HomeMy WebLinkAbout2013-00225 - siding CITY OF ORONO * 2 0 1 3 — PJB 2 2 5
2750 KELLEY PARKWAY DATE ISSUED: 04/08/2013
t ORONO,MN 55356-
(952) 249-4600 FAX: 952) 249-4616
ADDRESS 100 NORTH SHORE DR W
PIN 06-117-23-22-0004
LEGAL DESC UNPLATTED 06 117 23
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 23,592.11
NOTE: THIS PERMIT INCLUDES REPLACEMENT OF SIDING,WINDOWS AND DOORS
APPLICANT PERMIT FEE SCHEDULE 398.25
MEYERS,PETER&CAROLYN STATE SURCHARGE(VALUATION) 11.80
70 NORTH SHORE DR W
TOTAL 410.05
MAPLE PLAIN,MN 55359-
OWNER
MEYERS,PETER&CAROLYN
70 NORTH SHORE DR W
MAPLE PLAIN,MN 55359-
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 wi the State Building Code.This permit may be
revoked aty t' a for d cau
i
(GOA
A can e it a Signa a Date Issue4, ignre Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
O�T Mailing Address: Permit number: Q/
!VO PO Box 66 Z
Crystal Bay, MN 55323-0066 Date received: _ �J
Street Address: Received by:
y 2750 Kelley Parkway Plan review fee:
`� o Orono, MN 55356 kESH04�
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:
5 3
Job Site Address: j c)o ,Q&u O
Will this be a Parade of Homes, Remodelers Showcase 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: C � / ( � i
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) (, 2- c D c� 3 � 1e, (office)
Mailing Address: _�U�(L'�# � hd.NC City: ,`;�1� ZIP:
Contact Person: , i �) mc-16 � Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION: (J
Name:
Phone (day): „ ('� '� � . �3�i b
Address: Q ? V"G City: ,QytJo ZIP: -3 S
Email and/or Fax: a.,2 �� . U E_
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
T5-,Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof, other(specify) Q,Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
7?5[-Window(s) www.minnehahacreek.org
Estimated Construction Valuation of Project(excluding land) $ 2 : :a j 2. I
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 infor ,'atiQh,the appticaon may not be issued.
Date: J
Applicant's Signature: �y; ' �� '�� '
Owner's Signature: i !-!� l� Date:
Last Updated:03/06/2013