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CITY OF ORONO * 2 0 1 7 - a 0 6 1 6 *
2750 KELLEY PARKWAY DATE ISSUED: 06/07/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3405 CRYSTAL BAY RD
PIN : 17-117-23-44-0022
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTNITY : O/S BUILDING-UNDEFINED
VALUATION : $ 13,442.00
NOTE: (4)WINDOW REPLACEMENTS
APPLICANT PERMIT FEE SCHEDULE 263.28
STATE SURCHARGE(VALUATION) 6.72
SCHERER WINDOW&DOOR CONSULTANTS MAIL-IN FEE 2.00
10751 EXCELSIOR BLVD. TOTAL 272.00
HOPKINS,MN 55343
(952)277-1635 Payment(s)
Minnesota State License#:BUIL-20239369 CREDIT CARD 3281 272.00
OWNER
SWEET,CATHERINE
3405 CRYSTAL BAY RD
WAYZATA,MN 55391-
AGREEMEIYT 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 dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified hereia 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 responsibie 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.
� �a � �� 7 �17
Applicant Permitee Signature Date Issued By ' ature Date
, , Jun. 7. 2017 11 :41AM � � u No. 3665 P. 1
City af �rono
. .,,, ..
Building Permit Application for Maintenance/ Replacement!Remudel—,. ;."'.;�d��i.t���:�;�lV;��
(i.e,windows, doars,siding� re-raof,etc.--NO STRUCTURAL EXPANSION)
yr� Mslling Address: --:.�:,:,:--=.:..R:.� �— �?i - ""'i�:=:
PO Box 66 ��Re�fil.l,4;^ntr�i4�r�:��Y �=�.: ..:._... .�_� �
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Grystal Bay,MN 55323-0086 �pa�;i�rved',�J�=���;;�!':°`'°x=�--.�;;���; _
Street Address: =�I�ecelVed;ti�:���- __ - - ---
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Maln' 952�249-4600 Fax: 952-249-4696 www.a.orono.mn.us - -- - �:.,�-
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This appllc�t(on form must be completed in full and al(required information must be submitted.
Incomplete appltcatlons will be retumed. (Please print)
GENERAL INFORAAATION: � ���1 �
Job Site Address: �
Wlll thls foe a Parade of Homes, emodelers 8ho se Home or oEher Dlsplay HomeT Yes Ido
N yes,d 8pecial event permit is required wifh PoGce Deparfmenf and Cify Coundl approva!80 days pryor fp the evenK ShufHe bus serv w'�l be
requhed unless applicant demonstrafes sulficient on-site parkfng ls ava!lable. Nony,�ar�nitted evenfs wrTi not be allowed.
CON7RACTORlAP�CANTINFORMATIQ ; � �Q��
Name: ,Q,r' � �� � .
C'75tate License# '� ^ Expir�tion Date: �
�.ead Certlflcatlort Number: (,o Expiratbn Date:
(lPo1'work on hamea thet were cons cted o�ta 197'B
Phone: (cell) �j�' a � � 7 (of�ice)
Mailing Address: Cit � ZIP:
Contact Person: ,�� Appllcant Is: Co�tra / Homeowner �ci��o o�a
Emafl and/or Fax: ,� r � , ��fY�
PROPERTY OWNER INFOR ATION:
Name: (Jl� ,�
Phone(day): .-� � �
Address: � �City�dY'�c� ZIP�`}���
Emall ahdlor Fax:
PROJECT INFORMATION: Overall ro ect descr� 'Nan:
Type oF P�oject: Any earth movament may also requlroe
❑Door(s) ❑Ramodel �Fire Damage MCWD review 8 permits: '
�Re-rooF,asphalt ❑Repair ❑Storm pamage Mlnnehaha Creek Watershed Districl(AACWb)
15320 Minnetonka Blvd
❑F�e�roof,cedar ❑Restorat(on ❑Water Damage Minnetonka,MN 55345
❑Re-roof,othel'(speclfy) ❑Siding ❑Olhe�:(speC'ify) Phone: 952-471-0590
Fax: 852-471-0682
w(s) __ www.minnehshacreekora
Estlmated Construction aluation of Project(exclu irtg land) $
APPLICAN7 ACI�WOWLEDGEMENT:
• Agrees to provlde all information required or requested by the Building Department;
+ Certifies fhat the information supplied fs true and c�rrect to the best af hislher knowtedge. The applicant recognizes that they are
sofely responsible for submitting a compfete appiication being aware thet upon fallure ta do sa, lhe staff has no allemati�e but fo
reject il uMil it is complete;
• Some or all of lhe informatlon Ifiat you are asked to provide on this applicabon is dassified by State law as either private or
confidential. private data is informadon which generally cannot be glven to ihe publlc bui can be given to the subject oF the data.
Confidential data Is information which generally cannot be given io either the public or the subject of the date. Our purpose and
infended use of this intormation is to annuafty update our records snd records oF other governme fal agencies required by law. if
ou reFuse to su I the i rmalion tha a liption ma not be issued.
Applicant's Signature: � bate: � �
Ownar's Signature� Date:
Lasl Updaled:January 201 B