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Home My WebLink About2009- - chimney repair CITY OF ORONO PERMIT NO.: 2009-00361 � _ 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 06/07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1375 REST POINT RD PIN : 07-117-23-32-0037 LEGAL DESC : SUBD REST POINT PARK LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : CHIMNEY - REPAIR ACTIVITY : O/S BUILDING-UNDEFINED VALUATIOI�T : $ 1,100.00 NOTE: REBUILD TOP 5 COURSES OF CHIMNEY. OK'D BY LYLE f \ APPLICANT PERMIT FEE SCHEDULE 44.50 SELA ROOFING&REMODELING, INC. STATE SURCHARGE(VALUATION) 0.55 4100 EXCESIOR BLVD TOTAL 45.05 ST. LOUIS PARK,MN 55416- (952)915-7227 Minnesota State License#: 0001050 OWNER GERLICHER, MR. &MRS. 1375 REST POINTT RD MOLIND, MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perYormed 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 construc[ion authorized is not commenced within day�of the date of issuance,or if construction is suspended for a' riod of 180 days at any time after work has commenced. The applicant responsible�or assuring a ired inspections are � , requ in formance th the State uii ng Code.This permit may be �� re oked at y ime fo c se. ' �j,.... �]_/C� . / � ,/ � / l� f �� i i A lica itee ignature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � Jun-O7-2010 10:45am From-CITY OF ORONO +9522494616 T-289 P.001/001 F-192 , � `rv��l�� - Ci of Orono �! � � �� Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Malling Address: Permit nur(tber. � —�d� 0.�,O,�O PO Sox ss . • Crystal eay,MN 55323-0066 pate recelved: D� � � Street Addreas: Received by: ' 2750 Ketley Parkway Plan review fee: �.��,�� Orono,MN 55356 `- 7otsl Fee: �(�C'�"Q� Main: 952-249-4600 Fax: 952-249-4616 www.oi.orono,mn,us i This application form must be completed in full and all required information must be submitted. Incomplete applications will be retumed. (Please print) GENERAL INFORMATION: ` ' Job Site Address: j��F��5� j�j/�T Will this be a Parade of Homes, Remodelers Showcase H4me or other Display Home? Yes No lfyes,a spacial evenr permit is required wifh Polke Department and Ciry Councll approva!60 deys pdor to the ewnt. ShutNe bas service will be required unlass app/icant demonstrates sufficianf on�site parkin9 is eveilaDle. Non•permittetl events will nof ba afbwed. CpNTRACTOR I APPUCA INF R ATIO : Name: State License# Expiration Date: _,fj /d Phane: � � office „ �-��T cell Mailing Address: C' .� P:,�-r/y� Contact Person: Applicant is: Contractpr / Nomeowner �co-�.o�.� Email and/or Fax: , �-• a--� PROPERTY OWN F A O : Name- / Phone(day): — Address: ,? Ci : �/r ZIP: �� Email and/or Fax PROJECT INFORMATION: Type of Projod_ Any earth movement may require MCWD r�view&permit8 0 Door(s) C]Remodel C]Water Damage � Minnehaha Creek Watershed Dis�rict(MCWD) ❑Window(s) ❑Repair []Storm Damage 18202 Minnetonka BNd Desphaven,MN 55391 ❑Siding ❑Restoration ❑Other:(specify) Phone: 952-471-0590 Fax: ��52-471-0682 ❑ Re-raof ❑Pire pamage .min��ehahacreek.o�a Overall Project Description: � � Estimated Construction Valuation of Pro"ect excludin land) � APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all informaGon required or requested by lhe Building Department; • Certlfies that the infarmation supplied is true and correct to the best of his/her knowledge. The�ppllCant recognizes fhat they are solely responslble for submitting a complete applicadon being aware that upon failure to do yo,the stsff has no aftema6ve but to reject it until k Is complete; • Some or all of the information that you are asked to p�ovide on this applicatlon is dsssified by State law as efther private or confidential. Private data is information which generally c2nnot be glven to Ihe public but csn be givgn to the subject of the data. Confidencial data is information which enerally cannot be given to either the public or the subject of the data. Our purpose and intended use of this informatio is to annually update • cords and records of other gov�mmental agencies r uired b law. ►f ou rafusa to Su I d�e i rmadon, e a II o a not be issued. Applicant's Signature: ..�• Date: � Last Updatod: 05-04-2�09