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Home My WebLink About2011-00308 - roofing CITY OF ORONO PERMIT NO.: 20��-oo3os � � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE Isst7En: OS/06/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 716 SANDSTONE CIR PIN : 33-118-23-11-0050 LEGAL DESC : STONEBAY : LOT 001 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 3,600.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 103.25 MIDWEST ROOFING STATE SURCHARGE(VALUATION) 1.80 6541 SYCAMORE CT N MAPLE GROVE,MN 55369- TOTAL 105.05 (763)427-9696 Minnesota State License#:20637010 OWNER M.ANN RUTLEDGE,G. STUART ACKMAN& 716 SANDSTONE 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 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 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 conformar�ce with the State Building Code.This permit may be revoke at any time for due cause. / � / [' �� `( A plicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. " ��, City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) �O� MailiPg�Bd�Xre�ss: Permit number: �� dG O Q Crystal Bay,MN 55323-0066 Date received: � �� Street Address: Received by: �ti`� 2750 Kelley ParkwaY Plan review fee: ��08� Orono,MN 55356 � Total Fee: /Q,j. ��J' 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. Incompiete applications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No ff yes,a specia!ever►t permit is required with Police DepaRment and City Council approval 60 days prior to the event Shutt/e bus servioe will be required uNess applicant demonsbates sutficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: �/ Name: /rl��G✓l��` �omF�h9 ��i,`y l�✓y�►do� LnC State License# ,`Z p p/p a 7 7 Expiration Date: �3/3�O oZ pe� Lead Certification Number: Expiration Date: (for work on homes that were construc�prlor to 1978 Phone: 76 3—�/a� 7-9 G 9(� (office) 76 .3 0�84— /.3a Z (ce11) Mailing Address: (p ,S'/ �Q�-►,pr Cy� City: !l� v�- ZIP: Ssj 6�{ Contact Person: �ryn.�i �P.�b••i Applicant is: on actor / Homeowner �ci��o�� Email and/or Fax: ')63 - �/ �7� JrOD� PROPERTY OWNER INFORMATION: Name: �tc.�c,�� C��c��+ Phone(day): Address: 1 ! (� S�t��,; Sf-E'�t (,��'"C/{ City: ��Z,,�lu,f� ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: My earth movement may require ❑ Door(s) ❑Remodel ❑Water Damage MCWD review 8 permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑Repair ❑Storm Damage 18202 Minnetonka Blvd ❑Siding ❑Restoration ❑Other:(specify) Deephaven,MN 55391 Phone: 952-471-0590 '�Re-roof ❑Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) S , �% APP�ICANT ACKNOWLEDGEMENT: Agrees to provide all information required or requested by the Building Department; Certifies that the infomnation supplied is true and correct 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 aftemative but to reject it until it is complete; . Some or all of the information that you are asked to provide on this application is classfied by State law as either pnvate or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. ConfidenGal data is informatlon which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this infomiation is to annually update our records and rec;ords of other govemmental agencies re uired b law. If ou refuse to su I the information the a lication ma not be issued. ApplicanYs Signature: �"'4v/ � `�-.,�� _ Date: � � r � � Last Updated: 03-01-2011 D E TIME � CITY OF ORONO CALLED IN ,�j / INSPECTION NOTICE SCHEDULED / /D�OD / PERMIT NO� !l- 3�� COMPLETED ADDRESS �i� Q�I��i��----��[�-� OWNER TELE ONE NO.��O3`�$O�`3 a� CONTRACTOR � � � DESCRIPTION ��L�� "�11 � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � J O �. � O � � W � � Q � Z W � W � � W WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE d � ❑/ RECT WORK&PROCEED ❑�SSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-460� OwnerlCo�tractor on site: Inspector. � ��( White Copyllnspector's File Canary CopylSite Notice