HomeMy WebLinkAbout2016-01249 (windows) . • CITY OF ORONO * Z 0 1 6 - PJ 1 2 4 9 *
2750 KELLEY PARKWAY DATE ISSUED: 10/03/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2474 CASCO POINT RD
PIIY : 20-117-23-12-0020
LEGAL DESC : NAVARRE
: LOT 000 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 10,826.00
NOTE: WINDOW REPLACEMENT INTO EXISTING OPENINGS
APPLICANT PERM[T FEE SCHEDULE 216.81
STATE SURCHARGE(VALUATION) 5.41
THE HOME DEPOT A.H.S. MA[L-IN FEE 2.00
2690 CUMBERLAND PKWY, STE 300
ATLANTA,GA 30339- TOTAL 224.22
(763)542-8826 Payment(s)
Minnesota State License#: BUIL-CR268257 CHECK 76047 224.22
OWNER
STEWART,JEREMY&MAGGIE
2474 CASCO PT RD
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 thc
State Building Code. This pennit is for only the work described and does
not grant permission for additional or related work which requires separaCe
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 nuli 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 permiC may be
revoked at any time for due cause. ' -
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Applicant Permitee Signature Date Issued B Signature Date
.
� City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number: O/�"���
PO Box 66
C rystal Ba y, MN 55323-0066 D a t e r e c e i v e d: �Q��—7��
Street Address: U�, U� ZU�u Received by:
ti�, � 2750 Kelley Parkway Plan review fee:
tqk£ ��L Orono, MN 55356 ���
S Fi� ��� 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: p�y 7 Cp �', � _
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 �is available. Non-permitted events will not be allo�ved.
CONTRACTOR/AI THD �t- I lorrie Service, Inc,
Name: ?690 Cuil�berland PK���y, Ste 300
State License# Atfanta, GA 30339-3913 Expiration Date: �.-,�j�--��
Lead Certification N Lic# CR?6K257 f']h. 7Ciz�'S42-�8�6� Z-7(o -2 Expiration Date: �—�cj-Zp
(for work on homes rnar were cvnsiruc�eo Nn�. iv �y�o
Phone: (cell) (office)
Mailing Address: City,_ ZIP:
Contact Person: ^ Q � 7 _3�(S ���� Applicant is: Contractor 7 Homeowner (Circle One)
Email and/or Fax: �'�
PROPERTY OWNER INFORMATION:
Name: �CX e v�Y�,�/ S�"G(.lJ�-
Phone (day): 3�� Gj Z� l��jc�
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ 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
'�°Window(s) 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 information is to annually update our records and records of other governmental agencies required by law. If
ou refuse to su I th information,the a lication ma not be issued.
Applicant's Signature: �' � -1.,.� v �-- Date: � �2� '/ �
�
Owner's Signature: Date:
Last Updated:January 2016