HomeMy WebLinkAbout2017-00238 - windows ' CITY OF ORONO * z 0 1 7 - 0 0 z 3 8 *
2750 KELLEY PARKWAY DATE ISSUED: 03/15/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 908 DAKOTA AVE
P[N : 26-118-23-33-0022
LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE
: LOT 007 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 22,000.00
NOTE: REPLACE(10)WINDOWS WITH[N EXISTING OPENINGS.
APPL[CANT PERMIT FEE SCHEDULE 387.20
STATE SURCHARGE(VALUATION) 11.00
RENEWAL BY ANDERSON MAIL-[N FEE 2.00
1920 COUNTY RD C. WEST TOTAL 400.20
ROSEV[LLE, MN 55113
(612)502-4777 Payment(s)
Minnesota State License#: BUIL-BC130983 CREDIT CARD 8788 400.20
OWNER
KNUTSON, SCOTT&JULIE
908 DAKOTA AVE
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
'Che 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 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 l80 days of 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 the State Building Code.This permit may be
revoked at any time for due cause. _ / —
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Applicant Permitee Signature Date [ssued B ignature Date
City of Orono
�ui�ding Permit �►pplication for Maintenance ! Renovation
(windows, doors, siding, reMroof, etc.)
Marling Addreas_ PeRntt number� �/ �
����`yO Crys2aXBay,MN 55323-Q066 Daf.e rsce➢vsd: �' — 7
Received by_
��+.� 1� � 5treet Address � �'
, 2750 Keiley Parkwey plgn review fee:
���$����,� Qmno,MN 55356 � �� 2�
Total Fee: vL
Nlain: 952-248-d6Q0 Fa�c= 952-249�616 vvw��+a ci.orc,Zno.m�i,�
This appllcation forfn must be comp{eted in full and all requited infofsn2tlon must be submitted.
{ncomplete applicatlons wi11 be returned. (Please pt�nf)
GENER/�16 iNFORMA710N: q ag .���� ��
Job Slte Address:
Wilf�thts be a Parade of Hom�s, Remadelars Showcase Home ar ather D�splay Hom�? Y�s o
!f yes, a specia!evsnt perm�t Is requ/red wlth Polica Department arrd City Council approval 60 dsys pr�or to the event. ShutiJe bus servlce wil!be
r�qufred unless appficant demonatrates sulf7cient pn-srte parking?s avail6b/e. lVon-pem�ltfed aVents wl11 nof be alloW6d.
GONTRACTOR/A�PLiCANT INFORMATION:
Name: �£ u�b•\ 'A`��°��'N
State Llcense# �G��b�1 � �xpira#ian Date: �(�S
Lead Certification Number'
N `�� a�,a$3 � �xpiration Date: '�
(for work on homes that were constr'uct�d prfar to 98�'S� (��c�) (Cell)
Phone' ���� c�� "'��0�' ZIP:
Mailing AddreSS' o'�� , '� `• r. CyJ�. ��tY��}e.V,l � SS ��
Contact F'erson: Applleant is' ntra r / Homeown�r �c;rc+e o�o�
�mai!and/or Fax=
PROPERTY OWt�IER iN�ORMATlON:
IVame' S 'n �� �
Phone (day): - �r � �� ZIP:
Address: � City:
Email and/or�ax
PR4JECT INFORANATION: Any 0arth rnovamerrt may requlre
Type ofi Project: M�Wb revlew&perrnits:
❑Door(s) ❑ Remode! � Flre I�amage Minnehaha Creek Watershed District(MCWD)
18202 MlnnetOnka Slvd
❑Re-roo�,asphalt ❑Repa+r ❑ S#arm C7arnage Deephaven,MN 55391
❑R�roof,cedar ❑Resf�oratlan [,�Water Damage Phone: 952-471-0590
c Sidin ❑Other(spe�►�Y) Fax' 952-471-06�2
❑R�roof,other isPe �iy1 � g www_min nshac eek.or
�Window(s} .
�verai! Project Descr�ptlon: c� C.v�
W/�n �Q..k i 5 � � i
Estlmated Censtructlon Valuation of Project exaluding tand $
APPLiCANT ACKNOWLEDGEMENT:
. Agre�s fo provide a(I In#ormatlon requfred or r�equasted by the Buifding Departmeni;
. Certffies that the lnformafion supplied ts true and correct to the best of his/har knowledge. Ths applicant recogniaes that they
are solely resp4nsiblA ISor subrrcftting a compleie applicativn being aware that upon failurs tn do so, the staff has no aftemative
but ta reject iF untl(it is compiete;
. Some or aA of the InfQrmation that you are asked to provide on thls applicatiott is classi�ied by State iaw as etther p�ivate or
confldential. Private data is inf'ormation which generally cannot be given to the publfc but can be given to the subject of the
data. Gonfldentia! data is Informatlon wt'ilch generally cannoi be given to either the public or the subject of the data_ Our
purpose end I�tended us� of this informatlon is to annualiy update our records 8nd reaords of other govemmental agencles
re uired b 12W. If u r�efuse to su I tha infbrmatlon,the a fication ma not be issued.
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Apolicant's Sianatute:
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DATE TIME �
CITY OF ORONO cnLLED IN �'
INSPECTION OTI SCHEDULED � � �a
PERMIT NO � COMPLETED
ADDRESS Q� �� �
OWNER TELEPHONE NO.��• Z��'�
CONTRACTOR �1
t�� DESCRIPTION
y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�j ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
�i1 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICOI�TRACTOR TO MEET Y�U:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE
� ❑CORRECT WORK�PROCEED ❑ISSUE CERTiFICATE OF OCCUPANCY
O ❑CORRECT WORK�LL FOR REINSPECTION TEMPORARY
V BEFORE CaNERING PERMANENT
❑(�RRECTUNSAFECONDITIONWRHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
CaM forthe next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
�nspeCtor. /✓I4��L�-
White CopyAnapector"s FlN Gnary CopylSib Notke