HomeMy WebLinkAbout2013-01275 - windows/patio door replacement CITY OF ORONO iiiiiiiiiiiiiiiiiiiiiimiiiiiiiiiiiiiiiiiiiiililI
2750 KELLEY PARKWAY * 2 1 3 - P1 2 7 5
DATE
E ISSUED:: 12/11/2013
ORONO,MN 55356-
(952)249-4600 FAX: 952)249-4616
ADDRESS 4495 NORTH SHORE DR
PIN 07-117-23-31-0005
LEGAL DESC BERGQUISTS ADDN TO SAGA HILL
LOT 007 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE WINDOWS
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 47,754.00
NOTE: 14 WINDOWS AND 4 PATIO DOOR REPLACEMENTS
APPLICANT PERMIT FEE SCHEDULE 660.25
PELLA NORTHLAND STATE SURCHARGE(VALUATION) 23.88
15300 25TH AVE N.-SUITE# 100 MAIL-IN FEE 2.00
PLYMOUTH,MN 55447 TOTAL 686.13
(952)345-6047 Payment(s)
Minnesota State License#: BUIL-BC645090 CHECK 66998 686.13
OWNER
RYAN,MIKE
4495 NORTH SHORE 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
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 Issued By S' ature Date
DEC/09/2013/MON 12:33 AM Elder Jones Building FAX No, 952 854 4909 P, 002
0 P-1
City of iJrono kill
Building PerMit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: D 13—6 1275
PO Box 66
Crystal Bay,MN 55323-0066 Date received: 2'1
o., 13
. oSReceived by:
i~ Street Address:
2750 Kelley Parkway Plan review fee:
Orono,MN 55356
Main: 952-249-4600 Fax: 952-249-4616 www d.orono.m_mus Total Fee: A
This application form must be completed in full and all required information must be submitted,
incomplete applications will be returned. (Please print)
GENERAL INFORMATION: y q ,?, /V �,�� C�,� ��.J.V c
Job Site Address: Ar
Will this be a parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
lF yes,a special event permit is required with Police Dapartment and City Council approval 60 days prior to the event. Shuttle bus service wip be
required unless applicant dem•onstrates sulfiClent on-S/te parking is available. Non-permitted wants will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: Pella Northland
State License# (cell)
Phone: 15300 25th Ave N. Ste 100
Mailing Address: Plymouth,MN 55447 z1p:
lomeowner (cireie One)
Contact Person: Lemic#BC645090 Ph. 763/745-1400
Email and/or Fax:
PROPERTY OWNER INFO MA ION-
Name: t fL Rya n
Phone(day): G 1-71 8 L 5 -, 7 L f �'
Address: o �' �J a `4 ZIP: �3 L
Email and/or Fax
PROJECT INFORMATION:
Type of Project, Any earth movement may require
MCWD review&permits
`cNoor(s) %P*�ib ❑Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
Windows) < </ ❑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 vA".minne hacree .or
Overall Project Description: Iq W /I do ti �'
Estimated Construction Valuation of Project(excluding land) $ Z 'S
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 you refuse to supply the information,the ap2lication may not be issued.
Applicant's Signature: Date:
-113
Last Updates: 05-04-2009
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Certificate of Survey
dor Gerald L. Anderson
of Lot 7, "Bergquist's Addition to Saga Hill �✓�
Hennepin Co. Minn."
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I hereby certify that this •is .a true
' �o;''t �'�• 1 ��SO , and correct representation of a survey
M of the boundaries of Lot 7, "Berg-
M �$ Ex�sfi�9 's I quist's Addition to Sa
n ga Hill, Hen-
14 h°"se �+ p
ne in Co.- Minn. " and of the location
1O• ag f' '� oall buildings, if any, thereon.
_M 2t does not purport to show ariy other
Har sC a�" improvements or encroachments,. other
than the hardcover surfaces on said
lot.
AID
• oti°
p9CK C IN & GRONBERG, INC.
AVG.,D€GK
Mark S. Gronberg Reg.011o. 12755
c Gordon R. Coffin Reg. No. 6064
Engineers and Land Surveyors-
Long Lake, Minnesota
- Phone 473-4141
o Scale: 1 inch = 40 feet
'N Date : March 29, 1985, .Revised on .
i o Iron marker ..August 9, 1985
to show existing
�s�c�• houses on Lots 6
and 8 ,
Shoreline M;� �`
on Mnr29,1985 7ejC % '
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