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Home My WebLink About2017-01242 - 28 sash and full window replacements 1 ,. CITY OF ORONO * z 0 1 7 - 0 1 z 4 z * 2750 KELLEY PARKWAY DATE ISSUED: 10/02/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 880 PARTENWOOD RD PIN : OS-117-23-43-0001 LEGAL DESC : PARTENWOOD : LOT 006 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-LTNDEFINED VALUATION : $ 22,000.00 NOTE: 28 SASH AND FULL WINDOW REPLACEMENTS APPLICANT PERMIT FEE SCHEDULE 387.20 PCS RESIDENTIAL STATE SURCHARGE(VALUATION) 11.00 2005 PIN OAK DRIVE MAIL-IN FEE 2.00 EAGAN,MN 55122- TOTAL 400.20 Minnesota State License#: BUIL-BC593158 Payment(s) CREDIT CARD 8984 400.20 OWNER GRAY,JERRY&CYNTHIA 880 PARTENWOOD 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 l80 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. C % � C�' -(' �� i �J�i � � Applicant Permitee Signatur� Date Iss�ed y Signature Date „ , .. 1014802-Gray City of Orono Building Permit Application for Maintenance/Rep[acement!Remodel —Residential ONLY (i.e.windows, doors, siding, re-roof, etc. —N4 STRUCTURAL �XPANSIONy Ma!lingAddress: permitnumber. � � �� a �0�� Crystal Bay,MN 55323-0066 \� Date received: d”d?✓' - � SfrestAddress: � Rec�ived by: �il�Vl..l.u�� y `'` 2750 Keliey Parkway � �� Plan review fee: ��qkfSH��`'�G Orono,MN 55356 Total Fee: � �, �� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono,mn.us This application form must be completed in full a�d all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL iNFORMATION: Job Site Address: 880 Partenwood Road, Lon Lake, MN 55356 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? Yes No If yea,a special event pe�mft!s required w�h Polke Department and CJty Counci!approval 60 days prla to the evenl. ShuttJe bos servke wlU be requlred unless appl'Kanf demonsGates suh"rclent on-slle paAcing is avallable. Non-perm�Tted events wpl not be sllowed. CONTRACTOR I APPLICANT INFORMATION: Name: PCS Residential State License# BC593158 Expi�ation Date: 03/31/2018 Lead Ce�tification Number. �oT_F�Q��_� � Expiration Date: �7/A1l�(LO (for work on homes that were constructed prlor to 1978 Phone: (cell) (office) Mailing Address: 2005 Pin Oak Drive City: Eagan ZIP: 55122 Cont2Ct PeI'SOt1: Pam Pomerenke Applicant is: Contr�Ctor / Homeowner cc�ro�e o�o} Email and/or Fax: ppomerenke@pcsrenew.com Fax: 651-994-6806 PROPERTY OWNER IPIFORMATION: Name: Jerry&Cindy Gray Phone(day): 952-�71-801B Add�ess: 880 Parternvood Road Clty: Long Lake ZIP: 55356 Email and/or Fax: jerry.e.gray1 @gmail.com PROJECT INFORMATION: Overall r 'ectdescri tion: tg '�� ' �'�t� W�w1uy �t�ll�4rw��,. . Type of ProJect• . Any earth movement may also require ❑Door(s) . ❑Rernodel ❑Fire Damage MCWD review&permits: ❑Re-roof,asphaft [yRepair ❑Storm Damage Minnehaha Creek Watershed Distrlct{MCWD) 15320 Minnetonlca Blvd ❑Re-roof,cedar ❑Restoration ❑Water Damage Minnetonka,MN 55345 ❑Re-roof,other(spectfy) ❑Siding ❑Other:(speciiyj Phone: 952-471-0590 Fa� 952�71-0682 ��y��W�g� 28 Sash&1 Full Wind Replacemen�.minnehahacreek.orq Estlmated Construction Valuatfon of Project(excluding land) $ � APPLICANT ACKNOWLEDGEMENT: . Agrees to provide all information required or requested by the Building Department; . Certifies that the informaUon supplied is true and correct to the best of his/tier knawledge. The applicant recognizes that they are solely responsible for submitting a complete applica6on being aware that upon failure to do so,the sfaff has no a{temative but to r�eject it until it is complete; • Some or all of the inforrnaaon that you are asked to provide on this application is classified by State law as aither private or confldential. 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 eithe�the public or the subject of the data. Our purpose and intended use of this inform ' is to annual[y ate our records and records of other govemmental agencies required by law. If ou refuse to su the' ation t e a c 'on ma nof be issued. ApplicanYs Signature: '�- �� Date: 10/2/2017 Owner's Signature: Date: last Updated:January 2016