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CITY OF ORONO * 2 0 1 8 - 0 0 3 3 2
2750 KELLEY PARKWAY DATE ISSUED: 03/22/2018
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2200 DEVIN LA
PIN : 03-117-23-21-0011
LEGAL DESC : THE NURSERY
: LOT 006 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES
VALUATION : $ 23,282.00
NOTE: (15)WINDOW REPLACEMENTS
APPLICANT PERMIT FEE SCHEDULE 418.18
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 11.64
10751 EXCELSIOR BLVD MAIL-IN FEE 2.00
HOPKINS,MN 55343 TOTAL 431.82
(952)277-1600 Payment(s)
Minnesota State License#:BUIL-BC239369 CREDIT CARD 3281 431.82
OWNER
MAJOR,THOMAS&SUSAN
2200 DEVIN LA
LONG LAKE,MN 55356-
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.
0Rm 12ek ) Mx,
Applicant Permitee Signature Date Issued By ature Date
Mar. 21. 2018 1 : 53PM No. 4465 P. 1
City of Orono
Building Permit Application for Maintenance 1 Replacement 1 Remodel— giIrtiONL
(i,e.windows, doors, siding, re-roof, etc,—NO STRUCTURAL EXPANSION) _
Mailing Address: � :ay: ,,.,.�, ,:•:::�� : '
(� PO Box 86 eml,fijU(neY„`
0 Crystal Bay,MN 55323-0066 Date - - . , ..
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.w Street Address:
-es Y 2750 Kelley Parkway psnr�v�ew
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Orono,MN 55356
FaX www.ci.orono.mn.us
Main: 952-249-4600 :.._... �-
This application form must be completed In full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GEJob NERAL Slte Address:ORMATION; '7 1 i n In
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes .0 10
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 INFORMATI• ;
Name: ` - �'y b
State License# )3c-=.), 3 9 Expiration Date: 3
Lead Certification Number: — f r 7.. 33' ^ ' Expiration Date: [Fr fcSe-?-0
(for work on homes that were constructedpnor tb 197
Phone: (cell) j 'c\ 8 rO V L( 7 (office)
Mailing Address: /0--7.57 Fix. (' i /J> !r R1(/'d City: jj ofZIP:,sj 5
Contact Person: i -_ Cc`Applicant is: ontraetor / Homeowner (circle pne(
Email and/or Fax: p) p w,1 p vi C-o- gcher s-
PROPERTY OWNER INFORM TIONi ' 1 � �
Name: IvG vSanl _f1°V- "U-
Phone
Phone(day): , _ -, ' ' 6.4.
Address: U(,) City: ZIP:
Email and/or Fax:
12PROJECT INFORMATION: Overall project description: 0 WS
Type of Project: ` Any ea movement may also require
review&permits:
❑Door(s) LIRemodel ❑Fire Damage MCW•
Minneheha Creek Watershed District(MCWD)
❑Re-roof,asphalt• 0 Repair 0 Storm Damage
15320 Minnetonka Blvd
❑Re-roof,cedar ❑Restoration ['Water Damage Minnetonka,
❑Re-roof,other(specify) ❑Siding Other.(specify) 952-471-0590
.s..]:1Fax: 852471-0682
indow(s)
Estimated Construction alua n of Project(excluding land) $ 3 2-SI 2.-
APPLICANT
rAPPLICANT 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 thi� atio;il: to annus ly update our records and records of other governmental gencies required by law. If
you refuse to suppl fo ,z on the .-'lication may not be issued. �j
Applicant's signature: milk /
l D. - a C/ I , S'
Owner's Signature: Date:
•
Last Updated:January 2016