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CITY OF ORONO * z 0 1 4 - 0 PJ 7 4 1 *
2750 KELLEY PARKWAY DATE ISSUED: 07/15/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 55 GOLDEN VIEW DR
PIN : 33-118-23-43-0011
LEGAL DESC : PETERMAN 2ND ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
VALUATION : $ 9,693.00
NOTE: RF,PI,ACF:"I'WO PATIO DOORS AND 2 WINDOWS
APPLICANT PERM[T FEE SCHEDULE 191.75
STATE SURCHARGE(VALUATION) 4.85
HARMONY HOMES INC. MAIL-IN FEE 2.00
1120 WINTER ST.NE TOTAL 198.60
MINNEAPOLIS, MN 55413-
(763)413-1 100 Payment(s)
Minnesota State License#: BUIL-BC501883 CREDIT CARD 9556 198.60
OWNER
ANDERSON, DAVID&JUDY
55 GOLDEN VIEW DR
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
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 goveming Ihis 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 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenccd.
The applicant is responsible for assuring all required inspections are
requested in conformance wi[h the State Building Code.This permit may be
revoked at any time for due cause.
/ /
Applicant Permitee Signature Date Issued By Signature Date
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`" CITY OF ORONO * 2 0 1 4 - 0 0 7 4 1 *
2750 KELLEY PARKWAY DATE ISSUED: 07/14/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 55 GOLDEN VIEW DR
PIN : 33-118-23-43-0011
LEGAL DESC : PETERMAN 2ND ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : M1NOR ALTERATIONS
F'ROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
VALUATION : S 9,693.00
NOTE: RGPLACI:TWO NA"1�[O DOORS AND 2 WINDOWS
APPLICANT PERMIT FEE SCHEDULE 191.75
STATE SURCHARGE(VALUATION) 4.85
HARMONY HOMES 1NC. MA[L-IN FEE 2.00
1 l20 WINTER ST. NE TOTAL 198.60
MINNEAPOLIS, MN 55413-
(763)413-1 100 Payment(s)
Minnesota State License#: BUIL-BC501883 CREDIT CARD 9556 198.60
OWNER
ERICKSON, VAN & NANCY
55 GOLDEN V[EW DR
LONG LAKE, MN 5��56
AGREEMENT AND SWORN STATEMENT
"I�he work for which this permit is issued shall be peribrmed according to
the approved plans and specitications,applicablc City approvals,and thc
State Building Code. This pcmiit is for only the work described and does
not grant pem�ission for additional or related work which requires separate
pennits. All provisions of laws and ordinances goveming this type of work
shall bc compied with whether or not specified hercin.This pennit will
espire and become null and void if construction authorized is not
commenced within 180 days of Ihe date of issuance,or if construction is
suspended for a period of 180 days at any time atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code."I�his permit may be
revoked at anv time for due cause.
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Applicant Permitee Signature Date Issued B ignature Uate
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City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
-""� A`�' Mailing Address: Permit number: �O/ -"�d �/
���V � PO Box 66
Q Crystal Bay, MN 55323-0066 Date received: 7�/`�-/`�
� ' Street Address: Received by: ��0.5
' 2750 Kelley Parkway Plan review fee:
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� ; Orono, MN 55356
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_ ' 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:
�ob site Address: 55 Golden View Drive; Orono
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
lf 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:
►vame: Harmony Homes Inc.
State License# gC501883 Expiration Date: Mar'Ch 31, 2015
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) 612-238-0520 (office) 763-413-1100
Mailing Address: 1120 Winter Street NE C�tY�MinnP�plig ZIP: 55413
Contact Person: grian Allen Applicant is: Co r °ctor / Homeowner (Circle One)
Email and/or Fax: IIPn(n7h�-mC1n��hC1111PS�11C L1Pt
PROPERTY OWNER INFORMATION:
rvame: Brian and Judv Anderson
Phone (day): q4A-���-A17��
Address: 55 Gnlden View Drive City:Or�n� Z�P� 55356
Email and/or Fax:
PROJECT INFORMATION: Overall pro�ect description: R I w i r n in t II tw in rt win owS
Tyne of Project: Any earth movement may also require
_' Door(s) ❑ Remodel ❑ Fire Damage
MCWD review 8�permits:
❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof, other(specify) ❑�Siding ❑ Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
�j Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ 9.693
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 pl the information,the a lication ma not be issued.
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ApplicanYs Signature: -a--_=�__ Date: J��I� 11_2014
, ---
Owner's Signature: Date:
Last Updated:03/06/2013
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
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OWNER TELEPHONE NO.
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Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
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� �EINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
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_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
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V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDEFi POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952� 249-4600
OwnerlConVactor on site:
Inspector. Q ���--� 7�
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PERMIT NO. ��%�`��UC�� COMPLEfED
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ��NJAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERlCONTNACTOR TO MEET YOU:_YES_NO
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��-eT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDiT10N WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP OfiDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call ' spection 24 hours in advance. (952� 249-46��
Own rfContractor on site: �
Inspector. ►�-
White Copyllnspector's Ffle Canary CopylSite Notice