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Home My WebLink About2009-00864 - roofing ,� , CITY OF ORONO PERMIT NO.: 2009-00864 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/OU2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3150 RIDGEWOOD CIR PIN : 04-117-23-23-0022 LEGAL DESC : ROUTSON ADDN : LOT 002 BLOCK 001 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 8,750.00 NOTE: TEAR OFF AND REROOF APPLICANT PERMIT FEE SCHEDULE 177.00 NORDKAP CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 4.38 1881 STATION PARKWAY TOTAL 181.38 ANDOVER,MN 55304- (763)607-4845 Minnesota State License#: 20635312 OWNER EFIGENIO, BARTOLO&MARIA 3150 RIDGEWOOD CIR 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 specifica[ions,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 wi[h whe[her 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. �� Z � � � � � e , � Applicant Permitee Signature Date � I ed B Si nature Dat� � Y g SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , , �r � �R � � • City of Orono £ - �. �.,� Building Permit Application for Internal Work '~ (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: • Q�O� 4v�,� PO Box 66 �'� ` � Q �,\ Q Crystal Bay, MN 55323-0066 Date received: Q Q J'� ` :, �'� Received by: /�f�j�{ � �� F:�� F I Street Address: �+' � ti 2750 Kelle Parkwa � � pr` � Y Y Plan review fee: - �`�kEsxoQ'� Orono, MN 55356 � Total Fee: Q � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �� U �`� This application form must be completed in full and all required information must be submitted. � Incomplete applications will be returned. (Please print) � �;.;; GENERAL INFORMATION: �; s,, Job Site Address: 3 �Sc� �,�dc�,e :,.�o�� C� �z . :� 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 s� required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. .�`� CONTRACTOR/APPLICANT INFORMATION: � Name: No(z-��c�� CC��St2..��i�,�1 1..� C. �`'� State License# � 2C�(�'�S� � �z Expiration Date: Phone: � � to'3 - �'1 co�-t -1 ti �S (office) (cell MailingAddress: � ,��z_k.,,�,� Cit : �,��,, > ZIP: 5 5 ) � Con tac t Person: `��bb" ��5��,� Applicant is: ontrac o / Homeowner (Circle One) ;� �� Email and/or Fax: `; �., �: . '� PROPERTY OWNER INFORMATION: }'. Name: �MA2_,�y.� E �e�e t.�;O �� Phone (day): ��S Z - �1 3Q�-�3�5 y _� r4 Address: 31 SC) SZ�a�.�� woo�{ C � �Z Cit : Q�Zprv p ZIP: S S 3 S� � `'' Email and/or Fax � ' � PROJECT INFORMATION: � �� Type of Project: Any earth movement may require '� '�"' MCWD review&permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) 4 ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd �� 3'� Deephaven, MN 55391 � ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 �� Fax: 952-471-0682 u e-roof ❑ Fire Damage www.minnehahacreek.orq y'- Overall Project Description: '�� Estimated Construction Valuation of Project(excluding land) $ �-� � 's'f, � '' APPLICANT ACKNOWLEDGEMENT: �;: � • Agrees to provide all information required or requested by the Building Department; xs `�'"� • Certifies that the information su lied is true and correct to the best of his/her knowled e. The a licant reco nizes that the `� ��`.� pP� 9 PP 9 Y 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 alf 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, the a lication ma not be issued. �s': � '� Applicant's Signature: ��(� �__� Date: i2- � ' �`7 r Last Updated: 05-04-2009 - ';. a �, , { . � , ,� � .,m�� ,,,.• �� .,� ; ..��" .� .�s ,_-::: � w� � ��.��;r �. s