HomeMy WebLinkAbout2013-00358 - siding � CITY OF ORONO �
� 2750 KELLEY PARKWAY * DA�TE ISSUED: 05/14/Olg3 *
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 425 HUNTER PASS
PIN : 25-118-23-31-0008
LEGAL DESC : HUNTER PASS
: LOT 004 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
VALUATION : $ 4,600.00
NOTE: PARTIAL SIDING ON HOUSE
APPLICANT pERMIT FEE SCHEDULE 118.00
LECY BROS HOMES STATE SURCHARGE(VALUATION) 2.30
15012 HWY 7 TOTAL 120.30
MINNETONKA,MN 55345
(952)944-9499
Minnesota State License#: 20325555
OWNER
Tonkawa,Inc.
301 CARLSON PKWY#275
MINNETONKA,MN 55305-
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 sepazate
permiu. All provisions of laws and ordinances governing this 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 commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revok a an time for due cau .
�s7' /� �/3 � �
App icant Permitee Sig ature Date Issue y nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHE N DESCRIBE ABO E.
05/1�/2013 TU$ 14: 24 FAx 555 5555 LOCy $roe Homee �002/002
� ' �ity of Orono ao`.� -oa3�
Building Permit �lpplication for Maintenance ! Repls�cement/ Renovation
� (No structural expansion. Only windaws, doors, sidin , re-roof, etc.)
( '� M�1!ingAddress: *, �d ,.,; ,:���•, ��.; '�� •..�:
�I ', � ��tti�;rt�rii r•�� :ti.:y� �'��. ;�; . 'b:�,�'
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� PO BOX 66 � r , '' �••,„s•.:;.•,�••
;', Crystal8ay�MN 55323-W66 p,�.,��:;�9�: r��.,", �;,.., ',:
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,�, StraetAddress: '���;.�r;..,.�t;. ' � ; ; `:.
, '� �,:
2750KeIleyParkwaY ::F�I' �.R,, :''' '"' ;,,�`.
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Orono,MN 55356 ,;�;�; ,,,: ,,���:� '���;,. '�<�;�: ��1�, � � . :
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Main: 962-249-4600 Fax: 852-24&4616 �vww ci.orono.mn.us ..,,�,.r&:;'`�';f'.'�;T;';;; �'',, ��•
This applic�tion form must be campleted In fulf and att required information must be submitted.
Incomplete appllcatJons wlll be returned. (Please print)
GENERAI.INFORMATION:
Job Slte Addrsss: ��S �I�VL'�.p"'r QFS
WIII lhls ba a Parade af Homes,Remodslers Showcase Home o�other Dlsplay Home? Yes�o
lf yes,�speciel event permit is requiied witl�Poi�oe�ps►bnent end City Councq 8ppvovel BO deys pAor M d1e eVenf. ShufNe bus se�vke w1H be
requlred urUeas applkanf dematshmtes suA�PClen!on-slte psrMrp Is ava!labfe. NorwparmKted events wlll not be albwsd.
� CONTRACTOR 1 APPLICAMT(NFORIIpAT ON: '
R A
Name: �r�� ��,
State License# ��y����� �xpiradon Date: �-��l--�1p I
Lead Cert'�i'ication Number: • Expira�an Date:
(for work on homee that were const�vcted pHor io 7B7B
Phone: (cell) (offlce) g�a-� .-��g�
Malling Address: �4 w C' : ZIP: e.�s
Coni�ct Persdn, �,h�qg �,,,�Nd��ti,-� Applic�nt is; Gontractor / Hameowner �ciroieo�e�
Emall andl ax G��-c�t���(bGg — _ ,_„
PROPERTY OWNER INFORMAT1pN:
Narne: Cy'�oi,r"k �, �(r1 �1�C,pl
Phone(day): T'�
Address: ��,S Ei�cti►� v� �g�S �nY'd�"�Y1 a zIP: �a�3 6�
Email and/or Fax:
PR4J�CT INFORMATION: Overall ro'ect descri tion:
� Type of Projact; Any earth movement may also requlre
❑Door(s) �,]Remodel ❑Flre Damege AMC4UD revlew&permlt�:
[]Re-roof,asphalt ❑I�epair ❑Storm Demege Minnehaha Creek Watarshed bistri�t(MCWD)
18202 Mlnnetonkp Blvd
❑Re-roof,cedar ❑ResMreaon ❑WaRer Damege Deepheven,MN 56391
Phone: 952-471-0690
❑Fte-roof,other(speciiy� �,Siding ❑Other'(specliY} Fax; 852-471-�92
❑Wlndow(S) www.mirt h
Estimated Constructlon Valuation of Prvject(excluding land) � �f�QLQo_
APPLICANT ACKNOWLEDGEM�NT: �
• Agnees b provlde all Ir�formas�tion required or requested by tha Building Dep�rdner�t;
. Certlfles that the Informatbn supplfed is tnae and wrrect to the beat of his/her knowledge. The applicent recognlzes Rhat they are
solely responsible for submiltin$a oomplete epplicefion being ewere that upon fatiure to do so,fhe staft has no aNernative but to
rejec�it until it ie complete;
• Some or all of the informatton thai you are asked to provide on this epplication 18 dassified by State law Qs elther private or
corifldential. Priv�te data is informetion whioh generally aennot be glven b the publlc but can be plven to the subjec�of the dete.
Confidential dete is ir�formetion wh(ch general{y cennot be given to e�her the pub11C or the subjeCt of the data. Our purppae and
intended usa of thie i rmaUon Is to annually u te our records and recards of other govemmentai ag�aes r�equl�ed by law. if
ou refuse ta su e Mormatlon th ' tlo ma not be issued.
Appllcant's SIgn2�ture: � Date: ��^/y`"��
�wners Signature; Date:
I A17�I IfY'IAMfI•n3mann�z