HomeMy WebLinkAbout2011-01055 - windows � � ~ CITY OF ORONO PERMIT NO.: 2oi�-oioss
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/14/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 855 PARTENWOOD LA
PIN : OS-117-23-34-0012
LEGAL DESC : PARTENWOOD
: LOT 005 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVTTY : O/S BUILDING-UNDEFINED
VALUATION : $ 24,900.00
NOTE:
REPLACE(11)WINDOWS AND(1)DOOR INTO EXISTING OPENINGS
APPLICANT pERMIT FEE SCHEDULE 413.00
CRAFTSMAN'S CHOICE,INC. STATE SURCHARGE(VALUATION) 12.45
26219 FREMONT DRIVE#105
ZIMMERMAN,MN 55398- MAIL-IN FEE 2.00
(763)633-1390 TOTAL 427.45
Minnesota State License#:20384780 PAID WITH CC# 5194
OWNER
GUL, SHAIKH ASIM
855 PARTENWOOD 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 dces
not grant permission for additional or related work which requires sepazate
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.
��/ T � � T� �� �l � l
Applicant Permitee Signature Date Is By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, . .
City of Orono
Building Permit Application for Internal Work
windows, doors, s�din , re-roof, etc.)
MailingAddress: pertnitnumber: •
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Og�O.I�o Po s�ss .
Cryst�l 6�y, MN 56323-0066 p����;
� SOneefAtldress: Received by: :'
b►� 2750 Kelley Parkwsy Rlan reviow�fee:
�� prono,MN 55356 , . '� �
Total Fee'. ��� � . ,
Main: 952 249-0600 Fax: 952-249�616 www.ci.orono.mn.us •� : ,
This application form musE be completed in full and all required information must be submitted.
Incamplete appllcation�will be returned. (P/ease p�rrt) .
QENERAL INFORMA710N:
Job 3ite Address: ^J(� `,,,.,Q, •
� Will this be a Parade of Homes,Remodelers Showcase Home or other Dispiay Home? Yea No
�ff yes.a speaal ever�t psrmlt!s requlred wQh Police Department and Cily Council approval 80 days prior to the event Shr�ltls bus aeiv/ce w�be
requ!►eal unksc applir.ent demonabstes aut�er►t or►,sRe parking is availebfe. Norr-perrn/tted events wal not be adowe0.
CONTRACTOR/ PLI ANT INROItMATI ;
Nsme: � �, 1
State License# l�"'� p Expiration Date: (3
Lead Certiftration Number. h(A T- t O�n�o Q- 1 Expiration Date: �
(forwork on homea thatwrere co»swctedpr�o►!o 1978
Phone: �I�o �-� �SSI _ �O (office) l0 I a,- � - l y(q� (cell)
Mailing Address: a ! C�ty: ZIP:
� Contact Person: ' m S�'��J�.nCS ' Applicsnt is: ontfact / Hortteowher �c��a onq
Email and/or Fax: _� �
PROPERTY OVYNER INFORMATION:
Name: __�• ASaM C,►► �
Phone(dey): ��a� c�
Addres3: City: 21P: �rj�
Email and/or Fax • .
PROJECT INFORMA710N:
�°'� je�� Any earth movemerrt may r+equlre
�Ooor(s) ❑Remodel ❑water Damage ��re���Permits:
Minnehaha Creek Watershed District(MCWD)
�INirtdow(s) �Repair ❑Stvrm Damage 1e202 Mlnnetonka Blvd
❑Siding ❑ Restoration ❑Other:(specify) Deephaven, MN 55391
0 Re{oof ❑Fite Damage PF�ce:952�7110-0�590
www.minnehah�Gfeek Oro
Overe�ll Project Desc�ption: � S �j�p � ���� � �
Estimated Constn,ctioe Valuatjon of Project(excluding I�nd) s • C"- �- J-S �"'�'�"��$
APPLICANT ACKNOWLEDQEMENT:
• Agrees to piovide all informatlon required or reques�d by the Building Departrnent;
• Cer�fies that the inf�rmatlon supplied is vue and correct to the best of his/her knowledge. The applicant recogn¢es that they
are solely responsible for submiaing a complete application being aware that upon faiture to do so, the staff has no altema�ve
but to reject it ur�il3t is complete;
. • Some or all of the information that you are asked to provide on this application is dassified by State law as elther privste or
confidential. Private data fa information whieh generalty cannot be given to the publie but pn be gNen to the subjsct of the
data. Confidential data is information which generally esnnot be given to either the public or the subject af the data. Our
purpose and irnended use ot this infoRnation is to annually update our records and recards of other govemmental egencies
uired law. If ou� se to su I the informa�on the a lication ma no�bo iasued.
Applicant's Signature: , � Oate: q �� ��
Lest Updated; 0&01-2D11 