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Home My WebLink About2015-01245 - doors CITY OF ORONO I*� IL 11 L ell II 14 51 I*I'' 2750 KELLEY PARKWAY DATE ISSUED: 09/25/2015 , ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 565 OLD CRYSTAL BAY RD S PIN : 04-117-23-31-0010 LEGAL DESC : AUDITOR'S SUBD.NO.230 : LOT 023 BLOCK 000 PERMIT TYPE : MIN R ALTERATIONS PROPERTY TYPE : RESI ENTIAL CONSTRUCTION TYPE : DO S ACTIVITY : 0/S UILDING-UNDEFINED VALUATION : $ 1,7 0.00 NOTE: REPLACE WINDOW&DOOR EXISTING OPENING 1 APPLICANT PERMIT FEE SCHEDULE 67.17 STATE SURCHARGE(VALUATION) 0.85 LEMKE,BRUCE&LINNE TOTAL 68.02 565 OLD CRYSTAL BAY RD S Payment(s) LONG LAKE,MN 55356- CHECK 11628 68.02 OWNER LEMKE,BRUCE&LINNE 565 OLD CRYSTAL BAY RD S LONG LAKE,MN 55356- AGREEMENT AND SWORI1 STATEMENT The work for which this permit is issued shall le performed according to the approved plans and specifications,applicle City approvals,and the State Building Code. This permit is for only a work described and does not grant permission for additional or related ork 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 iss ance,or if construction is suspended for a peed of 180 days at any tim after work has commenced. The applicant is res nsible for assuring all uired inspections are requested in confo ance with the State Buil ing Code.This permit may be 00 1//� revoked at any time for due cause. `Y ,.....,(A_ P / " - 9 /Zs/ /S /� Ap licant Permitee Signature . Date Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �o A Mailing Address: Permit number: 2 o� PO Box 66 Crystal Bay, MN 55323-0066 Date received: Lf _S Street Address: Received by: i'lq � y 2750 Kelley Parkway Plan review fee: F L Orono, MN 55356 l9kESHOT- C 2. Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (.; i) ` 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: 5l05 0%--1J C),a)-t silk- C t.,-\ ‘42-0 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? El 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: -e_ State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (office) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (circle one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: paVG E_ M V- - Phone(day): Co 12, 3%o l',k,3-2 _ Address: 519S- MAO c¢•(STR\_ '5 y243 r1 4 City: O /v ZIP: S 5 -38 , Email and/or Fax: lai t'LVG-0 (... AAA./. . Q G LS ce ,44 PROJECT INFORMATION: Overall project description: (ret)Z.0 ' avr //'7 %;5 fJYl Type of Project: Any earth movement may also require NDoor(s) ❑ Fire Damage MCWD review&permits: pn,c. ❑ Re-roof,asphalt 0 Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration 0 Water Damage Minnetonka, MN 55345 El Re-roof,other(specify) ❑ Siding 0 Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Window(s) www.minnehahacreek.orq e. Estimated Construction Valuation of Project(excluding land) $ / "700 - 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 inf tion,the a, lication may not be issued. // Applicant's Signature: -'`�/ Date: 9 (Z 5 1 i S— Owner's Signature: ,•-- Date: 9 12,s---ft s Last Updated:January 201 i 7.7.7 „ ILd__ I DATE TIM CITY OF ORONO CALLED IN � `/-/.-1 Vie INSPECTION NOTICE SCHEDULED / L PERMIT NO. f?lS- DI*2 (COMPLETED ADDRESS 5i S 0 lc( C rL 0 L OWNER i ' # - TELEPHONE NO.v Le 4A 39k -iy. CONTRACTOR >. DESCRIPTION L 1i c ncyzA ��f7 a l W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS • ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL J ■ 0.--'10-SITE EP IC INSTALL • N ••NTRACTOR TO MEET YOU. YES NO C.% a MMENTS: cc IQ / CC .64.1 0 ,.ccL. O wpw( ,1 cc Q / I1 W z W cc J d W 0 WORK SATISFACTORY:PROCEED PROJECT COMPLETE CCW CI CORRECT WORK&PROCEED UE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ho rs in adva -- 0 ' r7 ) 249-4600 Owner/Contractor on site: �'i/ r Inspector. White Copy/Inspector's File / Canary Copy/Site Notice