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Home My WebLink About2013-01036 - windows CITY OF ORONO * Z 0 1 3 - 0 1 0 3 6 * � - 2750 KELLEY PARKWAY DATE ISSUED: 10/02/2013 ! ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 80 LUCE LINE RIDGE PIN : 31-118-23-34-0010 LEGAL DESC : PAINTERS CREEK : LOT 008 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 14,840.00 NOTE: 7 WINDOW REPLACEMENTS IN EXISTING OPENINGS APPLICANT pERMIT FEE SCHEDULE 265.50 �` PELLA NORTHLAND STATE SURCHARGE(VALUATION) 7.42 15300 25TH AVE N.-SUITE# 100 PLYMOUTH, MN 55447 MAIL-IN FEE 2.00 (952)345-6047 TOTAL 274.92 Minnesota State License#: BC645090 OWNER GRAJCAR,ZDENKO 80 LUCE LINE RIDGE MAPLE PLAIN,MN 55359- 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 responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / / / / Applicant Permitee Signature Date Issued y S' nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A VE. � ' � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) --- Mailing Address: Permit number. �Q 1►� : POBox66 � �V�A Crystal Bay, MN 55323-0066 Date received: 'I� �rRy�5� ; �,I Street Address: Received by: �� .� {�r� ti/ 2750 Kelley Parkway Plan review fee: �1�.��li i�lir��sv°% Orono, MN 55356 ��ESA�S��: - -= 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: � O / U C� � / /� Q► 17 ( C� G Job Site Address: ��+ Will this be a Parade of Homes, Remodelers Showcase Home or other isplay Home? ❑ Yes ❑ No If yes, a special event permit is required with Po/ice Department and Crty Council approval 60 days prior to the event. Shutt/e bus service wi/l be required unless applicant demonstrates sufficient on-site parking is available. Non-permitfed events will not be aUowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# Pella Northland Phone: 15300 25th Ave N. Ste 100 (cell) Mailing Address: Plymoutll, MN 55447 ZIP: Contact Person: Lic# BC645090 Ph. 763/745-1400 �omeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMA ION: G't. 4 C G � Name: � C�L n � Phone (day): ? � 3 2 � � � 'S Y'.� Address: g O U t.�. / /) 4 �l �a' 'C City�f�op�� Q�/� ZIP: SS ,� S g Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review& permits ❑ Door(s) ❑ P.2model ❑Water Damage Minnehaha Creek Watershed District(MCWD) indow(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: („� � n 4�� 4� f Estimated Construction Valuation of Project (excludi g land) $ /y g' y t� 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 suppl the information,the application ma not be issued. ApplicanYs Signature: \/ � Date: r r � 7 �, � � Last Updated: 05-04-2009