HomeMy WebLinkAbout2016-00753 - siding CITY OF ORONO * Z 0 1 6 - 0 0 7 5 3 *
� T 2750 KELLEY PARKWAY DATE ISSUED: 06/28/2016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3115 NORTH SHORE DR
PIN : 09-117-23-32-0013
LEGAL DESC : REG. LAND SURVEY NO.0269
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : O/S 131�I��
VALUATION : $ 23,280.00
NOTE: RESIDING
APPLICANT PERMIT FEE SCHEDULE 4]8.18
STATE SURCHARGE(VALUATION) 11.64
SIDING LTNLIMITED, INC. TOTAL 429.82
750 S PLAZA DR,SUITE 24 Payment(s)
MENDOTA HEIGHTS,MN 55118- CREDIT CARD 9870 429.82
(651)681-5000
OWNER
CONNELLY,THOMAS
3115 NORTH SHORE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and speci6cations,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 ny time after work has commenced.
The applicant is responsible for s ing all required inspections are
requested in conformance with t State Building Code.This permit may be
revoked at a y time for due ca e.
� � �/ /.CJ
Appli ant P rmitee Si natur Date Issu y Signature Date �
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
' � (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:
� a
Street Address: Received by:
y�, G� 2750 Kelley Parkway Plan review fee:
Orono, MN 55356
tq kES H���
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: �< // S p� .S O�2 r ,V`�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes,a specia!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/APPLIC�ANT INFORMATION:
Name: si o��✓l 0� � 'iwt f��P ; fi1�C•
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) (� S� - p - (office) (p �� - (Q� '� - Sn���
Mailing Address: 7Sc� ,So��� az� �. ���tL � City: �� ���� ss �o
Contact Person: � L (;��� �� Applicant is: ontractor / Home wner (Circle One)
Email and/or Fax: �,ke( 5,�;,��U,� ��,�,��'Tt�/ ��, r'c7w�
PROPERTY OWNER INFORMATION:
Name: `�c�'ti�1S �o vlvt�c��u
Phone(day):
Address: 3i) 5 c: S' o/� ��! City: �•�y�v ZIP: S S 3 `�f
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&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.ora
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 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 genera►ly 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 informa ' n,the a lication ma not be issued.
ApplicanYs Signature: -- Date:
Owner's Signature: Date:
Last Updated:January 2016
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE. '� SCHEDULED
PERMIT NO. nL� COMPLETED 2-� 7-/V
ADDREss 3//.5 #Vort' $h "as
OWNER TELEPHONE NO.
CONTRACTOR Si oL%icy L14 /• .v►. eS2
E DESCRIPTION Re -Sfdic
U ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
11.
❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
61) 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
• 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP aQLLOW-UP
i ❑AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL
• OWNEIYCONTRACTOR TO MEET YOU:_YES_NO
2 COMMENTS: rw►.t /was La. /eb0 c.c/(j 4
re eta/ ;4/De-GA 47.. .
a Permit has expireer MN Building Code Sec. 1300.120 subp. 11
• Expiration, no record of a Final inspection.
w
W 0 WORK SATISFACTORY PROCEED 0 PROJECT COMPLETE
W
• 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL.INSPECTOR D CITATION ISSUED
o INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
CaN for the next Inspection 24 hours I,advance. (952) 249-4600
OwnedCa ntractor on site:
inspector. g,
White Copy/Inspector's FIN Canary Copy/Site Notice