HomeMy WebLinkAbout2001-P03542 - re-side ' ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po3sa2
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 2i2ii2ooi
SITE ADDRESS: 2625 Kelly Ave
EXCELS IOR,MN 5 53 31
P ID: 20-117-23-14-0026
DESCRIPTION:
Proposed Use: itesidentiai
Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Side
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation• $ 10,000.00
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 186.25
APPLICANT: TWIN CITY EXTERIORS CO.,nvc. OWNER: KURT NEJEZCHLEBA ET AL
9060 ZACHARY Ln N 2625 KELLY AVE
MAPLE GROVE,MN 55369 EXCELSIOR MN 55331
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE.OF MINNESOTA BUII,DING CODE REQUIREMENTS.
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SUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
Cl l lr ur UKUNU �" 6124r�U5'10 U4/�4/�1t3 UtS:59 [� :U1/U� N0:368
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Total Fet: $ ���p-� � Date Rcceived: � � b�o�
�y�' tcrcd By: Pecinit�: `��J 3.So �—
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CITY O�' �RONO - BUILD�IG PERMIT APPLICATION
All iuformation musi be snbmitted In full before plAn review wiil be siarted.
(plcast prtnt all Ir{formaiion)
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'T��: APPLICANT IS: (circlt one) OWNER CONTRACTOR
JUB SITE ADDRESS: �� � �l� ZIP: ����
NA11�1� OF QWNER: C f�gf5� �,��-t��(��fl��4PHONE: (homc)�-�7J-�`�/a
(work) �–�
�it9,I.LING A.DDRFSS: __� CTTY: ZiP:
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CONTRACTOR: TIJIN CITY EXTERIO 0. , INC. pHp�; � 763) 425-4737
COP+TTACTPERSpN: JOHN JORU CLAUDIA IViOBILE/PAGER: N/A �
MA.'LINGADDRESS: 9060 ZACHAR ANE N. /�108CITy; MAPLE GROVE ZTP:55369
STAT&LICENSE: # 2535
�,� 7�� -�a��ys�
AR�C�CT/ENGll�ER: PHONE: �
MAILTNG AI?D�SS: �TT'Y: ZIP:
NAr��: REGISTRATIOi�#
TYI'E OF WORK: New Addidon Acccssory Stiucturc
Move RcmodeUAlteration I.and Alteration
PRQ�'OSED WORK(describe!n drtai�:__7�j�f���
ST'���: SQ.FEET OF EACH FLOOR:
NO. OF BEAROOlYiS: GARAG�STALI.�: ATT. DET.
6Q'
F.S'�"I3�IATED CONSZ'�UCTTON VALUATION(cxcludln$land): $_/��
I hcrtby apply for a buildisig permit and I acknowledge that the informatfon above is complete and '
accuraec; that the work will be un conformance wiih the ordinances and codes of the City and with
thc Statc Building Cade; that I und�rstancl thJs is not a pemut and work is not to start without a
permit; and that thc work wiIl bc in accordancc c approv d plan.
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APPI.ICANT'S SIGNA DATE: ���–� �
lVOTL! Pamd� offlome� tvanls requirs separotr permit approvai by Pollce Depurtmenl arrd
L'ily Councll 60 days pr�or to the cvact. Nort penrslttad evtnts will�tvt bc allowed.
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Ni�v,�y 1a� - � j����
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l.11 � �/l' VfIVIVV �] UIG'11JVJ1V V't/L't/ %U VJ.J% �j' .UL/VL I`IV.�VIJ
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Sea.17.04 RIGHTS OF NA7£CTS OF D,tTA
Subd. 1. 'C�ot datn. Thc rlghcs of indtvidus!oa wEom�he Caa is scoced or ro Dc scored shsD bc as sct foRh in this seccoa.
