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Home My WebLink About2014-00988 - addn/remodel/repair . • CITY OF ORONO * 2 0 1 �0 0 9 B B * 2750 KELLEY PARKWAY DATE ISSUED: 09/03/2014 ORONO, MN 55356- (952) 249-4600 FAX: 952)249-4616 ADDRESS : 1317 NORTH ARM DR PIN : 07-117-23-41-0032 LEGAL DESC : SAGA HILL REVISED ; LOT 003 BLOCK 007 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 3,100.00 NOTE: REBUILD CHIMNEY TOP FROM ROOF UP. APPLICANT PERMIT FEE SCHEDULE 103.25 STATE SURCHARGE(VALUATION) 1.55 DAYCO GENERAL INC P O BOX 278 TOTAL 104.80 LORETTO,MN 55357- Payment(s) (612)684-1243 CREDIT CARD 8949 104.80 Minnesota State License#: BUIL-20266544 OWNER DERBY,ANN&LORIN 1317 NORTH ARM DR MOUND, MN 55364- 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 permiu. AII 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 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 for due cause. < / / Appl c t ermite ' ature Date Issu d By Signature Date , . - City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: (' PO Box 66 Crystal Bay, MN 55323-0066 Date received: � Street Address: Received by: � G� 2750 Kelley Parkway Plan review fee: `� Orono, MN 55356 �'�kFSNo�`` 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: �3�� /l/�,,-J�, ��,,, /J� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ,�IVo If yes, a special event permit is required with Police Department and City Council approva/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: Name: �� o ,�,,�,� State License# ,S— � Expiration Date: � � �f Lead Certification Number: ��_ -,7� S—�/_ � Expiration Date: / �S� (for work on homes that were constructed prior to 1978 Phone: (cell) �Z _ 4 S—_ f^-� (office) Mailing Address: f,� d �,� k,,,�ti City: � ZIP: SJ":3S'�� Contact Person: �' I,,ri 5 CJUo�•� Applicant is: ontractor / Homeowner (CircleOne) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: �-t��trc (Jt�-�Y Phone (day): ys-,�- �G�- G2G3 Address: /3/� /f/��fj, /�.,H,, 1� City:��d ZIP: 5��G !.� Email and/or Fax: PROJECT INFORMATION: Overall pro�ect description: /��1�� N � n�,u !- Type of Project: A eart movement may als require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 �- Fax: 952-471-0682 ❑Window(s) �n�� r�� / v www.minnehahacreek.ora Estimated Construction Valuation of Project(excluding land) $ O • !�v 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, the a lication ma not be issued. ApplicanYs Signature: � Date: 'I " 3'-�� Owner's Signature: Date: Last Updated:03/O6/2013 �/� DP� DATE TIME Y CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED pp�_ �� PERMITNO. a��y- vd��g COMPLETED ADDRESS �3/7 N �a.�2 J��-- OWNER TELEPHONE NO.�•R6S-�`J"�p CONTRACTOR �� - � DESCRIPTION �� ""'� " ti W ❑ FOOTING ❑ PlUM81NG FINAL ❑ EXCAV/GRADING/FILLING � � POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS H Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � �FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � � a �R/y C�lr�Krt�y /'�-LJ��' '�vb�•2 C�� 4d. O � �I•y�LO�'�'G� T[.f�j/l��C� C/I L�►4 i!C'f '" L''a� �- SDa�� k✓r��o.�D rn u�� . � 0 W � �,J O ✓ K �"ONtlD IZZ� - Q � 2 � w �iiar.=. �c �tG�s� . � J � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 2a hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSfte Notice �'� �Je� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED /O�O , d PERMIT NO.�nI�– dd � COMPLETED ADDRESS�,/7 I1I�DIC�1 � DiC. OWNER TELEPHONE NO.��''�r'1' ��6Y CONTRACTOR . � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J BING RI ❑ SEPTIC NAL ❑ FOUNDATION/REMOVAL OWNE NTFiACTOR TO MEEf YOU:_YES_NO � COMMENTS: � a �— – � J O - �. � O � r W � ` Q � � 7"�i��.ae r»,,�� '��u,l�d� g- $ `� ,�r �T'.w - � ra;, �� ` ' " W O WORKSATISFACTORY:PROCEED ,�PROJECTCOMPLEfE�� ❑CORRECT WORK 8 PROCEED ,� ❑ SI SUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE COVERING pERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑STO O ER STED.CALL INSPECTOR �CITATION ISSUED N REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: ,,� inspector. � White Copyllnspector's File Canary CopyiSite Notice