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Home My WebLink About2009-00096 - dog house structure for fireplace i - . CITY OF ORONO PERMIT NO.: 2009-00096 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 03/09/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 1560 NORTH ARM DR PIN : 08-117-23-33-0073 LEGAL DESC : HICKORY HILL : LOT 014 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTMTY : 434-RESIDENTIAL VALUATION : $ 300.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) DOG HOUSE STRUCTURE FOR FIREPLACE-FIREPLACE CREATIONS IS RUNNING GASLINE ON PERMIT-2008-00235 APPLICANT pERMIT FEE SCHEDULE 25.00 LAWLESS,PATRICIA STATE SURCHARGE(VALUATION) 0.50 1560 NORTH ARM DR MOLJND,MN 55364 MISC FEE 0.00 TOTAL 25.50 OWNER LAWLESS,PATRICIA 1560 NORTH ARM DR MOLJND,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 pertnit 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 consVuction 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 reque ted in conformance with the State Building Code.This permit may be rev d at any time for due cause. ' l <3 / D9 D � � � �p pplicant Permitee Signature Date I s ed By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � , . City of Orono Building Permit Application Mailing Address: Permit number: Ogr�,�j•O PO Box 66 Crystal Bay, MN 55323-0066 Date received: a� ,� a. Street Address: Received by: �',�, � G��' 2750 Kelley Parkway Plan review fee: t•�Esxog,� Orono, MN 55356 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. (P/ease print) GENERAL INFORMATION: Job Site Address: �; , Will this be a Parade of Homes, Remodelers Showcase Home or other Display Hom ? Yes No 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 s�cient on-site parking is available. Non-permitted events wil/not be allowed. CONTRACTOR/APPLICANT INFORMATION: � Name: State License# Expiration Date: Phone: (office) (cell) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One� Email and/or Fax: PROPERTY OWNER INFORMATION: Name: -S Phone(day): �- — Address: Cit : ZIP: Email and/or Fax ,S PROJECT INFORMATION: Type of Project: Any earth movement may require � MCWD review 8 permits ❑ Door(s) �Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(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: p s � � � S� Estimated Construction Valuation of Project(excluding land) $ ?�D D , �D APPLICANT 8� OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department, • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and owner recognize 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. • The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property by City Staff,consultants or agents, for purposes of investigation of this request. • 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 su I the information,th a lication ma not be issued. Applicant's Signature: Date: 3--g-6� Owner's Signature: Date: � --�—() �'j �