HomeMy WebLinkAbout2009-00761 - windows � '� CITY OF ORONO PERMITNO.: 2 -
009 00761
2750 KELLEY PARKWAY
ORONO, MN ��356- DATE IssuEn: 10/27/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 1905 HERITAGE DR
PIN : 10-ll 7-23-13-0013
LEGAL DESC : FOXHILL
: LOT 003 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-LTNDEFINED
VALUATION : $ 2,000.00
NOTE: REPLACE 2 WINDOWS
APPLICANT pERMIT FEE SCHEDULE 73.75
C& D ANYELL'S TRIM WORK INC. STATE SURCHARGE(VALUATION) 1.00
16484 149TH STREET
SUITE 103 TOTAL 74.75
BIG LAKE, MN 55309-
(763)263-0586
OWNER
SCOTT, DAVID
1905 HERITAGE DR
WAYZATA, MN 55391
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 eoverning 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
revo}.ed at any t� ��e cause. j� -7 %(, _��� C;�
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Applicant Permitee Signature Date Issued }�Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCWBED ABOVR.
� '
� � City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number. Z�G�j- p -](p �
�v�,j� PO Box 66 2� '�
Crystal Bay, MN 55323-0066 Date received: G '
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a, ��y m^s;f;;� �,�,i Street Address: Received by: ,7
�'� ' '�" �,� 2750 Kelley Parkway Plan review fee: �
t�kESH�g'� Orono, MN 55356 J
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: / �f� s_ f-��-�2i��;�E- -�!� Gti�'4`;'Z�i--i�-- �� �� '`��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ,� No
/f yes,a special event permit is required with Po/ice Department and City Counci/approva/60 days prior to the event. Shutt/e bus service`will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/A���NT IN,�ORMATION:
Name: ��z�1G-E�L--� ' /d�i,'�l l.G�,2 i�. l�JC
State License# � ��� �� " D�'7 / Ex iration Date: ? �
L � P '�- _./- �� L;
Phone: �� -_ p S office cell
Mailing Address: �"T� T # �_� Cit : i� �E ZIP: ��'G'�
Contact Person: � ,., � u �� �,qN� Applicant is: C cto / Homeowner (Circle One)
Email and/or Fax: /}�.r��y�s��,,'�-1� IySN ; �_�s� �
PROPERTY OWNER INFORMATION:
Name: j���� ���'�j�_
Phone (day): yS2 - ?S � !?�
Address: ��� ��1 j7/fG� ��Z City: ��,✓���� ZIP:��5.�j�
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: - ti- �. lv-�,..r,-
Estimated Construction Valuation of Project(excluding land) $ v�l ��
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 th information, the a lication ma not be issued.
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ApplicanYs Signature: ✓ Date: ��%--�- �— O�
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Last Updated: 05-04-2009
�Vl �V DATE �q TIME v
CITY OF ORONO CALLED IN � �I�� '"/
INSPECTION NOT(I�,E SCHEDULED I O J7�I L�? l v �
PERMIT NO. ��'" ' �� �b � COMPLETED
ADDRESS 1 � D �' ���� f Q�l� ��
OWNER CONTR. � N � ������—S
TELEPHONE NO. �� �J `� �� 3 �U 5�
� DESCRIPTION lN�,�t,�� +' �Vl� � 5
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION O WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�YES_NO
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W{LL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-46QQ
OwnerlContractor on site:
/ �
Inspector. �.�1/ r—i
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