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CITY OF ORONO PERMTT NO.: 2oiaoioii
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 10/19/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2080 SALEM CT
PIN : 27-118-23-31-0016
LEGAL DESC : DICKEY LAKE ADDN
: LOT 000 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-CEDAR
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 14,000.00
NOTE: REROOF TEAR OFF-CEDAR SHAKES
APPLICANT pERMIT FEE SCHEDULE 250J5
TRADITION ROOFING&EXTERIORS STATE SURCHARGE(VALUATION) 7.00
2080 ITASCA AVE TOTAL 257.75
ST PAUL,MN 55109-
(651)698-3024
Minnesota State License#:206434827
OWNER
HIRSCHBERG,LAURA&ROBB
2080 SALEM CT
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 sepazate
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 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 responsibl for assuring all required inspections are
requested in c form ith the State Building Code.This permit may be
revoke e cause.
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Applicant Permitee Signature Date ed By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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C i#y of Orono
Building Permit Application for Interna� Vllork
(windows, doors, siding, re-roof, etc.) � �
Meiling Address:
'�fl� PO Box 66 Permit number. O/d-b/dD/
j Q Q Crystal Bay, MN 55323-0066 Date received: /b��Fl/O
i� �+ Sfreef Address: Received by:
�`% 2750 Kelley Parkway p�� ��eW�e:
�S�o�' Orono,MN 553� �
Main: 952-249-4600 Fax; 952-24�4616 www.ci.orono.mn.us TO��Fee: �S�,�,S
This applicatfon form must be complebed in full and all required infortnation must be submitted.
incamplets applic�tions will 6e returned, (Please prirrt)
GENERAL I�IFORMATI01�:
Jcb Site Address: �D�O s',4�Gfn? �T, pr0�0, mn. SS3SG
Will this be a Parade of Hames, Remodelers Showcase Home o�other Display Home? Yes No
N yes,a specia/eveiM peimit!s requbed wlth Poffce Depadmeirt arni Cify Councfl approva!80 days prror to the everu. Shutfle brrs servlce wiH,be
raquiied unless app/kant demons(rates sufficfent on-site pa�dng ls avallable, Non-peanitie�ol events wNf not be allowieri.
CONTRACZOR 1 APPLICANT INFORMATI�N: _ , .
Name: �/�A/�7� �LDOFIA� G �V TF�oK S ,7,�l� .
State License# ZpG,3 g a, � Expiration Dabe: 3 � �//
Phone: �5/-�48-�oay ot�ce (,a�- toia�63- cen
MaiFing Address: .20 Bo � A S�s� quQ Ci : �ST• �a4` ZIP: S5/1
Contact Person_ ��eT DSD�,1 Applicarrt is: ntractor 1 Homeowner �c�rc�eone>
Emaif and/or Fax 5/-(9 f -�3G�2g
PROPERTY OWNER 1NFORMATIQN: •
Name: /?obb l�vra. �i,�6Ql� ,(�,�.-
Phone(day): l�Io't- G(e -
Address: �?080 �i►�t Cit . O/r0/70 ZIP: S5.3SG
Email andlor Fax __ ULD Nf�Scy 19 �.o . Lom
PROJECT INFORNIATfON:
Type of Projec�
Any earth movement may require
MCVYD review 8 rmits
❑Door(s) Q Remodel ❑Water bamage �
❑Window(s) ❑ Repair ❑Sborm Dam e Minnehaha Creek Watershed District(MCWfl)
89 '182b2 Minnetonka Blvd
❑Siding ❑Restoration Deephaven, MN 55391
❑ Other. (specify) Phone: 952�71-0590
Lr1 R�raof Fax: 952-471-0682
❑Fire Damage www.minnehahacreek.o�a
Overafl Project Desc�iption: ,Q�o / N�GtJ �'�Ds►-� �NA� �P�IO�
Estimated Construction Valuation of Project(excluding land) $ / p�,�j —
APP�ICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the infnrmation supplied is true and cwrect to the best of his/her knrnMedge. The applicant recognizes that they
are solely responsible for submitting a compJete applicatiors being aware that upon failure t�o do so, the staff has no�tema�ive
but to reject it until it is complete; �
• Some or all of the in�Orma6on �at you are asked to provide on this application is classifled by SNate law as either private ar
confiderrtial. PrivatB data is iMormation which generally cannot be given to the�ublic but can be given to the subject of the
data. Confrdentia� data is inbrtnation which generally csnnot be gi�en to effher the public or the subject af the data. Our
purpose and irriended use of this inimmation Ps to ann�lly update our records arrd reoords of other governmental agenaes
re uired law. If ou refuse to su I the information, the a ication ma not be issued.
ApAlicanYsSignature: � � ��. /�j. �O �O
Oate:
Last Updated: 05-04-200g
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TRADITION ROOFING & EXTERIORS INC.
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TRADITI4N
RO(7FING AND EXTERIORS
oa�:oc�osEa 1�,zaio
Send to: Permtts and inspedions I From: Stu
Attermon: Office 612-363-7443
Off°e L°cab°^; , Phone Number;
Fax NurM�er:952-249-4616 Number of Pages,Inclu�ng Cover:
� URGENT ❑REpLY ASAP � PLEASE COMMENT O PIFASE REYIEUV ❑ FOR YOUR]NFORMATIph�
COMMEIrTS:
1Ne are start�ng the roof Tuesday October 19, 2010. Piease call when the
permit is ready.
Thank y. u ave a nice day.
Stu Hu son
Project Manager/Owner
612.363.7443 Cell
651.493.4527 Fax
stu�traditior�roofing com
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� DATE TIME V
CITY OF ORONO CALLED IN �a ��
INSPECTION NOTICE SCHEDULED �
PERMIT NO. 20/�a'0��� COMPLETED
ADDRESS �� � L��
OWNER TEL HON O.��`�g����
CONTRACTOR ��� � �� —
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�: DESCRIPTION
� ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
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 ❑ S TIC FINAL ❑ FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU• YES_NO
� COMMENTS:
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� RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. � �'�` � l, �
White Copyllnspector's File Canary CopylSite NoUce