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Home My WebLink About2010-01058 - windows , �• CITY OF ORONO PERMIT NO.: 2oiaoioss 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 10/27/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1845 LAKEVIEW TER PIN : 27-118-23-42-0016 LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN : LOT 004 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: (INSTALL REPLACEMENT WINDOWS INTO EXISTING OPENINGS) APPLICANT pERMIT FEE SCHEDULE 162.25 NORTHERN SUNROOMS&ADDITIONS STATE SURCHARGE(VALUATION) 5.00 1060 BROWN RD N TOTAL 16725 LONG LAKE,MN 55356 (612)290-7988 Minnesota State License#:20631256 OWNER JONES,CELAYNE 1845 LAKEVIEW TER LONG LAKE, MN 55356 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 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 re o ible for assuring all required inspections aze requested in conf m ce with the State Building Code.This permit may be re e t' e r due cause. (I l'� �d Q l �7/�L� A licant rmitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � City of Orono Building Permit Application for Internal W � (windows, doors, siding, re-roof, etc.) �� MailingAddress: Permit number: �D/�/�/OJ� g �v�,�. PO Box 66 Q � O Crystal Bay, MN 55323-0066 Date received: �%7 / a �� 4<:� �,' Street Address: Received by: �, �. �'.�, '� s%� �ti�' 2750 Kelley Parkway Plan review fee: �'�x'Esxo4`'� Orono, MN 55356 Total Fee: �� 5 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: , /�� L� / v/�� r��— Job Site Address: "1 /� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ill e required unless applicant demonstrates sufficient on-site parking is availabfe. Non-permitted events will not be allowed. CONTRACTOR/AP LICANT INFORMATION: f � Name: �k>�'�� S yt,:1<'p7�w�5 � Gl d-d-i�f'�v11s State License# �,p(o =� j• �.57P Expiration Date: 3-�i � Phone: (pf p - office CP+.1- a 7 cell Mailing Address: p r , Cit :L�� ZIP: � - s Contact Person: S Applicant is: „ Contr ctor / Homeowner (Circle One) Email and/or Fax: y��;�-�-h�-� ��u,,��Df��rS � A'lLhSi r GOrvl PROPERTY OWNER INFORM TION: Name: v � � � - ��1�5 Phone (day): � - � - �j Address: ,S �:.� !�r'�� Cit : � �� ZIP: SS 3 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: �j�� (rU t,� •5 Estimated Construction Valuation of Project(excluding land) $ g pp p , v U 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 the inf ation,the a lication ma not be issued. Applicant's Signature: Date: I� "- ,�2( •- `� Last Updated: 05-04-2009