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Home My WebLink About2011-01184 - windows CITY OF ORONO PERMIT NO.: 2011-01184 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 10/06/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 581 NORTH STREAM RD PIN : 25-118-23-34-0005 LEGAL DESC : NORTH STREAM LOT 002 BLOCK 001 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOWS ACTIVITY O/S BUILDING-UNDEFINED VALUATION $ 5,712.00 NOTE: (2)WINDOW REPLACEMENTS IN EXISTING OPENINGS. APPLICANT PERMIT FEE SCHEDULE 132.75 PELLA WINDOWS&DOORS STATE SURCHARGE(VALUATION) 2.86 15300 25TH AVE N.-SUITE# 100 PLYMOUTH,MN 55447 MAIL-IN FEE 2.00 (952)345-6047 TOTAL 137.61 Minnesota State License#:20165884 OWNER LARSON,DAVID&JANIS 581 NORTH STREAM RD 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. Applicant Permitee Signature Date Issued By Sire gop to SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Q,0 PO Box 66 Y Crystal Bay, MN 55323-0066 Date received: Received by: Street Address: m` A.r titi 2750 Kelley Parkway Plan review fee: SF10 Orono,MN 55356 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: / / Q M W61 Job Site Address: / Y 7''1 J T' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes El No ff 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: Iod� Name: d State License# Pella Windows &Doors 4S$ 3 y s (cell) Phone: 15300 25th Ave N. Ste 100 ZIP: Mailing Address: Plymouth,MN 55447 lomeowner (Circle One) Contact Person: Lic#20165884 Ph. 763/ 745-1400 Email and/or Fax: PROPERTY OWNER IN ORMATIQ N: Name: �G V I et L a r al-0 n Phone(day): 70! � 1 /�� fro n o ZIP: Address: f �/ i4nf e n IC ad City: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) XWindow(s) Repair ❑Storm Damage 18202 Minnetonka Blvd ox Deephaven, MN 55391 ❑Siding ❑ Restoration ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www minnehahacreek.org Overall Project Description: 2 W A Qr0 W f Q Gt M''III / / !n !n Estimated Construction Valuation of Project(excluding land) $ '71 7 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 classed 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 application may not be issued. / Applicant's Signature: Date: 101 c3( 11 Last Updated: 05-04-2009 ATE TIME v fY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. ?l' /- COMPLETED ADDRESS OWNER -TELEPHONE NO. tel_ S� v CONTRACTOR 1� >: DESCRIPTION t4 ❑ FOOTING ❑ PLUMBING FINAL ElEXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W T e J O cc O U- LU oc Q Z W Z W CC d WU E)WORK SATISFACTORY:PROCEED A-ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspectorl_.�_ White Copy/Inspector's File Canary Copy/Site Notice