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Home My WebLink About2010-00664 - windows � r ` CITY OF QRONO PERMIT NO.: 2010-00664 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/10/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 50 HACKBERRY HILL PIN : 33-118-23-44-0025 LEGAL DESC : DANIELS LONG LAKE HEIGHTS : LOT 006 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,430.00 NOTE: REPLACE(4)WINDOWS WITHIN EXISTING OPENINGS APPLICANT pERMIT FEE SCHEDULE 147.50 RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 5.00 1920 COUNTY RD C. WEST ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 (612)502-4777 TOTAL 154.50 Minnesota State License#: 20130983 OWNER AUTRY, MARY 50 HACKBERRY HILL 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 this type of work shall be compied with whether or not specified herein.This permi[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 commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Duilding Code.This permit may be revoked at any time for due cause. `�-Q-�-C � i i ��►'�c-�-� i i Applicant Permitee Signature Date Issued By i nature a�e SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. , , City of Orono � � Building Permit Application for lnternal Work (windows, doors, siding, re-roof, etc.) Mailing Address: D ID � '�� PO Box 66 Permit number: � , Q Crystal Bay, MN 55323-00B6 Date received� /O s �`.. F�• Street Address: Received by: �� 2750 Kelley Parkway Plan review fee: ��t�Hd¢��' Orono, MN 55356 � Main: y52-249-4800 Fax: 952-249-46'IB www,ci.orono mn.uc_ To1al Fee; ��l� �D This application form must be completed in fe�ll and all required information must be submitted. Incomplefie applications will be returned. (Please print) GENERAL INFORMATIO j:� �a��{ Lt ' � Job Site Addres�: n� ` Will this be a Parade of Homes, Rem�delers Showcase Home or other Display Home? Yes No If}res,a specia!event percni�is requi�ed�vith Police DepaRment and City Council appruva/60 days prior to the evenf. Shuttle bus seivice will be required un/ess app!lcant demonstrafes sufficient on-siGe parkirtg is available. Non per�itNed events will not be a/bwed. CONTRACTOR/APPLICANT INFORMATION: Name: _ Renewal By Andersen State License# (920 Count Road "C" West Expiration Date: Phone: y Mailing Address: Roseville, MN 55113 (cell) ` License #20130983 C�tv' Z�P: Contact Person: �t is: Contractor 1 Homeowner (CfrcleOne) Email andlor Fax� 651-264-4777 PROPERTY OWNEFt INFORMA�jO� Name: �_�{� r� � Phone (day): _ " 1` . ar.y .t_�.(�Ynl n Address: _ - � v Cit : Z�p; Emaii and/or Fax PROJECT INFORMATION: Type of ProJect: Any earth movement may require MCWD review S ermib ❑ Door(s) ❑ Remodel ❑Water Damage P ❑Window(s) �Re �� Minnehaha Creek Watershed District(MCWD) Pa� ❑ Storm Darnage 16202 Minnetonka Blvd ❑ Siding ❑ Restoration Deephaven, MN 55391 ❑ Other: (specify) Phone: 952-471-0590 ❑ Re-roof Fax: 952-471-0682 . ❑ Fire Damage www,minnehahac-�eek ora Overall Pro'ect D�crlption: ' � Estimated Construction Valuation of Project(excludin land) $ � �. � APPLICANT ACKNOWLEDGEMENT: • Agrees to provide atl information required or requested by the Building Depa�tment; • Certifles that the infortnation supplied (s true and correct to the best of his/her knowledge. The applicant recognizes thet they are solefy responsible for submitting a compiete application being aware that upon failure to do so, the staff has no altemative but ta reject it until it is complete; • Some or all of the information that you are asked to provide on this appfication 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 subjed of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. �Jur purpose and intended use of this information is to annually update our records and records of other govemmental agencies �e ulred b law. If ou refuse to s ( the informatio a lication ma not be issued. Applicant's Signature: a : � {� O , � Last Updated: OS-04-2009 Z 'd 06I9�+L9IS9 3�IA�13S 1IW213d Q B S f� 6Z =6 OTOZ b0 ��d �� _cy" ' ATE TIME v CITY OF ORONO — CALLED IN / l� INSPECTION NQTIC/E-� /�,/�,S DULED l� /�� PERMIT NO. �'��J—D�CUI[J�vIPLETED ADDRESS GJ OWNER TELEPHO NO. S —a(p �� CONTRACTOR � � DESCRIPTION —�7'��Lf � l.V�l.�� lL ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDAT�ON/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O �. � O � ti � Q � 2 W � W � � GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE � ❑CORRECT WORK&PROCEED '� ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContractor on site: Inspector. �,� , ��`. � �-� �� White Copyllnspector's File Canary CopylSite Notice