HomeMy WebLinkAbout2010-00818 - roofing . CITY OF ORONO PERMIT NO.: 2010-00818
� 2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE ISSUED: 09/10/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2135 SALEM CT
PIN : 27-118-23-31-0013
LEGAL DESC : DICKEY LAKE ADDN
: LOT 004 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-CEDAR
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 46,000.00
APPLICANT PERMIT FEE SCHEDULE 638.75
TIMBERLINE EXTER[ORS, INC. STATE SURCHARGE(VALUATION) 23.00
7026 E FISH LAKE ROAD
MAPLE GROVE, MN 55311- TOTAL 661.75
(651)329-6916
Minnesota State License#: 20633887
OWNER
WACHMAN, ERVIN & MICHELLE
2135 SALEM CT
LONG LAKE, MN 55356
AGREEMENT AND SWORIV STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry 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 wili
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.
Thc applicant is responsible for assuring all required inspections are
requested in con ormarkce with t State Building Code.This permit may be
revoked at y ime �_r due e. ��� ,
, � �-- 1C-._�<,,
✓� ,�� � , i�� � i , i G jCi � ��-�_ C`Yy'�c��'� i
Apqli� t er itee Signa e Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
- p- r`.� � � `'�' `�
_ :,; '_
; +�-
_ �''. � -��'�
� � � � ,, '
. �• City of Orono ��`�
���x, :
�f � .
! Building Permit Application for Internal Work �` ��� °��#�
(windows, doors, siding, re-roof, etc.) �
�
Mailrng Address: Permit number. �;
�,0,�. PO Box 66 ,
�� O Crystal Bay, MN 55323-0066 Date received: �
I '�� 3 _ �
a �'�'��" o-, � StreetAddress: Received by: �
�_�
�'�,c, 4 B"� �ti 2750 Kelley Parkway Plan review fee:
�
'���'� Orono, MN 55356 ,��
ESH� r�
Total Fee: j „(„ ` , � ''� ;
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �/lY �,�
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: /�� ;�_(�,.t.-v� ���- . =
' ' 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 wrll not be allowed.
CONTRACTOR/AP�CANT INFORMATION: �
Name: -r,t., ',c ti.z i-�G��-S �1� '�
State License# ���� J;�,r� Expiration Date: � ��j � �'
Phone: � �;) - ��� �- �;��' � office cell �
Mailing Address: ', (y h Cit : �i ��;y�ZIP: �„� �
Contact Person: ���,z..��y�L, Applicant is: ntrac or Homeowner (Circle One) -.
�;:
Email and/or Fax:
fl..
' PROPERTY OWNER INFORMATION:
Name: �rviv�t /�{��z�%�'l-�.CcrYl
�:�� Phone (day): �3�� � G � � `'SS "'
Address: ;�,/_3 5 Sa�E.v,/l � City: �I�G✓t.0 ZIP:.���(� �"
Email and/or Fax �;
`�_
PROJECT INFORMATION: ��
,: �
,`�: Type of Project: Any earth movement may require �
' MCWD review&permits ,,�
❑ Door(s) ❑ Remodel ❑Water Damage r '
' Minnehaha Creek Watershed District(MCWD) s
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd F
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other. (specify) Phone: 952-471-0590 "
Fax: 952-471-0682 ��
e-roof ❑ Fire Damage www.minnehahacreek.orq
Overalt Project Description: � � �� � � ��� ��;
I,�C�{/ L� _ /�//ir>.�!�' C` �;
Estimated Construction Valuation of Projec ( xclu ' g land) $ y(� ����
�:;
APPLICANT ACKNOWLEDGEMENT: �'�
x>: ?�;
• 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
y are solely responsible for submitting a complete application being aware that upon fail�re to do so, the staff has no alternative z�
� 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 Y;
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. '`
k � � ,_/,� ! ii + 1+;.
�,�, ApplicanYs Signature: � r;> Date: ,O� �'V��
.
Last Updated: 05-04-2009
�
;
_ � � � � ;� ,,;� �
.
� ::, � _..... . �. , ,.,.,., ,�„�
� ` ��
� .. . �._ .� .,. . � �.< _.._,,. � �_. - .,.,..
�� p� - �/
G���"�� /D D ') TIME
CITY OF ORONO CALLED IN �` ��
INSPECTIONrIQ��E��/� SCHEDULED
PERMIT NO��J v— COMPLETED
ADDRESS 47�..� �
1
OWNER TE�EPH
CONTRACTOR
� DESCRIPTION �` �`�C-eC�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXC RADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPIACE ❑ 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
J
� �L��1 C� : �,�.0 iZ n �a� ��
0
�
W
�
Q
�
Z
W
�
W
�
�
�
O
W� �ifORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALI INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-460�
Owner/ConVactor on site:
Inspector. ,ri _
White Copyilnspector's File Canary CopylSite Notice
v �� T TIME �
CITY OF ORONO ��IED IN �
INSPECTION TICE �y� Q/ SCHEDULED `
PERMITNO. �Q�b'v�/ v` � MPLETED
ADDRESS 3 S _—(��i�
OWNER TEL PHONE N�sl���—
CONTRACTOR �/ t- — �
>; DESCRIPTION ` G c
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS
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
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
C
�
�
O
�
�
O
�
W
�
Q
�
2
w
�
W
�
�
� ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFOREC�IERING PERMANENT
❑CORRECT UNSAFE CONDlTION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-46��
Owner/Contractor on.s�t . .
Inspector. "V �✓ 6,���
White Copyllnspector's File Canary CopylSite Notice