HomeMy WebLinkAbout2010-00869 - windows � �` CITY OF ORONO PERMIT NO.: 2010.00869
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/20/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1 I55 HERITAGE LA
PIN : 10-117-23-13-0022
LEGAL DESC : FOXHILL
: LOT 002 BLOCK 003
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,000.00
•
APPLICANT
PERMIT FEE SCHEDULE 1 18.00
INTEGRITY PLUS HOME EXTERIORS INC STATE SURCHARGE(VALUATION) 5.00
9800 SHELARD PARKWAY TOTAL 123.00
SUITE 30B
PLYMOUTH, MN 55441-
(763)225-8720
Minnesota State License#:20518486
OWNER
VILTOFT, JORGEN & LUCILLE
1 155 HERITAGE LA
WAYZATA, MN 55391-
AGREEME(YT AND SWORN STATEMENT
Thc work for which this pemiit is issued shall be performed according to
thc approved plans and specitications,applicable Ciry 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 governing this type ofwork
shall be compied with whether or not specified herein.This permi[will
expire and become null and void if construction authorized is not
commenccd widiin 1 RO days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
Tlie applicant is responsible for assuring all required inspections are
q es[ed in conformance with the State F3uilding Code.This permit may be
evo ed at �y ti e�#pr due cause.
' l, � l C' �1 yZC..Q-''l l l
� licant Permitee Signature Date Issued B ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
� City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
g,�,�. PO Box 66
Q �\ O Crystal Bay, MN 55323-0066 Date received:
�s��,
�,� �'` �`�` ,, � Street Address: Received by:
� a��
�',�, �� 'A" �ti� 2750 Kelley Parkway Plan review fee:
L9kESHOg'� 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:
Job Site Address: j�j -���� f E'� �a�,�
Will this be a Parade of Homes, Remodelers Show ase Home or other Display Home? ❑ Yes ❑ No
If yes, a specia/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 INFO ATION: /�
Name: �-�- � � Z �F�
State License# � Expiration Date:
Phone: - ,-7 �o office cell
Mailing Address � � . ,� �, Cit � cz �� ZI P: SSYY/
Contact Person: ��U Applicant i . Cont ctor' Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �c��,-��1 C��td�f
Phone (day): �'�,�='�7z, •� 8 (;s
Address: /��� ��,�7'�,r ��, City: C>,r�vn�v ZIP:
Email and/or Fax �
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review 8�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.minnehahacreek.orq
Overall Project Description:
Estimated Construction Valuation of Project(excluding land) $ ���, —
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.
ApplicanYs Signature: � C ��,�,��. Date: � � — U
� �
Last Updated: 05-04-2009