HomeMy WebLinkAbout2017-0079 - windows � - µ CITY OF ORONO * Z 0 1 7 — 0 PJ 7 9 4 *
2750 KELLEY PARKWAY DATE ISSUED: 07/12/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 425 OXFORD RD
PIN : OS-117-23-41-0023
LEGAL DESC : STIELOWS 2ND ADDN
: LOT 002 BLOCK 001
:ERMIT TYPE : MiNOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 6,089.00
NOTE: REPLACE(2)WINDOWS INTO EXISTING OPENINGS.
APPLICANT PERMIT FEE SCHEDULE 154.85
STATE SURCHARGE(VALUAT[ON) 3.04
RENEWAL BY ANDERSON TOTAL 157.89
1920 COUNTY RD C. WEST
ROSEVILLE,MN 55113 Payment(s)
CREDIT CARD 8788 157.89
(612)502-4777
Minnesota State License#: BUIL-BC130983
OWNER
WITHROW,JOHN&JESSICA
425 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 Yor additional or related work which requires separate
permits. All provisions of laws and ordinances governing this rype 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.
��u-�-� �� �� z � � i��/ 7
Applicant Permitee Signature Date Issued By gnature Date
e _.
�1�/ Of ��'Ot10
Building Permit Applicafiian far tVlaintenance I Renovation
(windorn►s, doors, �iding, re-roof, etc.)
��� MeJlfn��8ox BS� Permi�number: d/7—�7
� Q Crystal Bay, MN 55323-0066 Date r�eceived' — —
�r� :� �, StreetAddress: Received by: ��/,t.f
{ 2750 K�Iley ParY,way �^7
�, ` • Plan revtew.fee� �
�'�,�,��,�� Orono, MN 5535fi � � , ��
-- 7'a#ai Fee_ �
Maln� 952-248-4600 Fax: 952-249�616 www.cl.arono.mn.us
This application farm must be campleted in full and a1i required informatlon rrsust be subm's��d.
Incdmp�ete appllca#lons wi1[�e returned. (Pleese printj
GENERAL INFORMA7IQN: u�� �d ��
Job Slte Address: 1
Wt[)this be a Parade ort Homes, Remodelers Showcase Home or other Display H�rtte? Yes No
lf yes,a speciaf event p9rmft Is requfred w/th Palice Deparfmebt end Clty Counol!apAroval 60 days priaY to th9 9vent- Shuttl�bus servfce wifl be
rgqulr�d untess appfic8nf demolistf'�tes sCdi97Gl�nt onsile parking is avpi(abls. Non�9rmltl�id evertts wilf nof be allo�ved.
CONTRAGTQR!APPLICANT INFORMATiON:
Name: � ck\ 'AY�,�.'fS2�7
State �icense# �.13p�g� �xpiration Date: � j 3�
Lead Certifir,�tion Number: (`j�T_ a�a S3 -_t, Expiratian Date.
{for worls an homes th�t w�re canstncfed prlor fo 1978
Phone: �5�-' a�(0�}-�•0 r (office) (celI)
Mailing Address �• �� �je� Cify: ; Q, ZIP: SS t �
Contact Person: Appli�nt is: r / Horrteowner �ci�ia on�)
Emaii and/or Fax;
PROPERTY OWNER 1N�OFtMATf�N:
Name: ��.55 i C.Cv LL1:�►�O a.a,� �
_ _ _.
Phone (day): �lo�"a�� �����j(
Address: � City: Z[P:
Email and/ar�ax
PROJECt IN�4RMATION:
Type of Praject� Any earth rrtovement may requlre
[� E1oor{s) ❑Remode( �F��g pamage MCW�}review 8�psrm�#s:
Minnshgh�Creek Watet'shed Dlstrlct(MCWD)
�j Re-roaf, asphali []Repair ❑Storm Damage 1$202 Minnetonka 8t�d
❑ Re-roof,cedar ❑Restoratlon ❑Water Damage Deeph�ven, MN 5539�
Phpn�: 8b2-47'E-0590
❑ R4-rpof,pther(spactiy} ❑S!d[ng Q Ofher:(specify) Fax; 952-471-0$82
[�WEndow(s) www.minnehahacre.e.k,ora
�verall Praj�ct Descrlptlon: (G.c.c a �^-'���' Wl..� �C X��f►
Estimated Cflnstruction Valuation of Prnject(�xclud#ng Eancf) $
APPLtCANT ACKNOWLEDGEM��T:
• Agrees to provide a3I information required ar requested by the euilding Depar�ment;
. Cert'if'ies ifi�t#he infprrnation supplied is frue and correct ta the best of his/h�r knowl9dge. The applEcant re�ognizes that fhey
ar� soiely responsible for sUbmifting a cortlplete appllCetlon being ewere thet upon faiEure to do so, the siaff h8s no 8itemative
but ta reject it until it is compl�te;
. SQme or ail of the Inforrr�ation that you are asked to proVide on thPs applic�tlon Is classlfled by State law as either private or �
confldsntlaL Pr�vate data ls 1nfArmatlon whtch generalty cannot be give� to the public but can be glven to the subJect of the (
data. Confidentiai data is ir►form8t�on w�llch generaliy cannot be gfven to eiiher the public or the subjeet nf the data. Our
purpose and intended usg af this inform�tiqn is to annualfy update our records and re�ords of oingr governmental sgencIas
re uir�d b IaW. If ou refuse to su I the irtfqrmation ihe a Ifcaflon ma not be issued.
Annlicant's Sianature: � Date� ��E1��l�
�� � C�� , /
` TIME V
CITY OF ORONO cnLLED IN � Z
INSPECTION OTICE SCHEDULED `� /.' �r�
PERMIT N ' � C MPL D
ADDRESS �
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OWNER � L TELEPfjONE. O. S �°�-�� �`�
CONTRACTOR�� � � � ���'� ��� � �
� DESCRIPTION � Vv��v�'V-S
�y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAWGRADING/FILLINQ
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? OMINER�COKTRACTOR TO MEET YOU:_YES_NO
� COMMENT'� [:�l i►'� c�o w S j h��'S�(t� r��
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� ❑YMORK SATISFACTORY`.PFIOCEED �PROJECT COMPLEfE
W ❑OORRECT WbRK 8 PROCEED ❑ISSUE CERTIFIC/1TE OF OCaJP�NCY
O ❑CORRECT 11MORIC,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERINO PERIrtANENT
❑CORqECT UNSAFE OONDITION WITHIN HOURS. p pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O GTATION ISSUED
O INSPECTION REOUIRED.CALL TO ARRANCiE ACCESS.
Calllor the next inspection 24 hours in advsnce. (952) 249-4600
Owner/CoMractor on site:
inspector:
White Cop�rAnspector"s FlN C�nary Cop�IlSlb Notie