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Home My WebLink About2015-01253 - doors ,� -- CITY OF ORONO * Z 0 1 5 - 0 1 2 5 3 * 2750 KELLEY PARKWAY DATE ISSUED: 09/28/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3697 LYRIC AVE PIN : 17-117-23-34-0037 LEGAL DESC : NAVARRO : LOT 001 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 2,000.00 NOTE: DOOR REPLACEMENT INTO EXISTING OPENING. APPLICANT PERMIT FEE SCHEDULE 77.44 STATE SURCHARGE(VALUATION) 1.00 DESIGN CRAFT CONSTRUCTION INC. 3333 80TH AVE N TOTAL 78.44 BROOKLYN PARK, MN 55443- Payment(s) (612)597-5989 CHECK 6117 78.44 Minnesota State License#: BUIL-BC692134 OWNER ARONE,JOSEPH 3697 LYRIC AVE WAYZATA, MN 55391- 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 separate permits. All provisions of laws and ordinances governing 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 period o days at any time after work has commenced. The ap icant is responsible r assuring all required inspections aze requested in conformance w the State Building Code.This permit may be revo�ced at any time for due ause. , /: �'1�2��1� ( -�� PZ 0 /l� Applicant Pe ' e Signature Date Issue y Signature Date 1 - City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O�O Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: y � 2750 Kelley Parkway Plan review fee: `� �' Orono, MN 55356 l�'�FSHO�� / � 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: Job Site Address: � r�L ,ncv2 , Will this be a Parade of Homes, Remo lers Showcase Home or other Display Home? ❑ Yes o If 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 I APPLICANT INFORMATION: Name: '�2s�,a,, `�.G,�, ��,s�n,� 1 ra�. State License# �� Expiration Date: ��i��-� Lead Certification Number: �T _F-��S��j_ � Expiration Date: $�ti�2.�� (for work on homes that were constructed prior to 1978 Phone: (cell) � _1 _pg� (office) Ln,,�y _2,� Mailing Address: ��. � (�( City: p� ZIP: � Contact Person: "�' Applicant is Contracto / Homeowner (Circle One) Email and/or Fax: ��,a,� . PROPERTY OWNER I FORMATION: Name: ��XQ�, �,� Phone (day): �� _� Address: ��.� �r,� �Y,� City: ��o ZIP: �� Email and/or Fax: —S PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require �Qoor(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: � � Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,asphalt ❑ Repair ❑ 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) $ �. � 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 is in o ation which generally cannot be given to the public but can be given to the subject of the data. Confidential data ' information wh ch generally cannot be given to either the public or the subject of the data. Our purpose and intended use of is information is o annually update our records and records of other governmental agencies required by law. If ou refuse to s I the informat' n,the a lication ma not be issued. Applicant's Signature. Date: 9�2��►�' Owner's Signature: Date: Last Updated:January 2015