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Home My WebLink About2016-01175 - windows � CITY OF ORONO * 2 0 1 6 - 0 1 1 7 5 * 2750 KELLEY PARKWAY DATE ISSUED: 09/23/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 630 DEBORAH DR PIN : 31-118-23-22-0008 LEGAL DESC : MCCULLEY FARM : LOT 001 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 9,610.00 NOTE: REPLACING 4 WINDOWS WITHIN EXISTING OPENINGS APPLICANT PERMIT FEE SCHEDULE 201.32 STATE SURCHARGE(VALUATION) 4.81 RENEWAL BY ANDERSON MAIL-[N FEE 2.00 1920 COUNTY RD C. WEST ROSEVILLE, MN 55113 TOTAL 208.13 (612)502-4777 Payment(s) Minnesota State License#: BUIL-BC130983 CREDIT CARD 8788 208.13 OWNER KEILEN,MICHAEL&SARA 630 DEBORAH DR MAPLE PLAIN, MN 55359- AGREEMENT AIYD 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 applicant is responsible Yor assuring all required inspections are requested in conformance with the State Building Code.This permit may be ,� ' /. � revoked at any time for due cause. � � � �� ' �� ? /'-� c w f S�` � :� �� 1 � �� Applicant Permitee S gnatur Date Issued By Signature Date City of Orono Building �'ermit Apptication for IVfaintenance / Renavat�on (windows, doors, sid�ng, re-roof, etc,) .. r MailirrgAdd�ss: p��j�number: Q�O�O PO Sox 66 Crystal Bay,MN 55323-0066 Data r�ce3ved: � Recelved by: � � Street Address- _ � 2750 Keiley Paricway l�lan reviewfee: �'�� ,QG Orono, MN 55358 � Total Fee: � �� f�- Main: 952-248-4600 Fax: 95Z-249-4646 www.ci,orono.mn,c,?� � This appilcatiors farm must be cor►tpleted in fuii and ai) required irrformation must be submitted. Incomplete applic�tions will be returned. (f}lease p�int} �r�Sc4 ,_ GENERAL INFdRMATiON: � 2� � �,�� 1�� Job Site Address: J Witl this bs a Paracf�of Homes, Retnadeler^s Showcase Home or other Display Ham�? Yes Na !f yes,8&pe�Quired u�ss appl�a t demonstra/tes�Su�c/ent on-si'Ye p�Rg!s ava�labl�.'Non-permltted vants w71 nOt b�Ilow6d en+ic9 wllf be CONTRACT'QR!APPLICANT iNFORMATEON: Name: '�re \ 'A'��[�'� � State License# '$C,13p`1 _ �xpiration �ate: 3 j 3 S Lead Certlfication Number: �j r � a$� � Expiration Date: '{ (for work on hom�s thaf were consfruct�tf pripr to 79�8 (�ell} Phane: (05l� c�l� —��0�$` �, (oi#ice) Mailing Address. � � •• „ W��h' ��tY��Sev; �, ZIP- SS I 3 ContaGt Person: Appllcant is: ont cto / Fiomeowner {cs.��e o�> Emalf andlor�ax: �ROPERTY OWNER 1 FORMA�"10 Name: ��► -f.t��"`�� Phone(day): 1 a• S� r �1 O Address: C��' Zf�� Emafl and/or Fax PROJECT INFURMATtON: Type of Pro]ect: Any earth mavement may require MCWD review&pemtits: ❑ Door(s) [] Remodel [�Fire Damag� Minnehaha Creek Watershed District(MCWD) �] Re-roof, asph�It �Rep�ir [� Storrr►Dam�ge 482Q2 MinnBtanka 91vd D�ephaven, MN 55391 ❑ Re-roof,cedar ❑Resioration [�Water bam�ge phone: 952-471-0590 �Re-rodf,other{speciiy) ❑Siding ❑Other.(spec�jr) �ax: 952-471-0682 . www minnehah creek.o ❑Windaw{s) Overail ProJect Descrip#ion: �G� �-{. t�..;r�dow5 t�l;� �� ' Estimated Constructlon VaEuatlon af Pro (excluding land) $ q lA 0.0 APPLfGANT ACKIVOWLEDGEMEN . • Agrees tp provide�N information re red or qussted by the Bui{ding Departm�nt; . Csrtfies that the information eupplied is true and corr�ct to the besi o#his/her knawledgs. 3'he applicant recognizes that they are solety responsib}e for submitting s complete applicattors being aware that upon fa�fure to do so, ihe stafF has no altemative but to reJect it untll it ss complete; . Some or alI af tfie ��iormatlon that you are asked to provide on thls applicstion is alassi�ied by State law as either private or confidsntiai. Private data is information which ger+erallY cannot be given to the public but can be glven to the subject af fhe data. CRnfldenfia8( data is inforrnation Which generaily cannot be given to eiih0r the publEc or the subJect of the data. Our purpose and intended use of this lnformatiqn is to annueily update our recflrds and records of ott�er governrnenta! ag�ncles ra uired b law. If ou refuse to 8u 1 fhe info�rnati�n the a (icatlon ma not ba issued. Aot�licanYs Sianature: �a�" . �� ✓ � DATE TIME CITY OF ORONO CALLED IN INSPECTION OT CE � SCHEDULED � ►Z � PERMR NO. � � '� COMPLETED ADDRESS � l' ` ' �'�` `�� ' OWNER TELEPHON NO. j�� `��' CONTRACTOR � 1 � � �� DESCRIPTION T— l~y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ jNSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v�INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W�❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ DEMO-SITE ❑ SE TI INSTALL J 2 OWNEAlCOlRMCTOR TO ME�U:_ _NO y COMMENTS: W ` - � y w ,uca�� re�. sQ�� ,Z�; s�,�� o ��yt� - . '` 'r TG r��r� w� �r no�S D �'U vr,d e�rl d't � � ° 5�4�r /a�r�K�� W � Q � — F�.�.tj� Gtts<<G�K� ��` aJ►lVt7�-� - 2 � ��5�` o� �Jo�,� <bm,�ot..tc — j Gpr fCc��( /�rrH�� rlLl�� ❑WORK SAT�SFACTORY:PROCEED OJECT COMPLEfE W ❑CORRECT W'ORK 3 PROCEED O ISSU FlCATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERIN(3 PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ p�{OTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑INSPECTION REWIRED.CALLTO ARRANGE ACCESS. Call tor the next inspection 24 hours�n advanoe. (952) 249-4600 OwnerlContractor on site: Inspector:�� White CopyAnspsctor's Fils Canary CopylSM�Notks