The URL can be used to link to this page

Home My WebLink About2011-01227 - windows � CITY OF ORONO PERMIT NO.: 2011-01227 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 10/1 U2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2]95 FRENCH LAKE RD PIN : 10-117-23-21-0006 LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN : LOT 001 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 2,100.00 NOTE: RF.,PLACE(2)SKYLIGH"1'S APPLICANT PERMIT FEE SCHEDULE 88.50 SELA ROOFING &REMODELING, INC. STATE SURCHARGE(VALUATION) 1.05 4100 EXCESIOR BLVD ST. LOUIS PARK, MN 55416- TOTAL 89.55 (952)915-7227 Minnesota State License#: 0001050 OWNER GOTTSCHALK, ANDREW&ERIN 2195 FRENCH LAKE RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The Hork for which this pe�mit is issucd 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�equires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or no[specified herein.This permit will expire and become null and void if construction authorized is no[ commenced within 180 days of the date of issuance,or if construction is suspended tor 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."Chis permit may be revoked at any time for due cause. � i�/zv lO � f I / i i ��-L�I�L� �C�/ � � / � Applicant Permitee- 'gnature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) MailingAddress: �U//-6j� a.� /�,0,�. PO Box 66 Permit number: ;�� Q Crystal Bay, MN 55323-0066 Date received: lU / / ,�;. � �'�� ,;;�. Received by: ,a ;� � :� �, Street Address: \ � =�`'�� / 2750 Kelle Parkwa c�t G Y Y Plan review fee: �kESHo4� Orono, MN 55356 ��___� Total Fee: ��,�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us l/ ! This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION• Job Site Address: �,��j �r�L,� �.(�.1�e,, �� 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 Counci/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: �Z�(,� bo�►� �-�P�Cc�-��ii'1.G State License # ��a Expiration Date: ��3(/�� Lead Certification Number: �,`�_25 p 3..{ _� Expiration Date: by /og j�S (for work on homes that were construcfed prior to 1978 Phone: (o�L-�23-�3�-1b (office)G��Z-�j j-�"j -�ZZ� (cell) Mailing Address: �(C�U�XG�IS�o� g1.,VD City:Sfi. vis ��,�-�C ZIP: sy Contact Person: �n�� Applicant is: ontractZ�r- / Homeowner (CircleOne) Email and/or Fax: �Z_�L2—y�ICt$ PROPERTY OWNER INFORMATION: Name: �.t'►n C�}4`S�ta.( K Phone (day): (�!L-7�U �—�-i ia(� Address: 2.1�{S �x'v►� i„o.,ke IZcI City: fSr(;�1cv ZIP:r-�"53`1 \ Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage 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(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 �Window(s) � - www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project( xc ing land) $ 'Z pptt 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 re uired b law. If ou refuse to su I the information, the a lication ma not be issued. � Applicant's Signature: /� „,,%�_ Date: �O� �� I �1 �— Last Updated: 08-09-2011