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW ❑WORK SATISFACTORY:PROCEED c�PF�ECT COMPLETE
� ❑CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
�NSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
Owner/Contractor on site:
Inspector. aG ''�
White Copyllnspector's File Canary CopylSite Notice
�� /`"' DAT TIME �
CITY OF ORONO CALLED IN �a?
INSPECTION NOTICE SCHEDULED / �
PERMIT NOc�1f�- 'G���� COMPLETED
ADDRESS �C�C� �1'��C� '
OWNER TELEPHONE NO. ��� ��4� �S�/
CONTRACTOR '�' ���
� DESCRIPTION �-�11�� ��
�
1y� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
�
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COVER REMOVAL
J BING RI � SE ❑ FOUNDATION/REMOVAL
2 OWNE NTRACTOR TO MEET YOU YES NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca xt inspection 24 hours in advance. (g52) 249-4600
O erlContractoronsite: � a��
Inspector. �
White Copyflnspector's File Canary CopylSite Notice