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Home My WebLink About2010-00801 - roofing � CITY OF ORONO PERMIT NO.: 2010-00801 • 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 09/07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2140 SALEM CT PIN : 27-118-23-31-0012 LEGAL DESC : DICKEY LAKE ADDN : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOF[NG-CEDAR ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 22,000.00 APPLICANT PERMIT FEE SCHEDULE 368.75 KUHL DESIGN & BUILD, LLC STATE SURCHARGE(VALUATION) 11.00 1515 STH STREET SOUTH HOPKINS, MN 55343- MISC FEE 0.00 (952)935-9469 TOTAL 379.75 Minnesota State License#: 20195769 OWNER JOHNSTON, CHRISTOPHER& LYNN 2140 SALEM CT LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT Thc work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State E3uilding 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 goveming this type of work shall be compied with whether or not specitied 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�ime for due cause. �.��--{�y�i�� c�� p� l/�; / / Applicant Permitee Signature Date Issued By i nature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: '��,�,j�.� PO Box 66 /Q „ \ Crystal Bay, MN 55323-0066 Date received: � �s;,, � �"�� '�'� � Received by: ,� ,��.{��.i;� �, , Street Address:� �',F, �� ''�� ti 2750 Kelley Parkway Plan review fee: �9kE$H�4'�'G Orono, MN 55356 '__— 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: L I'�-t C c ,,-, �' � � ' ` ; ..� i� °-- -- "(,� 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 will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ` !��;,n I "5 ��kc... n�s State License# 2�� j�=, 1t�� Expiration Date: ��z��/Z�, i Phone: �ti7_-�� - `j�[o r (office) �+z.;e�c�� (f%17-Z72- �3�y (cell) Mailing Address: '� �f ,� Cit :__ - �a- ZIP: Contact Person: �}��` LL�� Applicant is: Contract� / Homeowner (Circle One) Email and/or Fax: ��" (,i k_;v�I,l:�•, c r.b:� ��I. c c�-� PROPERTY OWNER INFORMATION: Name: ��jo��ji;-� Phone(day): �SZ - y�3 -��S��i Address: Z I�i O �c,Le�� C v�.�t- City: L?��,��, ZI P: �� .��L_ Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ❑ New Construction �Single Family with Residence ❑Addition attached garage Garage/Accessory Bldg. ❑Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑Office/Commercial ❑Private Sewer �Other. (specify) �L.P - f u;:-� ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑Storage ❑Public Water '*Any earth movement may require ❑Commercial ❑Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑Other: (SpeCify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.m i n n e h a h a c re e k.o r Estimated Construction Valuation (excluding land) $ ZZ, GC:�C� Last Updated: 9/29/2009 - 17- STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a.Length(ft.)= Number of bedrooms= ❑Wood/Frame ❑Masonry b.Width(ft.)= Number of garage stalis: ❑Metal Attached= ❑Pole Bldg. Areas in sauare feet Detached= ❑ICF ❑On-site Prefab c.Basement= ❑Off-site Prefab d. 1$'Story = ❑Other(please speciry): e.2"�Story= f. YZ Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for our a lication to be rocessed: Not Enclosed licable ❑ ❑ Permit lication ❑ O Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all uirements ❑ O Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation s ❑ ❑ Se tic S stem Site Evaluation Re rt ❑ ❑ Access Permft ❑ ❑ Wetland Buffer Im rovement Plan ❑ 0 En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; . Agrees to pay the Cky of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and coRect 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; • Acknowledges the Escrow Agreement is completed and signed; • Some or all of the information that you are asked to provide on this application is dassified 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 govemmental agencies required by law. If you refuse to supply the information,the application may not be issued. ApplicanYsSignature: � /�/ Date: C�y- �7—/U � Last Updated: 9/29/2009 - 18- v ^ � �J `l DATE TIME ✓ CITY OF ORONO CALLED IN INSPECTION OTICE �CHEDULED � PERMIT NO. �� "/ coMP o ADDRESS � G `u .Q.�fQ�� OWNER ELEP ONE NO. � ` - �8� CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI p LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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. ❑ FO�LOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W C � J O >. � O � W � Q � Z W � W � � � �lORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnedContractor on si e: Inspector. White Copyllnspector's File Canary CopylSite Notice