HomeMy WebLinkAbout2010-01078 - windows CITY OF ORONO PERMIT NO.: 2oiaoio�s
2750 KELLEY PARKWAY
'"* ORONO, MN 55356- DATE ISSUED: 1 U08/2010
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 1525 LONG LAKE BLVD
PIN : 35-118-23-22-0002
LEGAL DESC : ALBEES LONG LAKE ADDN
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-LJNDEFINED
VALUATION : $ 3,719.00
NOTE: (5)WINDOW REPLACEMENTS IN EXISTING OPENINGS
APPLICANT pERMIT FEE SCHEDULE 103.25
THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 5.00
2690 CUMBERLAND PKWY,STE 300 TOTAL 108.25
30339-
(763)542-8826
Minnesota State License#:20268257
OWNER
WENDT, MARIE
1525 LONG LAKE BLVD
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 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 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 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 Issued By i nature �r,�c /ate /
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
- City of Orono
y Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
.¢,�,�. PO Box 66
O � � Crystal Bay, MN 55323-0066 Date received:
�.'�' ti Received by:
,� ;� . -��, �, Street Address:
`�,�, •' w� Gtiti 2750 Kelley Parkway Plan review fee:
'LykESH��`,� Orono, MN 55356
Total Fee:
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:/Sa� �b� /Q L� gl V
Job Site Address: �L <<
Will this be a Parade of Homes, Remodelers Sho case Home or other Display Home? ❑ Yes ❑ No
_ _ _
If yes,a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events wil/not be allowed.
CONTRACTOR/APPLICANT INFORMATION: ' J D e�, da �r�,r Jo�� s
Name: THD At- Home Services, Inc.
State �icense# 2690 Cumberland Pkwy, Ste 300 95� 3�/� "�°el�
Phone: � �
Mailing Address: Cuinberland Office Park Z�p;
Contact Person: Atlanta, GA 30339-3913 lomeowner (Circle One)
Email and/or Fax: Lic#20268257 Ph. 763/ 542-8826
PROPERTY OWNER IN�,Q RMATION: �'j S?�y ] L - G G D (�
Name: 1')Q f l !. �1 t /l Ct�I�
Phone(day): (5.'�S D A
Address: City: ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&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.or
Overall Project Description:�W� /�/_ � /1 !n b /�/ �
Estimated Construction Valuation of Project(exclu ing land) $ 3 '� ( 9'
�
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 information,the a lication ma not be issued.
ApplicanYs Signature: � Date: (( �� �� �
Last Updated: 05-04-2009