HomeMy WebLinkAbout2017-01134 - remove/replace windows CITY OF ORONO I I ISI I I II 1111311111111111111
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2750 KELLEY PARKWAY DATE ISSUED: 09/14/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3464 EASTLAKE ST
PIN : 05-117-23-13-0042
LEGAL DESC : BAYSIDE BEACH
: LOT 001 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 15,404.00
NOTE: REMOVE AND REPLACE(13)WINDOWS SAME SIZE,NO STRUCTURAL CHANGE
APPLICANT PERMIT FEE SCHEDULE 294.26
STATE SURCHARGE(VALUATION) 7.70
SEARS HOME IMPROVEMENT MAIL-IN FEE 2.00
1024 FLORIDA CENTRAL PKWY
LONGWOOD,FL 32750- TOTAL 303.96
(860)952-4112 Payment(s)
Minnesota State License#:BUIL-CR090017 CHECK 5789 303.96
OWNER
HUNSLEY FAMILY JT REV TRUST
3464 EASTLAKE ST
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 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 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.
Applicant Permitee Signature Date ssued By ature Date
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel —Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
pT Mailing Address: ,.-^�)
.0.Y PO Box 66 Permit number: f/J� ,/
Crystal Bay, MN 55323-0066 Date received: ,.;�, // _
Street Address: Received by: �-(� 0//`3 7
y 2750 Kelley Parkway Plan review fee:
`� Orono, MN 55356 _
�1kssHOV` Total Fee: Z tl 0.-
i g,�f
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 0"
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,-(1t. E. L--- C4 -
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes El 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 sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFO�ON:
Name: t.c,. ,--1,.-.. L _Lvvt.11 WIZ✓r\ac. -
State License# ('k..0"/ 001-7 Expiration Date: 3[3(l/5
Lead Certification Number: &J A't L-/(o.'/3— -. Expiration Date: /Lf /')--a
(for work on homes that were constructed prior to 1978
Phone: (cell) SCc e- i S off--///-- (office)
Mailing Address: ( p ..I 7 FL or, cf?ck, (rear.(-v-ea ai City: Cw._s„f"ko (, LZIP: 3,)..7 37).
Contact Person: SLo4i- .bcwKhn.a 4-, Applican[is: ontra / Homeowner (Circle One)
Email and/or Fax: SCS+-etc, "Is4,1m.c, ,-, •vim c e p eI'm ILS- 0r's
PROPERTY OWNER INFORMATION:
Name: a1 a r(/` -1-((A-".s-I e c- ,-
Phone(day): 9.5---.)._ - --- (001 34o
Address: 3,-{ (P L( E_. L.... ke_ - City: [.e1,. (c._. ZIP: SS- 3-5(0.,
Email and/or Fax:
l -vt�.evt.. cx.•c(. r=ri(o,ce_ 13 w,v\zecyoC , Seeezc
PROJECT INFORMATION: Overall project description: .S;2--0--- , (1-0 r''^-0.- `r"-e e gc- . _
Type of Project: Any earth movement may also require
ElDoor(s) ElRemodel ❑ Fire Damage MCWD review&permits:
0 Re-roof,asphalt LI Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 j
❑ Re-roof,other(specify) 111 Siding E Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
KWindow(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ /Si (-/D
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 aH-
solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but
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 dato
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose ar.'
intended use of this information is to annually update our records and records of other governmental agencies required by law.
you refuse to supply the information,the application may not be issued.
Applicant's Signature: t-' �— Date: V'7 //7.
Owner's Signature: Date:
Last Updated:January 2016
s
'1024 Florida Central Parkway,Longwood,gwc od,FT. 32750 PH:407-551-6000
March 2036
l ,, F AUTIIORTZATION
L Alfred W. Nyman, Jr.,Ass`starit Sret ry for Sears Home Improvement Products, inc., grant
permission to GO PERMITS, LLC and his a sociates>to submit permits and licenses, pick up
permits and licenses,make changes to permits, licenses and plans arid initial changes made by
the building department jrt behalf of Sears Home Improvement Produce Inc-
I also grant permission to GO Permits, LLC and his associates to purchase permits and/or
Ikensmil with a company check„persona]ellen .penal cr it card or cash.
I certifIy`that the above iartformation is true and correct.
1
•
Alfre W.Nyman, ..ASSiSkan "K`tiny
Sears Home Improvement ement Products,Inc.
STATE of Florida
COUNTY of S m nolo
SWORN TO AND SUBSCRri3I)BEFORE ME THIN , day of March 2036,by Alfred W.
Nyman,lr., Assistant Secretary for Sears Home Improvement Products.,.Inc.and who is X
personally know to me or has produced a valid Drivers Lice ,
a_ _ Print Nara& Deborah P.PhiIb. -
'r 's 1 Notary Publk,State of Florida
I: t:20i/ ° siott#t FF 219,
",v'w' MY COMMISSION EXPIRES:Aug.13,2Cr19
Go Permits, LLC
CPO 105 Buttonball Ln.
ECEi' , ' Glastonbury, Ct 06033
PERMITS SEP 1 ZU Scott Doughman
Phone: 860-952-4112
Fax: 860-430-6719
CITY OF ®RAN®
scottdoughman@gopermits.org
"WE UNDERSTAND THAT YOUR TIME IS MONEY"
September 7, 2017
To: City of Orono
Enclosed you will find a building permit application and check. If you have any
questions regarding this application, feel free to call me at the number listed below.
Please note the following:
• Please mail original permit to the owner.
• Please fax or e-mail a copy of the permit and receipt to:
Fax: 860-430-6719 (attn: Scott Doughman)
Email: scottdoughman@gopermits.org
• If fax or e-mail is not available, please mail a copy of the permit and receipt to:
Go Permits, LLC
105 Buttonball Ln.
Glastonbury, CT 06033
Thank you!
Jennifer Winke, Permit Expediter
Go Permits, LLC
Phone: 303-946-8685
Fax: 866-697-0768
jenniferwinke@gopermits.org
Go Permits LLC, 105 Buttonball Ln. Glastonbury CT 06033, scottdoughman@gopermits.org