HomeMy WebLinkAbout2006-P10564 - re-roof PERMIT
CITY OF ORONO
2750 KellPy Parkway- PO Box 66 Permit Number: P1o564
Crystal'�ay, Minnesota 55323 Permit Type:
Minor Alterations
(952) 249-4600 Date Issued: 11/15/2006
SITE ADDRESS: 2500 Shadywood Rd Unit#
Excelsior,MN 55331
P��� 20-117-23-11-0034
DESCRIPTION:
Proposed Use: Commercial-Business
Census Code O/S-Building
Permit Class: Building
Permit Type:
Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Tear Off&Re-Roof Garage
FEE SUMMARY: Perniit Fee: $ 97�25 vatuation: $ 3,090.00
State Surcharge Fee: $ 1.55
TOTAL FEE: $ 98.80
APPLICANT: Dalbec Roofing, Inc OWNER: Freshwater Foundation
2285 Daniels Street c/o Donald Brauer
Long Lake,MN 55356 2500 Shadywood Road
Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE [SSUED BY SIGNATURE
Copies: l-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
11/1512666 08: 46 0000000800 !11111111111111 PAGE 62/63
Auo-06-2003 11:21am From-CITY OF ORONO +852Z494616 T-93� P.002/003 F-3DA
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Tetal Fee: Petmi,t#: _,_. _�_�.�.1�:���' I
En�red 8y:
CITY 41� OR.ONO - BUIL�IING PER1V�'� �P`P'�ICA�'x`�ON
All inFarnaation rn�t be submitt�d tn ftill befvx ridn�review w�11 be starte�.
- (please p�ant ali �nforma ) _ . __ __w
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T�APPLIGAN'T gS: (circie a�te} • dWNE�t OR. ONTRACTOR
Jos sI7�JE ADDRESs: �C� �uuo �o Z�: S�`3�l _
1�1�1.N.� OF OWNER: _ FP-�s 1�r,Ji9' �Q������._ PHONE: (hoz�e)
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N1AIC,TNGADDFSSS: _�,SD� sHAn W�� —(�. CI"Y'Y: Exr�,�.r�vi ZIP: s, s,�� _
� PHONEs �Sa-��'��L.—
CQN'1'RAC�'OR.: '_ Q MOBTY.ElPAG�R: - � - 5 3
CdN'�A.CT PTRSON: � C7'TY: �=��-�
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STA'TE LI�CEN9E: �'�.o'���?� ,
ARCHITECTfENGriV�ER: PHON�:
CYTX: ZIl':,_�
MAILIl�IG�DRESS: �iEGISTRA'I'ION# '
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Addition ACcessOxy StruCiurc
�yp� oF WORT�: New �.nd Alteratioa.,,
Move Remodel/Alteiation�� / �,
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PRO�'OSED WORK(describe in demi�: S �
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STORYES: � SQ.F�T aF EACT3 FLU(JR: D�T. �� "
NO. OF BEDRa(��ViS: G��RAG� STAL�S: A►'I'r• _ �
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ESTY�TED C4NSTR7JCTIdN VA�.UATIQN(a�duaing laad}: S„—�jQ —
�bereby apply for a buildiag permit and'� a�ao�wledge that the infermadon abovc is c:flmplete and
accuxs�te;that�che work will,l�e in conforman�e wi�tb,e o�����s aot w stt�st Qri�o t a
t he�tate B u i l d i n g C o d e; s�a t�u n d�r s t a n d t t u s�s p
pernut; and that thc wark will be in accordance with the appraved plan.
A,ppLICANT'S SIG�NATUitE:
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�O�f dr � �S evenss reQuire sep�ate,permit approvai by Police De�rar�tment and
� GY�j, Coun.,�iI dd days p�or to dhe event. Non permitted events wild not be alloweti.
11/15/2606 08:46 0600990066 !11111111111111 PAGE 03f03
Aua-OB-2003 � 11��1a� From-CITY OF ORONO ; +95x24A4616 T-987 P.008/008 F-304 �
Sea.i3.�4 RZGI�S OF S[iSJ�CT�OF DAT�1 '
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ed W be�►ea tndl�idu�l. .Vt ladividual�0D�Ph'�7s0s oe aoaEdeaoal 6ala co�ema+6 b���a11
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(b�whss�eee ho euY Rtuse ar fs taSslb RW�ee suPP�y'a°ee4�eswd daa;(�)�, ��oc tede:al isw m receive ehe d�'���°meo�strelt
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of�o1od prlvam or pablie dao►on iadi�idls�ahalt be sbm+m�e da�w�a��m��d ot is�R�•�a daia weN aoC 6C dt�elo�d w hi�fos
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dKm[ter us+�� slse Indi+ridast subJece et dte data. The sr�Oos�'ble eud+oe�CY
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�be da�e nE d►e+equeu.�� �,idu�l.and may ha+►e an.ddldonal frva�dqys w�fa whioh�aaaplY
Wi�1n d14c dmt�he 6halt so 611aatn dte ovd
sund4yx�nd f�t twGaars.
a Aa i�ditidu�l mq wpose�t BOWfaeY or eompletalae�af publiC vr pritiam
Sybd.�. PtoaadurQ�hea datA is noe aewrrts or�P� � ���ry daaee�ib6�he n.wde of�he die�p�
dem cooaenfiel�bi�mNf. Ta exa'eisa d�dgbr.aa iHdividusl abW noofy in w�� � ���aed4r psu�cipiea�s oi
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DATA�RN�Y����
�3,04 Subd.3.'R�Bbc�of subj�ccs pf d�ta",+++e wculd lil�to iaform yau that your rtq,nes�
In a,�coxdaaae wi�M_S. • of� dzp�rtmea�s maY =equire you to futalsh certaiu pcxvate or
#or s permit o�t licease frou►r1�e Ciry ot Oranv or any
� coafldendal iafozma�i�o�.
You ut aotif'�ed diaz:
l. Tkza iafarmatfan Y�fu�nnnish will be used to decsrau�e Your 4�1�eatioa fot the Qermit ar lioeuse roques�ed.
tefuse w suPP�Y � buc refusal may �o'quire that tbe Ciry deny t�ue Pe�miK ar llaase�
2. You maY rA the tiaeat Aeces9arY to Process
3. The infiortt�uioa maY be shased wtth o�local�$ca�e ar ttdccal s�e�iee
the permit or lfeea�e. � becomc
�. ��Y�n�ed permit or licease tb4ut�es Couu� acc�on w apptov�e� so�ae inforr�a�ion waY
pwbiic. u�,der M,9. 13.04 (av e upon request} to revi�w private d�t�oa You�self.
5. You havt ce�taia righ�s .
6. Yo�r f1t11 asme is required to process chis�ppl an ar pezmic-
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From: �i �v� �Ll�YID� .,..
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Original to fo0ow by mail: Yes_____ No�_
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2285 Danisls Street — LonB Leke,MN 55356� � Phone:8 -4i3-8080 � Fax:952-4Ta-08a5
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