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Home My WebLink About2014-01017 - water damage - repair CITY OF ORONO � �'� I� ''I L �' �r ' - 2750 KELLEY PARKWAY * DATE ISSUED: 09/10/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 490 OLD LONG LAKE RD PIN : 36-118-23-34-0010 LEGAL DESC : SUMMIT STATION : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : REPAIR ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 10,000.00 NOTE: REAPIR-WATER DAMAGE • APPLICANT PERMIT FEE SCHEDULE 191.75 VUJOVICH DESIGN BUILD STATE SURCHARGE(VALUATION) 5.00 275 MARKET STREET TOTAL 196.75 MINNEAPOLIS, MN 55405- Payment(s) (612)366-1883 CREDIT CARD 2567 196.75 Minnesota State License#: BUIL-BC006077 OWNER WIKEN, LAWRENCE&BARBARA 490 OLD LONG LAKE 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. eriod of 180 days at any time after work has commenced. The applican/responsible for Suring all required inspections are requested i onformance witb t a State Building Code.This permit may be revoked . y time for due pa se. / I ./.107P‘174� ` 9 / /0, /1 •pplicant Permitee Si ure Date Issue. ,y Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof,9 'e/tc.) OA, Mailing Address: Permit number: c2D/ D/0/7 it_ !VO PO Box 66 Crystal Bay, MN 55323-0066 Date received: 9—/0 —� Street Address: Received by: y� 2750 Kelley Parkway Plan review fee: L Orono, MN 55356 ;c/_ �1kESHOV- /! 7S 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: Job Site Address: 1/76 06 94 Onr&&- 4 /�/ ' I Aa/�L2 Will this be a Parade of Hom s, 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: V UJO Y'r c fr/ ,045-/ -N X U/6 State License# A C 00 Q 7 7 Expiration Date: 3/i/2a/<o Lead Certification Number: fv"7"--21//6 y- / Expiration Date: c yi/2o/ 5"--- (for (for work on homes that were constructed prior to 1978 Phone: (cell) Ce 1 z _3Co 6-- / 3 (office) 6/e -Si g'_ 2a Z 0 Mailing Address: 2 7c i- /9pQ/. I.," 57' d '5--.0 J City: Ai its, ZIP: ,SyQs--- Contact Person: fo r.-f z,tgo,,z ef G . Applicant is: ontracto Homeowner (Circle One) Email and/or Fax: �0%1 Z,eir 4 Ge._ 4) i/U./vYe.i&/i.6 0,1 PROPERTY OWNER INFORMATION: Name: /-//XXY - /SlaA ,BAec/g wi/�,feti Phone (day): 6/2--Y05---200 2 Address: lige 04-D A c*i-IC, ,48X/ 72e AO City: a,2o.cro ZIP: 5' 1, -"C, Email and/or Fax: 4 40/A z,..i(e) /0i/•(,F- ,c,er-i PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) 111Remodel 111Fire Damage MCWD review&permits: 111Re-roof,asphalt cs.Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ®.Water Damage Deephaven, MN 55391 111 Re-roof, other(specify) ElSiding 111Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ %d 60 C.% . ° d 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 inform-tion is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the' ormation,the aa•• cat• may no7 issued. Applicant's Signature: „ , /_ IL-....-.11 Date: �1/0// 4/ Owner's Signature: .Jr.- PPII/P4O Date: 9//U//7- Last Updated:03/06/2013 (/' 61 0 (A /Z0410 REVIEWED for CODE COMPLIANCE a. PLAN CHECKED BY --DATE 941 — zoo y ..A,• AA ki i•11..0 CO, if 4 nr .5,11-z- r0._. f A'3p /?... 4 el h a A . -4e op /....... riviO i or 1404,21.-4 /?,E5►S w/it'd., �,�.�. �,�,�� ,�'� �` did''14r 12"4„acs , teep 5 04 14/, - � • Sv,gid' DATE T CITY OF ORONO CALLED IN 1 ' INSPECTION IiIICFy� " c7 SCHEDULED ` PERMIT NO. COMPETED ADDRESS LI�to (c pP( OWNER TELEPHONE NO. (e'( 2- - (3 73 CONTRACTOR V1 C • C Nom'IC o DESCRIPTION W 0 FOOTING ❑ PLUMBING FINAL XCAV/GRADING/FILLING ❑ POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS cl/ ❑ FRAMING LI MECHANICAL FINAL Li TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS • 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT 0 DEMO-SITE 0 SEPTIC MAINT ❑ FOLLOW-UP 121.1 ❑ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWN ERICONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc 1;4 d C W Q 4111W W CC ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE CCC RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou in advance/ 9 249-4600 Owner/Contractor on site: Inspector. White Copy/Inspector's File Canary Copy/Site Notice k-.- / -r DATE TIME CITY OF ORONO ✓ CALLED IN INSPECTION NO I E SCHEDULED -1174:7- -i /.00 PERMIT NO. / L / J coMPL ED -el ,6 #/d (4 , OWNER T2LEP E N,t�/�� Z� ,,--/57- CONTRACTOR 3_ �3 CONTRACTOR u /D 00 � 4GJ- - �J �� -� �".-o e-i' 37. DESCRIPTION W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GR•DING/FILLING LA.• 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS Q ❑ FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS FINAL 0 SEWER HOOK-UP ❑ COMPLAINT "J*-❑ DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP Z ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL v ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: cc aeco r�epq,r Copl-e-t — cc O X9'61 past -bra*w4S Ore 4,e41-42A- 0 W cc GI-49 r Q Lu12 z 5i-it �0,er, :s -4.141.E Lu V45141-O10/7 d J/L1-151[3? j LU EJ WORK SATISFACTORY:PROCEED "ROJECT COMPLETE rt W ❑CORRECT WORK&PROCEED CIISSUE CERTIFICATE OF OCCUPANCY O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY (.) BEFORE COVERING PERMANENT El CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site Inspector. Q 1•- White CopylInspector's File Canary CopylSite Notice