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. CITY OF ORONO PERMIT NO.: 2011-00679
� 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 07/25/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 115 LUCE LINE RIDGE
PIN : 31-118-23-34-0006
LEGAL DESC : PAINTERS CREEK
: LOT 004 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 13,251.00
NOTE: REPLACE(5)WINDOWS IN EXISTING OPENINGS.
APPLICANT pERMIT FEE SCHEDULE 250.75
RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 6.63
1920 COUNTY RD C. WEST TOTAL 257.38
ROSEVILLE,MN 55113
(612)502-4777
Minnesota State License#:20130983
OWNER
LOCKMAN, STEVEN&SONJA
115 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 dces
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 consVuction 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.�
�I�� liYl., l l l l
Applicant Permrtee Signature Date Issued By ' ature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
J:I-lo-2�11 OB:05am From-CITY OF ORONO +A5224A4616 T-058 P.002/002 F-1T0
• '� —� �■ ���v
" � Building Pe�mit Application for Internaf �
(wjndows, doors� sidin . re-roof etc. ��r�
Mellin0 AdOAas: � )
O�"�'� Po Box 66 Pumk number: — D � .9
� Crys�l eay,MN 35323-0088 Da6B rece;ved:
� /.
� � Stivet AddiaBs; R����,
2750 Kellsy Psrkway
��'� Orono.MN 56356 Plan r�view{e�:
�_�
M81�: 95Z-248-4600 Fax: 952-249-48i6 Total Fee: ���f3�
Thfs application fatm must he�pmpleted in tull an���� �
Incomple�app�ications w111 be�W� inform4tion�must be submi�ed.
4ENERAL INFORMATION: �d• (P�eere p�q
Job 8i1r Add�aa�: �,��
Will this be a Parade of Ha�nes� Rsmodelers Showc.asa Home er �ther splay Home?
�1Ms.�speNe!swnt pa,rrit/a roawas�d�,Aa/,bs o�pemnont ana►C!ry GounCil YeS
ro0u�rsd a�fksa 4AON�anl ahrhan�hradsa a�A�cient on-sUe OarJrinp fs a�N.bl�s. ��w��he srenf. Shuffla eas ss,viae wid be �
CONTRACTOR/APPLICANT INFORMAT1pW: ��•`�'�""�^or ea e,obw�t
Name: �e� B
Stste Licenae# ~— Y�dersen
Phone; �-- 1920 Cpunty Road "C"West � �iraYon De�;
Mailing qddress: ---- Roseville, MN 55113 ���
Contact Person: — " Lice�#20130983 C�� ZIP:
Email and/or Fex `� 65]-264.47'77 �t�� Contracto� I I�omeown��
� . tcau•o�.�
PRQPERTY OWNER INFO�b� N, .
Name� ��
Phone(day): �
Addr�eas:
Email and/or Fax � Ci :
ZIP:
PROJECT 1NFORMATION:
TYpp of Pro)sct:'�{p
❑ Door(s) "` c�., J W i� ��!V �p1'I('� 4ny MC mov�enont m�y roquirs
❑Ramodel ❑V►l�ter�arnape • WD rovisw�p�►rn�b
C]1Nindpw(s)
�R��r ❑Storm Damage Mi Aa C�eek Wate�ehed Oiatrlct(MC1AIp)
1a2a2 Minnetonke Bhrd
❑Sidin� ❑Restoralion
❑01her� (speClfY) �Phevcn.AAN �6381
❑ Re-root Phcme: 952471-0590
❑Flre Damape F�x; AS2-471..0882
dverall Pro t D�sc�lptlon: �acboa� �
�ma�ed Conatruetlon V�luation ot Pro s�t(excl�,din landf :
f—�
APPLICANT ACKNCWl.EpGE�AE�:
' A��s�P�lda aU iMorrrtatbon requa+ed or� uested b the 9ui1clln Do
� y 9 P��tment;
• Certilles th81 the Informatl� wpp�ad Is truo and opmect to�he pest af hlsfier knoMA
b��`�eh►�esponslble lfor submltting a compl�apppcatlon being aw�re tha� °�. 1'po applicant recegr�es thet they
Ject it untif it ia c�maeee; upon taA�re to do so �e steff has no e{temativ.
• Soms or a11 of the infmmaqp� tl�a�y��ag�@d to prov�da on this aPPlication is dAa�d
mnfideMial. Prlwdte dat� ie iMnrrnaUon wh{ch genete�, �� be glven lo the publlC but can
�. Confiqenbal dsla is fn �' S� ��eRher privete or
�upose end Intsnded �a� �"F'�� 9°�ranY �annot be given tv efther d�e �a�Ven to the�ub)act o�the
ui�ed � of�is informadon is 1�snnually updata our rooprds and ��� or the subjsct of U1e det�. p�r
law. If u rafuse b�u ihe information r000 racwde oi other pqyernrnental apenclss
tic�ma not bs letuod.
�pplkaM's Signature�
Date: _ $�V 1
�st�: 05-C4.zoos
Z �d 06I94G9iS9 3�IAa3S lIW2l3d Q 9 S 1'1 96 :9T iT02 8T Z�C
��� o TIME �
CITY OF ORONO CALLED IN �o'--���
INSPECTION NO IC n SCHEDULED �L �
PERMIT NO�ZD "" v COMPLETED
ADDRESS I I� LLZC� (_l.VIO IG �
OWNER TELEPHONE NO.�211�� � �
CONTRACTOR �(}�Q G1
� DESCRIPTION __LV�iZLY�S
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
Q ❑ FRAMING p MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAiNT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ` '�PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
D CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETUFN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTtON REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notfce