HomeMy WebLinkAbout2016-01297 - windows CITY OF ORONO * 2 0 1 6 - 0 1 z�
2750 KELLEY PARKWAY DATE ISSUED: 10/13/2016
ORONO, MN 55356-
' (952) 249-4600 FAX: (952) 249-4616
ADURESS : 2715 COUNTRYSIDE DR W
PIN : 04-117-23-12-0019
LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN
: LOT 004 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 2,957.00
NOTE: REPLACEC 2 WINDOWS IN EX[ST[NG OPENINGS
APPLICANT PERMIT FEE SCHEDULE 92.89
STATE SURCHARGE(VALUATION) 1.48
SCHERER BROS LUMBER MAIL-IN FEE 2.00
10751 EXCELSIOR BLVD
HOPKINS,MN 55343 TOTAL 96.37
(952)277-1600 Payment(s)
Minnesota State License#: BUIL-BC239369 CREDIT CARD 3281 96.37
OWNER
WILSON, MARK& K[RSTIN
2715 COUNTRYSIDE DR W
LONG LAKE, MN 55356-
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
Sta[e 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 govcrning this type of work
shall be compied with whether or not speci6ed 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 construclion 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. I��7
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Applicant Permitee Signature Date Issued By Signature Date
OcT, ?2. 2G16 12: �3PM � No, 3104 P, 1/1
� C��1 �v ��. Y
erm�t A lication fof Main�e�ance 1 Re �acement! RemQdei Res�d�ntia,l pN �
�� o rona
. Building P ' pp p L..Y.
(i.e.wir�dows, dovrs, sidir,�, re-rvof, etC.—N� STR!!�'�URAL �XPANSIO�!)
� �OA k MaIlIPQ Boa 66 I Pefmit number ,;t� '" s �� /
1 __. . >
VQ Crystal Bay, MN 55323-D066 Date;rec�iv�d '�►
Street Add�ess: Fteceived by
�. � 2750 Kelley Parkway PJ�n�revlev�(�a, +�-r. .
`�� . tiv Orono,MN 55358 : �, ',
��kFSH06 �'ofal Fe� ,� 1: �'
Main, 952-249�600 Fax; 952-249-4696 ww�H ci.orono.mn.us �(,'"J,-; ., _
This application form must be completed in full and alf required information must be submitted.
Incomplete applications wlll be returned. (Please print
G�NERAL INFOFiMATION• �7 � � �Q �I�����1 I � Ue
Job Sit�Address: - rZ'�- + l� ��� —
WIII thls be a Parade vf Homes,Remodelars Showcase ome or ofher Isplay Home? ❑Yes IVo
fl yes,a special event perml�Is required with Police Depanm�nt and City Councll approva180 days pnor t�!he e�enf. ShutUe 6us servrce Will bn
required Unless appficant demonsttstes suf�lGent on-srte parking is available. Non-permitted events wi11 not be allowed.
CONTRACTORIAPPLICANT INFORMATlON:
Name: ��irlL'.��� YI�S
State Licanse# C,c� ' Expiratlon Date� g
Lead Certification Number: `�(1�--� Expiration Date�
(for work on homes that were constructed rlor to 1978 �7 g
Phone: (cell) p (afFice) %`� ��� � � l c�
Malling Address: (/ City� f ZIP� L '
Contact Person: �r Appficant is: Contractor / Homeowner �c�ra�o�e�
Email and/or F�x: � �
PROI'ERTY OWN�R INFORMATION: ,
Name; ��
Phone(day): - �{ �
� itY: �U Zlp: � � �j
Address: r i�
Email and/or Fax�
PROJ�CT INFQRMATION: Overall pro'ect descri tion:
7ype of ProJect: Any earth movement may also require
MCWD revlew 8 permits:
� ppp�(�� [�Remodel ❑Fire damage
❑ae-roof,asphalt �Rapair []Storm Damage Minnehaha Creek Watershed District(MCWD)
95320 Minnetonka Blvd
CI Rs-roof,cedar ❑Restoration ❑Water Damage Minnekonka,MN 55345
p Re-roof,ot�er(Spacliy) ❑Sidfng ❑Other.(specify) Phone: 952-a71-0590
r� Fax: 952-471-Ofi82
__ �4(iqdflw(s) _ C_-- _ Nnaw.minnehahacreek.orq
Estimated Construcfion Valuatlon of Project{�xcluding land) $
APPLICANT ACKNOW��DGEMENT;
. Agrees to provide all information required or requesled by the Suilding Departmenl;
• Gertifies ihat the Information supplied is true and ccrrect to the best oF his/her knowledge_ "fhe applicant recognizes that they are
solely responsible for submitting a completa application being aware lhat upon failure to do so, l`�a staff has no alternative but to
reject it until it is complete;
• Some ar all of the informati�n that you are asked to provide on this appllcalion is classified by State law as aither privaEe ar
confidential. Private data is information which generally cannot be given to the public but ean be giv�n to the subject of the data.
Confidantial data is]nforma�ion which generally eannot be given to either the public or the subjec�of�he data. our purpose and
intended use of this information is io annually update our records and records of other governmental agencies required by law, 1f
ou refuse to su I t Info ation,the a lication ma not be issued.
App�icant's Signature: '` l.��ate� 1
Owner's Signature: pate: _
Lasl Updated:January 2016
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE _
'
PERI NO. e/a9
• 7 .�•a1/ct
ADDRESS 2?IS' eti4rrs:.62. ors IJ •
OWNER TELEPHONE NO.
CONTRACTOR Sc#1 a.r e3• /i os
DESCRIPTION k4 Vain')
ladle.
Q FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
t Q POURED WALL 0 PLUMBING RI 0 EXCAWGRADINGIFILLING
0 FOUNDATION WATERPROOF 0 PLUMBING FINAL Q TREE REMOVAL
Q RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q FRANKING Q MECHANICAL FINAL Q RATED WALLS
• 0 INSULATION 0 WOOD BURNERIFIREPLACE 0 COMPLAINT
i Q FINAL Q WATER HOOKUPLONNUP
Q AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATIOWREMOVAL
; Q DEMO-SITE Q SEPTIC INSTALL
TOMEET YOU:_YES_NO
COMMENT& Air -t AdAPe✓ 44.i pO 7 CA /( ,e•
n r rtreli s'it sPGc--4-go
Permit has expired per MN Building Code Sec. 1300.120 subp. 11
• Expiration, no record of a Final inspection.
i
0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
• 0 CORRECT WORN•PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE CNE ONO PERMANENT
O CORRECT UNSAFE CONCON WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN 0 CITATION ISSUED
0 STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Cal tar the next 6apectIon PA noun In advance. (952)249-4609
woo C.PyINmPooNes PN. C.nwy covyAi.Notlm.