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Home My WebLink About2011-01560 - windows CITY OF ORONO PERMIT NO.: 2011-01560 : �- � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 12/16/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2699 KELLY AVE PIN : 21-117-23-23-0041 LEGAL DESC : WALTERS PORT : LOT 002 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 APPLICANT pERMIT FEE SCHEDULE 162.25 SANDSTORM WINDOW STATE SURCHARGE(VALUATIOI� 4.00 515 WEST MARYLAND AVE TOTAL 166.25 ST.PAUL,MN 5511'7- (612)807-8816 PAID WITH CC# 1122 Minnesota State License#:20627522 OWNER UPHOFF,DARYL&LUCY 2699 KELLY AVE EXCELSIOR,MN 55331- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved ptans 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 permits. All provisions of laws and ordinances goveming 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 aze requested in conformance with the State Building Code.This permit may be /"1� revoked at any ime for due cause. C r� /�!�`�/ � � 1� / " / App licant e ignature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � �i��► a�€ ��a�o `r�uiiciing Permit �►ppii�a�io� for IVEainfena�ce / F�e�ova�ion (windows, doors, siding, re-roof, efc.) Maiting Address: Permit number: /'�.,D,j� PO Box 66 Crystal Bay, MN 55323-0066 Date received: �O � O �'��a,,r�-.�... �a , '.',�-�' Street Address: Received by: , M�. ,:r,''-� � I \�n ",;,?„'�, G/ 2750 Kelley Parkway Plan review fee: L'�gESHo�"� Orono, MN 55356 Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This appfication forrn must be completed in full and all required information must be submitted. incomplete appiications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: l�,� �..�� 1��1�� t Will this be a Parade of Nomes, Remodelers Showca e Home or other Display Home? ❑ Yes ❑ No If yes, a specia/event permit is required with Police Deparfinent and City Counci!approva/60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is avai/ab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��,v��k `�� .� 1,�,�._��{�w� State License# '�� {�� Expiration Qate: (�, �S ��,� � Lead Certification Number: Expiration Date: (for work on homes thaf were construcfed prior fo 1578 Phone: �� - ��}� -�'S'I b (office) (cell) Mailing Address: �� I r c.< <v�o( �z City: �� „�� ZIP: �c,�� Contact Person: E i ` Appficant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: � Name: ��,��y L�� . Phone (day): 1�-' � -,�\\� Address: `` V /'4' Y� ��'�l s: S S �I z�L' � � �c •;ti Cit ZIP: � Email and/or Fax PROJECT INFORMATION: Type of Project: i Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage � MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 I ❑ Re-roof, other s eci Phone: 952-471-Q590 ( p fy) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 .�Window(s) � www.minnehahacreek.orq Overal! Project Description: Esfirnated Construction Valuation of Project(excluciing land} � ��C�C�. �) APPLICANT ACKNOWLEDGEM�NT: • 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 app(icant recognizes that they are solely responsibie for submitfing a compfete appficafion 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 appiication is ciassified by State taw as either private or confidentiaf. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential da:a is inform�tion which generally cannot be given to either the pubiic 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 reauired b law. If vou refuse to su I the inf rmation,the a plicafion mav not be issued. � . ApplicanYs Signature: �,y'� ,-' � �� -- Dat,.: -- o Last lipdated: OS-09-2011 �� 1 � / �� DATE TIME � l�CITY OF ORONO J CALLED IN � � INSPECTION NOTICE SCHEDULED �� -' �� v1 �ERMIT NO. ,-3,;�,.�(T�,,� �L% COMPLETED ADDRESS �' " � � t� ' OWNER TELEPHO � NO. �� '� �� CONTRACTOR �-- '�`�� I� �Y�r� �'��:�uf , � DESCRIPTION � � - � � �('I l�1,�� 1 I �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE � SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PIUMBING RI ❑ SEPTIC FINA ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � j d W� ❑WORK SATISFACTORY:PROCEED �GROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR � INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. �,L, � White Copyllnspector's File Canary CopylSite Notice