HomeMy WebLinkAbout2017-01284 - windows CITY OF ORONO � I l i '1 11 11111 II
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2750 KELLEY PARKWAY DATE ISSUED: 10/12/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1980 HERITAGE DR
PIN : 10-117-23-42-0006
LEGAL DESC : AUDITOR'S SUBD.NO. 356
: LOT 006 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 67,500.00
NOTE: (11)WINDOWS AND(4)PATIO DOORS
APPLICANT PERMIT FEE SCHEDULE 857.76
STATE SURCHARGE(VALUATION) 33.75
PELLA NORTHLAND MAIL-IN FEE 2.00
15300 25TH AVE N.-SUITE# 100
PLYMOUTH,MN 55447- TOTAL 893.51
(952)345-6047 Payment(s)
Minnesota State License#:BUIL-BC645090 CHECK 79049 893.51
OWNER
GRUMAN,GREGORY&CARRIE
1980 HERITAGE 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 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.
H 9 ��) ,J ( 7,-17:7777;:) /G //tel / 7
Applicant Permitee Signature Date Issued By Signature Date
OCT/09/2017/MON 01 : 44 PM Elder Jones Building FAX No, 952 854 4909 P. 002/002
City of Orono
Building Permit Application for Maintenance / Replacement I Remodel — Residential ONLY
(i.e.windows, doors, siding, re-roof, etc. --NO STRUCTURAL EXPANSION) c�
Mailing Address: Permit
/7- 01�o
PO Box 66 /�
Crystal Bay,MN 55323-0066 Date received: 7Q?/ 2 7
Street Address: Received by:
ti 2750 Kelley Parkway Plan review fee:
`�r G Orono,MN 55356 �i�j
41c4HOR� g 6q✓-
Total Fee:
5-7
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: 198o fit ui�
Will this be a Parade of Homes,Remodelers Sho ase Home or other Display Home? Ei Yes Vo
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 INFORMATION:
Name: Pella Northland
State Licei 15300 251h Ave N Ste.100 Expiration Date:
Lead Certi Plymouth MN 55447 r(5(7 8 2~i Expiration Date: 9—7—z(7
Phone wet 763-745-1400 s (office)
Mailing Ad BC645090 expires 3/31/19 City: ZIP:
Contact Person: ,� �� Applicant iC Contract / Homeowner (Circle One)
Email and/or Fax:it)1 t'e,. '( c !}CIYles,COW)
PROPERTY OWNER INFORMATION: LJ
Name: [rreg 6ruvnaVt
Phone(day): S' _810-(
Address: City: ZIP:
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:
0 Re-roof,asphalt 0 Repair El Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑Re-roof,cedar 0 Restoration ❑Water Damage Minnetonka,MN 55345
Phone: 952-471-0590
❑Re-roof,other(specify) ❑Siding ❑Other:(specify)
Fax: 952-471-0682
kWindow(s) /ruin. eytp 1rar.4 www.minnehahaoreek,orq
Estimated Construction Valuation of Project(excluding land) $ (07�57)--0
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 is infopation is to annually update our records and records of other governmental agencies required by law, If
you refuse to sup ely t•e information,t as plication may not be issued. G� -7
Applicant's Signature: 1� " — Date: /a- ! r/
Owner's Signature: Date:
Last Updated:January 2016
v
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel - Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
i
�!VOMailing Address: Permit number:
PO Box 66 �jllim
RCrystal Bay, MN 55323-0066 ECEIV a received:
Streef Address: Received by:
12
2750 Kelley Parkway �CTI 2U Flan review fee:
Orono, MN 55356
fkestio�`� CITY OF OROIVTO
tal 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: 19 3 0 ffei -tf c., .
Will this be a Parade of Homes, Remodelers Showdase Home or other Display Home? ❑ 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 sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: Pella Northland
State Licei15300 25th Ave N Ste.100 Expiration Date:
Lead Certi Plymouth MN 55447 E15-17$2.--( Expiration Date: -I-7-w
Phone wor 763-745-1400 $ (office)
Mailing Aa BC645090 expires 3/31/19 City: ZIP:
Contact Person: _j li_s) 'L Applicant i Contract / Homeowner (Circle One)
Email and/or Fax:id i e.fG�eActe..0 or.ES.CCAn l
PROPERTY OWNER INFORMATION:
Name: Cr 6r umay\
Phone (day): J(p(i- SW-810 -(
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
ElDoor(s) ElRemodel iiiFire Damage
MCWD review&permits:
1:1 Re-roof,asphalt ❑ Repair III Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka,MN 55345
CI Re-roof,other(specify) 0 Siding 0 Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
kWindow(s) //WM. '`�( ,to I4 Y4 www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ (07) .SZl'
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 infor •ation is to annually update our records and records of other governmental agencies required by law. If
you refuse to sup ly tr- information,th a plication may not be issued. -7
Applicant's Signature: ,-,J� /
Date: l0— —/
Owner's Signature: Date:
Last Updated:January 2016