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Home My WebLink About2013-01120 - roofing CITY OF ORONO * 2 0 1 3 - 0 1 1 2 0 * = t 2750 KELLEY PARKWAY DATE ISSUED: 10/23/2013 ORONO,MN 55356- (952 249-4600 FAX: (952)249-4616 ADDRESS : 2770 RAINEY RD PIN : 04-117-23-43-0014 LEGAL DESC : TREES TO BE : LOT 001 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 12,000.00 NOTE: VALUATION OF PERMIT:$12,000.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY$E ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 221.25 NMC EXTERIORS STATE SURCHARGE(VALUATION) 6.00 P O BOX 694 TOTAL 227.25 BUFFALO,MN 55313- (612)490-4846 PAID WITH CC# 6775 Minnesota State License#: BC639088 OWNER WYSOCKI,RICHARD&APRIL 2770 RAINEY RD WAYZATA,MN 55391- AGREEMENT AND SWORN STA'�EMENT 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 whiC�h reyuires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be wmpied with whether or not specified herein.'�his permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or jf construction is suspended for a period of 180 days at any time after wotk 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. �o i 23 i/3 G-�-��Q--�� /D /Z3 / / � t Pe 'ee Signature ate Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ��----;�- --_Tn. �:�.�, - City of Orono • Bu�ding Permit Application for Maintenance / Replacement / Renovation �� (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O� Mailing Address: Permit number: � ' � O PO Box 66 /� : �;;: Crystal Bay, MN 55323-0066 Date received: � V �� — � �```' Received by: ` Sfreet Address: � Ap i, y� � 2750 Kelley Parkway Plan review ee: �' Orono, MN 55356 ' t�kESH�4� �—'�� 5 ? 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: �'�' Job Site Address: �"� � 7 � �/�i��i�� /�� ' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No °� /f 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. �'a CONTRACTOR I APPLICANT INFORMATION: � �� Name: � - , 7" - �c�2 s� �..,1r'":�f: ,i "�' State License# /� �,�' Ex iration Date: ,.,, � C C 5 5� � P � i�r ' Lead Certification Number: ivt�T �I7�3 -�/ Expiration Date: �� (for work on homes that were constructed prior to 1978 � ` Phone: (cell) 7�.� . �33� f�33 (office) '�L"s 2�/5! -1;�&/ ��^ Mailin Address: �'�' Cit �- ZIP: 5 s`�{�� ,�, 9 /Z - 23 ,� n/ Y� y . �'�; Contact Person: �,;,,� ,�'�.. Applicant is: �"ontract / Homeowner (CircleOne) ��k' Email and/or Fax: �<�� 't-4�.,,, �u 'oe r, � vJ �'+'� C �'�,L.�"-�►� i VdZ s. C.c.�:r'1 �;u;�' � �: PROPERTY OWNER INFORMATION: �° Name: � � c 1-/ ri ��2/L �/1�`f s��' Ck l �,"�: ,,. Phone (day): � Address: � ��v Cit : � r; Z7?C, �A � 4- Y �'/l-�ti-D ZI P: y s�� y� rs:x' Email and/or Fax: >.:�;. s.:; PROJECT INFORMATION: Overall project description: w,t,` Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: �Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) � Y' 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 x, ' Fax: 952-471-0682 �.• ❑Window(s) www.minnehahacreek.orq �z� Estimated Construction Valuation of Project(excluding land) $ 0!) , '•!' �:�: �`' 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 �i intended use of this information is to annually update our records and records of other governmental agencies required by law. If ��i ou refuse to su I the inf mation,the a lication ma not be issued. �^, �, ApplicanYs Signatur � � Date: �3 Z 3 l� ��;' Owner's Signature: Date: Last Updated: 03/06/2013 � DATE TIME V CITY OF ORONO CALLED IN IO_cZ '� "(3 INSPECTION NOTICE SCHEDULED ll�od5-�3 .�-�/Y1�� PERMIT NO. ��13--�5//0� COMPLETED ADDRESS O OWNER TEL HONE O. CONTRACTOR �/�/�( ' ,��2f'1�S >; DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS 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 Q O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL p HARD COVER REMOVAL v ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W � � J O � � O � W � Q � 2 W � W � J J^ ��RKSATISFACTORY:PROCEED O PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next ins ion�4 hours in advance. (952� 249-46�0 OwnerlContractor on te: Inspector. White Copyflnspector's Ffle Canary CopylSite Notice �_� Gc/�z� � AT TIME ✓ CITY OF ORONO CALLED IN � INSPECTION TICE SCHEDULED ///��3 PERMIT NO. � ' COMPLETED ADDRESS d OWNER E PHONE NO. � CONTRACTOR � IDYS � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/AEMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � j d W� ❑WORKSATISFACTORY:PROCEED �OJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTOTAKEN INSPECTOR WILL REfURN O CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. \ � White Copyllnspector's File Canary CopyfSite Notice