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HomeMy WebLinkAbout2011-00958 - windows CITY OF ORONO PERMIT NO.: 2011-00958 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 08/29/2011 (952)249-4600 FAX: (952)249-4616 ADDRESS : 580 ORCHARD PARK RD PIN : 32-118-23-23-0004 LEGAL DESC : ORCHARD PARK : LOT 012 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 2,072.00 APPLICANT PERMIT FEE SCHEDULE 88.50 CLEAR CHOICE WINDOWS STATE SURCHARGE(VALUATION) 1.04 1712 3RD AVE. SE ROCHESTER,MN 55904- MAIL-IN FEE 2.00 (507)280-2444 TOTAL 91.54 PAID WITH CC# 2926 OWNER KYLE,RICHARD F&KATHLEEN A 580 OXFORD RD 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. Applicant Permitee Signature Date Issued By natureDate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABC . To:City of Orono Page 2 of 2 2011-08-29 19:48:11 (GMT) 18008805798 From:Brian O'geary - City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: -Permit:nuirib -g„0,7© PO Box 66 :: .. ... .: :' '.::':•::. ;...: .. 0 Crystal Bay,MN 55323-0066 a*' , StreetAddress: Parkway t lti i'ik'4�1 2750 Ooo0o Ile k ::Plan:review fee:':: ': ,:'.. Vital.;Fee- ' ..:•••.':.`; : •:, '-'e, .,'':-....:.:•:.' - Main: 952249-4600 Fax: 952-249-4616 wvvwci.orono.mn,us This application form must be completed in full and all required information must be submitted. incomplete applications will be returned. (PI ase print) GEJob S to LA INFORMATION: f� 0�P [h r1 K nA Job Slte Address: 1 {•� Will this be a Parade of Homes, emodelers Showcase Home or other Display Home? U Yes ['No if yes,a special event permit is required With Police Department and City Count*approval 60 days prior to the event. Shuttle bus sdfidoe will be required unless applicant demonstrates sufficient on-site parking is available, Non-permftsd events will not be allowed. CONTRACTOR I Ain24.1CANT INFORMATION: Name; ( CIX (IhDiCA ( IS State License# R( Q �pyL Expiration Date: Lead Certification Number: /� J / � Expiration Date: (for work on h a O /fit rlorio 1978 Phone (office) (cell) Mailing Address: ( ( -2 Q City: rZIP:6 90 14 a u � � Contact Person: `. i. i 4, t"ti Applicant is: sr+n+=,...=►=-/ Homeowner (Ckee on.) Email and/or Fax . , j4 ;)elearchoft A..I on t ('L PROPERTY OWN - INFO- ATION: Name: ( �' r • 1 ti- Phone(day): , I- . Address: , 750 IC-4. It 4 "• If D�D City: Arora ZIP: 5 -1 : Email and/or Fax . brikrorio ten • 1 in1Af i‘ scorn PROJECT INFORMATION: Type of Project: Any earth movement may require CIDoar(s) ❑Remodel. ❑Fire Damage MCWD review 8.permits: Minnehaha Creek Watershed District(MCWD) 0 Re-root asphalt 0 Repair . 0 Storm Damage 16202 Minnetonka Blvd 0 Re-roof,cedar 0 Restoration 0 Phone: Water Damage v95,MN 55391 Phone: 95271-0590 0 Re-roof,other(specify) 0 Siding 0 Other:(specify) Fax: 952471-0682 EAWindow(s)..fepl orst- www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ a 07 0. av APPLICANT ACKNOWLEDGEMENT: • A,graAs 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 hes 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 information is to annually update our records and records of other governmental agencies required by law. If you refuse to pply the form- on,the application may not be issued. ,,..ma,�yy��// ( Applicants Signature: r� i Ly.c l I i A S Date: 'R;2'f/L'l,f . y r Lest Updated: 08-09-2011 1