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Home My WebLink About2011-00305 - roofing / • M CITY OF ORONO PERMIT NO.: 20��-oo3os 2750 KELLEY PARKWAY ORONO,MN 55356- DATE IssuEn: 05/06/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2460 SANDSTONE LA PIN : 33-118-23-11-0029 LEGAL DESC : STONEBAY : LOT 026 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY ; O/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE � 162.25 MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.00 6541 SYCAMORE CT N MAPLE GROVE,MN 55369- TOTAL 166.25 (763)427-9696 Minnesota State License#:20637010 OWNER MATESKI,THEO&LYNNE 2460 SANDSTONE LA 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 goveming 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 aze requested in conformance with the State Building Code.This permit may be revoked a y time for due cause. �' � � ��l � 5, �� Applicant Permitee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. i , ti.. City of Orono ��33 Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: o2U//- U(J � O.��,�.0 PO Box 66 Crystal Bay,MN 55323-0066 Date received: � r � Street Address: Received by: 2750 Kelley Parkway Plan review fee: i��4�� Orono, MN 55356 � Total Fee: �� v 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 appiications 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 H yos,a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be requlred uNess applicant demonstrates suficient on-site paAcir►g is availab/e. Non-pe�nitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: /rl��wl S� �o��,ky �i�i� I,✓lhd0� Ln C State License# ;Z p O/p a 7 7 Expiration Date: �3/3//a fit,� Lead Certification Number: Expiration Date: (for work on homes that rrere construc�prlor to 1978 Phone: 76 3-�l a� 7'9 b 9� (office) 76 3 o�gO- /3� � (cell) Mailing Address: (p ,S'/ Cqr-►-pr� f� City: Q�e vG ZIP: S'Sj 6 4' Contact Person: �rynf� �Q�'b••� Applicant is: on actor / Homeowner (ClrelsOns) Email and/or Fax: 763 .-. y �7- y00/ PROPERTY OWNER INFORMATION: Name: j-�'� j"''it �c'S l�� Phone(day): Address: o'Z N �; � a�t r�S�e�. �n. City:�e'j/xy ��'-C.- ZIP: Email and/or Fax PROJECT INFORMATION: Type of ProJect: Any 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 � � �� Deephaven,MN 55391 ❑Siding ❑Restoration ❑Other: s ci Phone: 952-471-0590 �Re-roof ❑Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuatlon of Project(excluding land) S APPLICANT ACKNOWLEDGEMENT: 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 are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altemative 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 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 recorcls and records of other govemmental agencies r uired b law. If ou refuse tp su I the information the a lication ma not be issued. ApplicanYs Signature: -�-�!/ G`�1�--�'�''��^. Date: .5,�`�( '�� Last Updated: 03-01-2011 DAT TIME � CITY OF ORONO CALLED IN � I/ INSPECTION OTIC/E, ` SCHEDULED �� PERMIT NQ� �l'�/ �J COMPLETED ADDRESS � '�o D ��G� cs�ZYC.L �� !�� OWNER ,,� ,�TE/LEP NEN0.��3-a��a`� CONTRACTOR _ ��/ `�`� �; DESCRIPTION � � ❑ 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O >. � O � '' � W � Q � Z W � W � � W��WORK SATISFACTORY:PROCEED �OJECT COMPLETE WO�RRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� Owner/Contractor on site: Inspector.__A,� ".Jr� � White Copyllnspector's File Canary CopylSite Notice