HomeMy WebLinkAbout2010-00172 - siding • ` CITY OF ORONO PERMIT NO.: 2010-00172
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 03/25/2010
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 800 OLD CRYSTAL BAY RD N
PIN : 28-118-23-43-0010
LEGAL DESC : N/A
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 6,800.00
NOTE: R&R SIDING AND UPDATE CONCESSION DOOR
NEW FASCIA ON DUGOUTS
THIS IS THE BASEBALL FIELD PROPERTY AT 1030 OLD CRYSTAL BAY RD N
APPLICANT PERMIT FEE SCHEDULE 147.50
D B RASKOB CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 3.40
2864 ARDMORE AVE
MAPLE PLAIN,MN 55359- TOTAL 150.90
(763)479-1393
Minnesota State License#: 3481
OWNER
Orono School District 278
278,ORONO SCHOOL DISTRICT
PO BOX 46
LONG LAKE,MN 55356-0046
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 i onformance with the Sta Building Code.This permit may be
revok at time for due cause
SZ 3 X25--/ /U41. l l
App scant Permitee Signa Date Issued Big gnature6151),At.s_
SEPARATE PERMITS REQUIRED FOR WORK OTHE' THAN DESCRIBED ABO
City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
riv0� PO Box 66
\ Crystal Bay, MN 55323-0066 Date received:
,.r
4,'i Street Address: Received by:
�r r, ti 2750 Kelley Parkway'�L ,v,��li p Y Y Plan review fee:
E`sHo4`� 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 return d. (Please rir1
GENERAL INFORMATION: rntit cvkdh-t t -'
Job Site Address: 800 OC,B 2d /V /O3o Cid C P")
Will this be a Parade of Homes, Remodelers Showcase ome or other Disfay Home? n Yes 44 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 willbe
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATI/ON:
Name: LDC. : , I R . rt:s,Kdb b 6 .(=Asks,' QeA.5-/ kc.::Ibr.) 4,_1___c.:.-__
State License# ,34i5l Expiration Date: t1O ( I
Phone: '76:s- `-/ -11 -./Y-L3 (office) ( 3- .'6 c'- 6 Y7 (cell)
MailingAddress: -W
��� (�. �M C. {'Q_ C�.ti�.. City: .s�r�r r�,;C ZIP:J 3� ,
Contact Person: D0,1,f-Q Kor5 KZ b Applicant is: ontract / Homeowner (circle One)
Email and/or Fax: d. (-) C'0.`_ 1\t MC I1 S i , L r✓1
PROPERTY OWNER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review& permits
❑ Door(s) I ❑ Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Siding
MN 55391
g ❑ Restoration [' Other: (specify) Phone: 952-471-0590
❑ Re-roof &- C r< COi`};c55/Of• ;p t9 Fax: 952-471-0682
❑ Fire Damage www.minnehahacreek.orq
Overall Project Description: R-4 R " I cki ti-I -- `14 , _ c cry 5517)t�, 11 c).5"' r6a..0 - j,sj 6n,, ' i..)9 6013
Estimated Construction Valuation of Project (excluding land) $ 6 8 0 .0
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department; I
• 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 ... , e information, the application may not be issued.
Applicant's Signature: 4, ''C/,BSc \a----7/ - Date: //C414 ',;"4 j, a.0 O
Last Updated: 05-04-2009