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Home My WebLink About2016-01362 - doors � ' ' CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 6 — 0 1 3 6 2 * DATE ISSUED: 10/26/2016 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 1540 LONG LAKE BLVD PIN : 26-118-23-33-0007 LEGAL DESC : ALBEES LONG LAKE ADDN : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 3,230.00 NOTE: DOOR REPLACEMENT APPLICANT PERMIT FEE SCHEDULE 10838 PELLA NORTHLAND STATE SURCHARGE(VALUATION) 1.62 15300 25TH AVE N.-SUITE# 100 1vIAIL-IN FEE 2.00 PLYMOUTH,MN 55447- TOTAL 112.00 (952)345-6047 Payment(s) Minnesota State License#:BUIL-BC645090 CHECK 76317 112.00 OWNER GHANDY&RACHEL CARPENTER,WILLIAM 1540 LONG LAKE BLVD LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this pertnit 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 pertnission for additiona!or related work which requires separate pertnits. All provisions of laws and ordinances governing 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 responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time or due cause. . � - �` oV O� �/� Applicant P mitee Signature Date Issued By S' ature Date ` � � City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRU AL EXPANSION) �O�O Mailing Address: R Permit number: ��(�—D�3� PO Box 66 Crystal Bay, MN 55323-0066 OC-� 2�p�received: 2 �� Street Address: RReceiyed by: y G� 2750 Kelley Parkway C�-r(OF F'1�N eview fee: � t � Orono, MN 55356 '�KEst�o� � �� , l/l/ -�.._ 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 ubmitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: / � v� L b !1 L. A � � I�/' Job Site Address: [ Will this be a Parade of Homes, Remodelers Show ase Home or other Display Home? ❑ Yes ❑ No lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: i�lame: State License # Pella Northland Expiration Date: Lead Certification Numk 15300 25th Ave N. Ste 100 Expiration Date: (for work on homes tl Plytnouth, MN 55447 Phone: (ce L�c # BCC45090 Ph. 763%745-1400 (office) Mailing Address: ZIP: Contact Person: �� g 5 � � ys , L b y 7 Applican is: Contractor omeowner (Circle One) Email and/or Fax: PROPERTY OWNER IN�FQ RMATION: Name: K Q C� � l �a � l /1 �e l Phone (day): (, ( 7 3� S''• � � 3 ' Address: � .s �/b a � ry Q �,� �� City: �en� �6 �,t ZIP: �S 'S'S� � Email and/or Fax: PROJECT INFORMATION: Overall project description: T pe of Project: Any earth movement may also require Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Re-roof, as halt �Re air Minnehaha Creek Watershed District(MCWD) p p ❑ Storm Damage 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ �J O � 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 required by law. If ou refuse to su I the information, t ication ma not be issued. ApplicanYs Signature C--� Date: � b � � � ` Owner's Signature: Date: Last Updated:January 2016 �j V � DATE TIME CITY OF ORONO cnLLED IN '� INSPECTION N TIC �j �EDULED .//�-a �5-/F2 PERM(T NO. —D/`� COMPLETED ADDRESS �� - OWNER NE NO�%!'L 7�(o-clSal` CONTRACTOR � �� 1 DESCRIPTION �-1�%�'`^ -�/'G"t� W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO �Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL ? OMfNEAlCOKTRACTOR T�0 MEET YOU:_YES_NO y COMMENT'� � 4 j j, ��-, � r^ � � � , OO '�1- ��„�� C � `� U�_- � 0 W � Q � � W � J � ❑WORK SATiSFACTORY`.PFiOCEED PROJECT COMPLEfE W O OORRECT YMORK a PROCEED O I E CERTIFICATE OF OCCUPAHCY O ❑OORRECT WORK,CALL FOR REINSPECTION TEIiAPORARY V BEFORE Cd1/ERINO PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED O INSPECTION REWIRED.CALL TO ARRANGE ACCESS. CaN for the next inspectfon 24 hours in advanoe. (952) 249-4600 OwnedConlractor o�si�e: ��t«: C�� YVhib CaPYAnspectors FII� C�n�ry CopyISIN Notles