SuW... Iafvrsnatloa requinti!to ba�lren ladl�lduY1. An indirldu�l»kcd to fupply Arivut or cont;deoca!d�n contemis�a Aimsslf sh�ll
Ga inlorm�d of` (t)the purpose ind inundcd use u(the rtQucstaci dtts wltDlu the colladna lule�gtncy,poliocal rubdivi�iop,os 7tttawido rystam;
(b)whechsr he may rr}Uu ot is]e�illy requfm!ro rvppiy ihe rrquaied data:(c)iny k+wwn co�ewccce�risiny!rom his�upplyin�or rclUsinj to supply
• pri��m or eonRdanod d�a:and(d)�he idenary af oeher prnom or enoac�svd�orired by suu or fedecal!aw co recai�e�he dau. Thls requlremeac shall
no��pply W1�n an lndiv;dusl!s asked,co nippty inveso�.6��dara,pursuant�o section 13.d2,iubdiviiion S,co a lnw ento�ement oftuer. -
e Q�ma=��p�er of te�enut mev �lace ehe nooce r�aulrrd undrr�his wbdivision in �hc ImfiviQual inenmc wx ar omaern u� retund
lntttuCdoro tn��q�d of on�o�e formt.
' Subd.3. Aecw to dnto by Indl•idual. Upon reque�s to�respon�ibte auchoriry,an indi�idual shall be infomse4 whethet Ae i�th�n+bjeet
of aWroC dats on indiriduilf,u,d wheeher I�is classified u public,prir�m or confidenCd. UQon hls Nr�her reQuie,in individual who Is tke euDjeet
of uprtd prtvur or publtc d��on individu�J�ch�l be sEovm ehe diea���houc rnr charpe to him and, if hc desiru,sDaU De InfornxQ o!the tontent
�nd mt►nin{o!chu dan. Aher in tndi�idual hu ban showa�he p�iriu d�u ind infurmed of iu meudnQ.tho daa nccd noc be dlsdoted to h!m for
�ix moatfif tharethet unlets i dispuee or�cdon pursuan�m�his ucrion is pcndinj or iddiooaat C�u oo�he indi�idual hes Deen tollecad or ere�ttrd.
Tha respoatible iutDactry th�ll provide copies oC che yrivtte or public dau upon rcQuest br the indlrldual mbJecc of che dita. Tha reiponsible iuehoriry
miy rsqulrc d+r rcquesdnj p�non to piy che utust cosu of makin�,certifying.and�omyilin=e6e copies.
The n7pon�ibl�authotiry shtll comply itnmed'utely,if yossi0te,wi�h say requasc tniJe punuant tn rhis n,bdivision,ur wirhln Rve day�of
tht Qate of du nqucst,eaehtQio�Stturdays,SunQiys end lesal Lolidays,if irtu�xdt�te enmptitnce a not yossible. if he ctnnot comply wld�dfe tequeu
withito that tifie.he thdt co inlorra the iadividuu.and rtuy h+�ve an�ddicoael t[re d�y�wid�in which ro cumply wi�h the requesr,e:dudint S�turdays,
Sundiys u�d It;tt holki�ys.
Subd.4. Proetdur�wh�n d�tn b noI accwsl�ot complet�. An lndlridud msy�onh:t the�tcuncy or eompletene�s of 9ublit or pdv�ee
d�a conetminp himulL To uarclsc�hir rieht,in liufividuu�T�W nocry in wri�rhe mponslDle�u�horiry dexri6lnj the rucure ot th�diujteea»ac.
'17�e rv�pvn�lbla�u�honry ihill wieAin 70 d�y�cieher. (i)�ortcc<<hc d�n found to De inacn+nm or incomplece and utempe ta notifr pa�e neipiean of
ttuteunca or incomplcu dan,tncludln�recipienu namcd by the indivi0ual:or(b)notity Ne individual that he beltevts the deta tu De corraeG Diu
ta dlsput�ths11 be dl�closrd onJy If�he individuil'�mtemrnc o�dii�=roemcnc!s Included Mi�h tho d'uctoud din.
71w deurmin�aon of�he rc:ponsible xutRoriry ttuy be�ppt.led punu�nt to the provisionf of the sdminisazdve pcoeedute tct n13dp=ro
eontested caies.
