HomeMy WebLinkAbout2012-00799 - windows CITY OF ORONO * 2 0 1 2 - 0 0 7 9 9 *
. 2750 KELLEY PARKWAY DATE ISSUED: 08/17/2012
. ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2675 PHEASANT RD
PIN : 21-117-23-23-0010
LEGAL DESC : PHEASANT LAWN
: LOT 006 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVTTY : O/S BUILDING-UNDEFINED
VALUATION : $ 13,356.00
. NOTE: (18)WINDOW REPLACEMENTS IN EXISTING OPENINGS.
APPLICANT pERMIT FEE SCHEDULE 250.75
THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 6.68
2690 CUMBERLAND PKWY, STE 300
30339- MAIL-IN FEE 2.00
(763)542-8826 TOTAL 259.43
Minnesota State License#:20268257
OWNER
SHERF, S&J
2675 PHEASANT RD
EXCELSIOR,MN 55331-
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 goveming 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 1 SO days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for d�e cause�
��Zt�C �. i i � �
Applicant Permitee Signature Date Issued By S' ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED AB E.
' City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
�,0,�. PO Box 66
Q ^Y � Crystal Bay, MN 55323-0066 Date received:
��
''a�� Received by:
� �� �J��,-�;:� �, Street Address:
,�s, R�'� �� 2750 Kelley Parkway Plan review fee:
L.ykEs��`,� 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 and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: � G ,� �» Ph Q a S on � �Q a �
Job Site Address: 7
Will this be a Parade of Homes, 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: THD At- Home Services, Inc. �d '�10��r '1�n� s
State License# � Y ' G , 7
Phone: 2690 Cumberland Pkwy, Ste 300 (cell)
Mailing Address: Cumberland Office Park ZIP:
Contact Person: Atlanta, GA 30339-3913 lomeowner (Circle One)
Email and/or Fax: Lic#20268257 Ph. 763/ 542-8826
P'ROPERTY OWNER I ORMATION:
Name: Q V 1 Q� 0 �
Phone(day): ? 3 j,� � ,'�p r /
Address: 6 1 43 o p l Cit :,C �'!�/S/v/� ZIP: ''ss 3 l
Email and/or Fax
Z
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits
❑ Door(s) ❑ Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
indow(s) Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage www.minnehahacreek.orq
Overall Project Description: in�oW rt Q i / / /� � �n O / J
Estimated Construction Valuation of Project(excludi g land) $ / 3 3 5' (e
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 information is to annually update our records and records of other governmental agencies
re uired b law. If ou refuse to su I the information, e a lication ma not be issued.
ApplicanYs Signature: Date: � �l s( ��
Last Updated: 05-04-2009
� D T TIME v
CITY OF ORONO C LED� a-? �
INSPECTION NOTICE SCHEDULED a�o?l�- /.3 _Q" J
PERMIT NO. —��� COMPLETED
ADDRESS o�C� � Gl�+c� �
OWNER � T PHONE NOG��d� S�
CONTRACTOR
� DESCRIPTION)7 IQ�,C.� �`�`�.
� � FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED �OJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CAlLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
�nspector. i..� 4 S
White Copylinspector's File Canary Copy/Site Notice