HomeMy WebLinkAbout2011-00993 - doors * ' CITY OF ORONO PERMIT NO.: 2011-00993
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/02/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3090 NORTH SHORE DR
PIN : 09-117-23-32-0006
LEGAL DESC : CRYSTAL BAY PARK
: LOT 000 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,135.00
APPLICANT pERMIT FEE SCHEDULE 132.75
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 2.57
10751 EXCELSIOR BLVD
HOPKINS,MN 55343 MAIL-IN FEE 2.00
(952)277-1600 TOTAL 137.32
Minnesota State License#:20239369 PAID WITH CC# 3989
OWNER
MCGLYNN,DAN
3090 NORTH SHORE DR
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned 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 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 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
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
` � O�[ / l �o�-t/
Applicant Permitee Signatu Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Sep, 1. 2011 4; 38PM No, 7944 P. 2
� . -
City of Orono
Building Permit Application for Interna! Work
(windows, doors, siding, re-roof, etc.
g,�,� Ma/',PO Box 66� Permit number. � — ��
O O Crystal Bay, MN 55323-0066 �ate received: � � /
Street Address: Received by:•
� 2750 Kelley Parlcway Plan review fee:
�� . �� Orono,MN 55356
�A��� . . � 3� , 3 ai
Total Fee:
Main: 952-248-4600 Fax: 952-249-4616 www.a.orono.mn.us
This application fonn must be completed in full and all required information must be submitted. .
lncompl�te applications will be retutned. (Please print)
GENERAL INFORMA710N:
Job Site Address: �� � �� � �� '�.s�� �•�-e-- ���v- • , � �
Will this be a Parade of Homes, Remodelers Showcase Home or other Dispfay Home? Yes o
Il yrs,a special event permit is required with Police Departmenf and Clry Counal spprova160 days p►ror to the eve»t. Shaltle bus service will De
required uMess applicant demonstrates sul�ient on-sire parlang is available. Nony�e►mifted evenes wld not be allowed.
CONTRACTOR 1 APPUCANT INFO T10N:
Name: ScJ�.+�'4:.r 5
State License# _:zo,�3 r�3 lo ti „_ Expiration Date: .3 0 �.
Phane: �Sa-� 7 7- /6 O U office � (cell)
Mailing Address: �r�,��s� � �� ( C' '�h S ZIP:S�3 S/ �,
Contact Person: �y-f� �,,,�;c I�: Applicant is: ontra / Homeowne� iciru.oe��
Email and/or Fax: _
PROPERTY OWNER INFORMATION: �
Name: m L.Ca �_w,_
Phone(day): - 1-- . �
Address: a C� Y'V n �� . �n � Ci : �ct��.:�:� • ZIP: .�S�
Email and/or Fax
PROJEGT INFORAAATION:
Type of Project Any earth movement may requlre
MCWD review 8 pertnits
�oo�(s) ❑Remodel ❑Water Damage
Minnehaha Creek Watershed Dlstrict(MCWD)
Q Window(s) ❑ Repair ❑Stortn Damage 18202 Minnetonka Bivd
Deephaven,MN 55391
❑Siding ❑Restoration p Other.(specity) Phone: 952�71-0590
Fax 952-471-0682
❑Re-roof ❑ Fire Damage www.minnehahacreek.orq
Overall ProJect DescNpdon: _, „_
Estlmated Construction Valuation of Pro ect excluding land S � �
APPLICANT ACKNOWLEDGEMENT: _
. Agrees to provide all i�formadon required or requested by the 8uilding Department;
• CertiFes that the infonnatien supplied is true and correct to the best of hisfier knowledge. 7he applicar��cognizes that they
are solely responsible for submitting a complete application being aware thet up�n fallure to do so,the staff has no altemative
but to rejeCt it unal it is complete;
• Some or all of the inforrnation that you are asked to provide on this application is �1ass'rf'ied by Stste Isw es either private or
confidential. Private dab is infortnation which genecally cannot be given to the publio but Can be given to the subjed of the
data. Confidential data is information which generelly cannot be given to either the public or the subject of the data. Our
purpose and intended use of this infortnation is to annuslly update our records and records of other govemmental agencies
re uired b law, If ou refuse to su I the information,the a lication ma not be issued.
ApplicanYs Signature: �Cy,�� �l'1 L Date: C1 ' 3��� �