D�ITA PR.TVACY A VY 4RY
In:ccordnnce with M.S. 13.04,Subd.2, "Rights af subjecu of dzta",we would fikr to inform you that yourrequest
for�permit oT licensa trom the City of Orono or any of ite departments may require you to furnish eectain private ar
confidenciel information.
You aro notlAcd that:• ` �
1. The information you furnlsh will be used to detetmine your qu�lification for the permit or license requested.
Z, You rnzy refuse co supply daca, but refusal may rcqui�e that the Ciry deny the perauc or liceme.
3. The infotmntion may be shued with other local, state or fedtral agencies to the excent necessary to process
the germit ar Iicense.
4. I!your requested pecmit or licease nquires Council actioa to appro�e, some iaformation may become
public.
s, Yoo have certain rights under M.S. 13.04 (avnilable upon request) to review pr�vete data on youne2f.
b. Your tUll name is zequ;rcd io praess this zpplication or persnit.
Fint M1dC1a Lut
Addnu ,
Clty Snp Zip PEoae
I understand m Qhcs as statcd bove.
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Sl=aam�e
2-20-201 3:35PM FROM TWIN CITY EXTERIORS 612 a25 6d57 P. 2
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C111' ui• UKUNU p" G1L4(�US1U U4/�4!`J�i UtS:59 [� :U1/�)2 NU:36�3
,,.I oI Totai Fcc: $ J�D �- o�,� � Dat�Rcccivcd: �� o- o
�1� F.atcccd B /
� Y= ._.., pernut�: � " ,5�� ' _ .
✓P CITY O� �RONO - BUILDING PERMiT APPY.�CATIOI� �
All iniormation mt�st be submlttcd��ull beiore pl�n review wili be s�tarted.
. (please prfiu atl��jonnution)
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1`�I�:APPLICANZ'IS: (circic onc) O�VNER ' CONTRAG"TOR�`' �^ � �.
JUB�I1'E ADDRF.SS: ������ ZIP: ��j f
NAME OF OYVNER: �'�/�Q f5��,�E�,�G'�1 �PHflNE: (homc)9.5�-�7�i`�/?�
(work) -�-r
�u.nvG�nnx�ss: -- �����' crr�t: 2rn-
CONTI�ACTOY�: TWIN CITY EXT�ERIO 0. , INC. pgp�; �.7b3) 425-4737
COP+u"TACTPERSUN: �OHN JORU CLAUDII� �OBILEIPAGER: N/A �
M1��.INGADDRFSS: 9060 ZACHAR C N. lf108CY'I`'Y; MAPI.0 GROVE �YP:55369 �
STA�LICENSE: � 2535 �
�,� � ��� -�as�ys�
A��C�CT/FNGI�:ER: � PHQNE: �� �
�LTl�1G ADDYt�.SS: � � CTTY: Z�':
NATrYE: � RECrISTRA'TIOi�i# �
TYi'� OF WORK: Ncw Atldidon . Accessory S�ucturc
Mo�rc � Rcmodel/Aicczation Laad Alteration
PRO:OSF.D�YORK(describe�iri drtai�: .
STfl�t�.9: SQ.�'EET OF EACH l�'LOOR: � ,
N0. QF BEDitOO1V1.S:�. GARAG�STALIS: A7T. DET.� .
: . � � ..
F.S"u'i�lATED CONSTRUCi70N vALUATiON(c.�nccludin�land): $ ���i�Y� �
I hct�hy apply for a buildit:g gctztZit and I ac3mowledge that thc informatIoct abovc is cou�plete sad � �
accurs�c; that th¢wvrk wiJl bc izt cottfarn�anc�with thc ordinanacs amd codcs of thc Ciry a�d with
thc Statc Butldii�g Cade; tltai I uuderstan,d this is oot�a gcrmi� and work is nol to start without A
permic; aad that thc wark wiIl bc in accor�acc � approv d pInn. �
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APPLYCANT'S SIG1�iA DA'ri::�-O �
NOTE! Pamde,��,�,�avsnls reqrtire aepara«p�nr�ft apprroval by Potice Depurtment and
GY�y Counelt 60 days p�ior to �he ovant, Nnn-permltrcd evrnl.s w�l1�o�be allvwed.