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Home My WebLink About2015-00417 - windows CITY OF ORONO * z 0 1 5 - 0 0 4 1 7 * � 2750 KELLEY PARKWAY DATE ISSUED: 04/13/2015 1, � ` ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS � : 825 FOREST ARMS LA PIN : 07-117-23-12-0011 LEGAL DESC : FOREST ARMS : LOT 003 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: REPLACING 6 WINDOWS IN EXISTING OPENINGS APPLICANT PERMIT FEE SCHEDULE 170.38 STATE SURCHARGE(VALUATION) 4.00 NIEMELA CONSTRUCT[ON INC. TOTAL 174.38 15170 87TH ST NE Payment(s) OTSEGO, MN 55330- CREDIT CARD 9522 174.38 (763)428-4484 Minnesota State License#: BUIL-BC602194 OWNER BRANDENBURG,NATHAN& BETH 825 FOREST ARMS LA MOUND, MN 55364- 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 no[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 construc[ion 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 due cause. �l /" � �S- `�,�� _;� ' � � v ' 'll�� ` i App�icant Permitee Signature Date Issued By S gnature Date City of Orono E�uil`�1ing Permit Application for Maintenance / Replacement / Remodel �(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) �O�O Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: y � 2750 Kelley Parkway Plan review fee: F �, Orono, MN 55356 `�k�SH�� 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: `,�� D r�, � t �,�,�� 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 service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �1,�� cY.7 r.y-�t�E-r+�r � �!1� State License# �� -��q y Expiration Date: s� �r - "Z� s � Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) �C�� ?`l�' - �� ?�'`� (office) 7�j-- `-f L�� `�f Lf'�� Mailing Address: ��-� �p �7 rn "r- �� City: �� , ZIP: j 5`; j v Contact Person: � � /�.� (, , '.� Applicant is: ontracto / Homeowner (Circle One) Email and/or Fax: ,' ;�z. c-% i� �c �u�� n;t';;_��-��;,:��1 �'tiv� t PROPERTY OWNER INFORMATION: Name: /��r�-f-G��. •� �s«v��-YL�r��.�%� Phone (day): 6�� - 75 c --� b S�3 � Address: �Z� �;,�z5t �r�i �,n City: t)(�,� � ZIP: Email and/or Fax: � !� ' � - _ ��c,� PROJECT INFORMATION: Overall project description: � i� �� Type of Project: Any earth movement may also equire � ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review& permits: ❑ 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 ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 [S�,Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ '3�7 � 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 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 required by law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: =��-�`--�� -?--� Date: `�'�? � � S Owner's Signature: Date: Last Updated:January 2015 � y� � ,/ DATE TIME �` ' CITY�OF ORONO CALLED IN -Y=__� � .� INSPECTION NOTICE SCHEDULED � � � PERMIT NO. ��- �� MPLETED ADDRESS � S OWNER � EPHO NO. �` ��Z CONTRACTOR �� `� - � � DESCRIPTION ��''��'��!'v ��-�n�� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � �„FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP � ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W a � J O �. _/ � O � W � Q � 2 W � w � j � GW ❑WORK SATISFACTORY:PROCEED tY�l PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WIIL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR G CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 h rs in advance. 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice