HomeMy WebLinkAbout2010-00295 - siding *
- CITY OF ORONO PERMIT NO.: 2oiaoo29s
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 05/03/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 145 MANOR CIR
PIN : 04-117-23-11-0024
LEGAL DESC : COUNTRYSIDE MANOR 3RD ADDITION
: LOT 1 BLOCK 1
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 25,000.00
NOTE: REMOVE EXISTING AND APPLY TYVEC AND HARDISIDING
APPLICANT pERMIT FEE SCHEDULE 413.00
WILLETTE BUILDING CO.
P.O.BOX 85 STATE SURCHARGE(VALUATION) 12.50
MOUND,MN 55364 TOTAL 425.50
(952)472-4332 PAID WITH CC# 6891
Minnesota State License#: 1804
OWNER
NAFSTAD,ADAM&KRISTIN
145 MANOR CIR
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 approva(s,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
shail 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
re� d a y ticpe for cau� � �
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Applicant Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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� - City of Orono ��
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,,; Building Permit Application for Internal Work
�
(windows, doors, siding, re-roof, etc.)
���� Mailin Address: �J
�� g,�,� PO Box 66 Permit number: �'�� -��� � �
� �1 � Crystal Bay, MN 55323-0066 Date received: ? C�
' � .� ������' �,� Street Address: Received by: �/'�- �
s <t,�.
��% �'� � �" �ti�' 2750 Kelley Parkway Plan review fee:
�` �`�kEsxo4'� Orono, MN 55356 ,
� � Total Fee: L �� �7�
� ; 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)
�LL GENERAL INFORMATION: .
� ' Job Site Address: ,��.5 �,�/l�� �i�/� G�� �
�;, Will this be a Parade of Homes, Remodelers Showcase 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 sufiicient on-site parking is available. Non-permitted events will not be allowed.
�:�' CONTRACTOR/APPLIGA T O ATION• , � '
Name: ��
� State License# j g Z� y Expiration Date: 3/ Z
t�,� Phone: -� C�—��� office �E���- cell
e" Mailin Address: �
9 c, Cit : ZIP:
'�.�!. Contact Person: pplicant is: ontractor / Homeowner (Circte One)
! � Email and/or Fax: .u•� �✓ , .
�' f PROPERTY OWNER INF RMATION:
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� Name: �(,�
,��� Phone (day): - - �
;�, Address: � Cit : �/Lbz--i�c.� ZIP:S��.S�(�
Email and/or Fax �
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�S`""' PROJECT INFORMATION:
� Type of Project: Any earth movement may require
�: MCWD review&permits
�� ❑ Door(s) ❑ Remodel
❑Water Damage
�: Minnehaha Creek Watershed District(MCWD)
�::y ❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
� j Deephaven, MN 55391
�„` �Siding ❑ Restoration ❑ Other. (specify) Phone: 952-471-0590
j Fax: 952-471-0682 �r
°'1� ❑ Re-roof ❑ Fire Damage www.minnehahacreek.or '
�•� Overall Project Description: � � l � *
� Estimated Construction Valuation of Project(excluding I ) $ ' �� �
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,.{ APPLICANT ACKNOWLEDGEMENT:
��, • Agrees to provide all information required or requested by the Building Department; �°
a4
i • 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 alf 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. :�
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k+ Aprlicant's Signature: Date: .� / (�
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Last Updated: 05-04-2009 �
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