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Home My WebLink About2013-00686 - windows CITY OF ORONO * 2 B 1 3 - 0 0 6 8 6 * r. 2750 KELLEY PARKWAY DATE ISSUED: 07/22/2013 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 66 HACKBERRY HILL PIN : 33-118-23-44-0024 LEGAL DESC : DANIELS LONG LAKE HEIGHTS : LOT 005 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 725.00 N07�E: RLPLACE (1)GARAGE WINDOW APPLICANT PERMIT FEE SCHEDULE 34.75 THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 0.36 2690 CUMBERLAND PKWY, STE 300 30339- MAIL-IN FEE 2.00 (763)542-8826 TOTAL 37.1 1 Minnesota State License#: 20268257 OWNER HENDERSON, JEANETTE 66 HACKBERRY HILL LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work Yor which this permit is issued shall be perfbrmed according to thc approved plans and specitications,applicable City approvals,and the State Building Code. This permit is 1or only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied witl�whether or not specified herein.'This permit will expire and become null and void if construction authorized is not commenced within 180 days oY the date of issuance,or if construction is suspended for a period of l80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with tqe State Building Code."1�his permit may be rcvoked at any time for du�cause. �;�iv�.d�-t.�. (it�' / � l l Applicant Pennitec Signature Date Issued By Si ure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: � '.�,�,�. �, PO Box 66 � Crystal Bay, MN 55323-0066 Date received: J, � ��' � .� t� �� s,i) Street Address: Received by: �',F, ��;�,�u;,,;,`Y,� �ti�i 2750 Kelley Parkway Plan review fee: ��ykEs�Kog,�� Orono, MN 55356 < - ,_: 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: � � �Q �� 6e��► (�i l/ Job Site Address: 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. Shut(le bus service will be reryuired unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# THD At- Home Service, Inc, Phone: 2690 Cumberland Pkwy, Ste 300 (cell) Mailing Address: Atlanta, GA 30339-3913 ZIP: Contact Person: Lic # CR268257 Ph. 763/542-8826 �omeowner (Cirde One) Email and/or Fax: �'s��3 Y s' G D �'7 PROPERTY OWNER INFORMA�JJ N: // v� d� Name: 0 Q. Tl' �T e !��0l�$�n Phone (day): 9 s? �{ L • 7 L � S l/ / / ` Address: (o � l P lTi ! Cit :��) 4 Q r� ZIP: � s3 5 6 Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review& permits ❑ Door(s) ❑ Remodel ❑ Water Damage Minnehaha Creek Watershed District(MCWD) �Window(s) Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www.minne ahacreek.or Overall Project Description: p f� p ! Q J?) /n Estimated Construction Valuati of Proj ct(excluding land) $ 7 a 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 b law. If ou refuse to suppl the information,the ap lication ma not be issued. ApplicanYs Signature: -''�� Date: 7 l� � j�3 Last Updated: 05-04-2009 ,� � � `�' � � `' / / � �� .. � � , ,. . �� _ . �� ►��;-�er-Jon�s ��.��ng �ermit S�n,�ic�, !,�° �120 E. 8i3th St ' :::��omorgton, !�N 55420 w ' ! ` PERMIT FEE CALCULATION S —JOBS OVER$500.00 If above does not apply;follow guidelines below•: 1. CONTRaCT PRICE * is 1.25%of contract price�s�ith a(Minimam Fee of S50.00) � � � � 7 �L�C� � x .0125S ��v�� . �� (contract price) (muimnm S50.60) 2. STATE SURCHARGE � � � ' l� r C C b Y .000s � "�1. 5 � ��a�t��> 3. POSTAGE&HANDLING(Only on I44ai1-In Applirations) S_ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Abo�e) S � "l� • C� — * CO'_�TTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted w�ork including materials,labor,profit,and other fixed costs. It is the amount to be charged to the customer for the�vork done. If any material, equipmenL labor or installations are furnished by the o�sner,teuant or any other party,the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the e�•ent that there is a dispute on the amount of the job cost, the City may request the submission of a siened copy of the actual contract. PLUMBING PERMIT APPLICATION AGREEMINT The undersigned hereby applies to the Ciry for issuance of a Plumbing Perniit, agrees to do all ��•ork in srrict accordance «•ith the ordinances of the Cit� and the regulations of tlie State of Minnesota, and certi that all�statements made on this application are complete, true and correct. ' �pplicant's Signature: ='� Date: � � �� ( ,j 3 DAT TIME " CITY OF ORONO CALLED IN r' INSPECTION NOTICE SCHEDULED _�� PERMIT NO. aoi3�DD�d'l0 COMPLEfED ADDRESS �OIP �GZC�� u �� OWNER TELEPHONE NO. CONTRACTOR �� `� � DESCRIPTION �� ❑ FOOTtNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a !�U/lti�J�/n 5�� ' q��4��-�' � � O �1 < < � - d/l��AGQ.o ot0�/<�e�. ° _��Fe.r►o'r is Scol�— W � Q z (,�JO f k CO►�•�dJl� W � W � J d W� ❑WORKSATISFACTORY:PROCEED �PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC0IIERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (95Z� 249-4600 OwnerlContractor Qn site: Inspector.��I'''L White Copyllnspector's File Canary CopylSite Notice