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Home My WebLink About2009-00775 - roofing CITY OF ORONO PERMIT NO.: 2009-00775 2750 KELLEY P�RKWAY ORONO, MN 55356- DATE IssuEn: 1UO2/2009 (952) 249-4600 FAX: (952) 249-4616 AllDRESS : 2189 SHADYWOOD RD PIN : 17-117-23-43-0137 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 008 BLOCK 002 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOF[NG -ASPHALT ACTNITY : O/S BUILD[NG-UNDEFINED VALUATION : $ 3,200.00 APPLICANT PERMIT FEE SCHEDULE 103.25 INCLINE ENTERPRISES INC STATE SURCHARGE(VALUATION) 1.60 26175 BIRCH BLUFF RD TOTAL 104.85 SHOREWOOD, MN 55331 (612)471-9065 Minnesota State License#: 20168831 OWNER LARSON,THOMAS 2189 SHADYWOOD RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvais,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 specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days o he date of issuance,or if construction is suspended for a iod of 18 d ys at any time atter work has commenced. The applicant i sponsibl f assuring required inspections are requ ted in c ormance i the Sta[ ilding de.This permit may be revo ed at a time for ause. i f�-- Z _ /��; �� -- � � `� � C��'� `- r �`-� i i ' nt rmrtee Sig t Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �^,�^ �-� s �+ r s s � �, ;t � #' � � ��,�'t� �, .. x . ��t p��,�� City of Orono f�A �� X �" t� � � Building Permit Application for Internal Work ,� (windows, doors, siding, re-roof, etc.) T Mailing Address: � 4v�,� PO Box 66 Permit number: Q , Q Crystal Bay, MN 55323-0066 Date received: �'� 1 '��3,�, : � ��'�? �-.��, a � Street Address: Received by: ; �'� °� ��' 2750 Kelley Parkway Plan review fee: � t`�kEsxo4`'� 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: �) .� p�,,� � �C� � � Will this be a Parade of Homes, Remodelers Sho case Home or other Display Home? ❑ Yes � No •• !f yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service w 1 be � required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. ;�° CONTRACTOR/APPLICANT INFORMATION: y Name: �irl,c��.�_ �'�?Q�`�'Z�.Q-�3 �-�L ,�: State License# o d 3 � Z f �� Expiration Date: / Phone: _ - office - )- `f 7 7 cell `-� , Mailing Address: ,.� )v Cit : .� p ZIP: �� ` Contact Person: � ) Applicant is: Contractor / Homeowner (Circle One) � _ Email and/or Fax: y� --�7d--/?�� PROPERTY OWNER INFORMATION:� � � � Name: J �� p� �' �:. Phone (day): - � Address: Cit : ZIP� '�� Email and/or Fax :� `< r��N PROJECT INFORMATION: �'$ �� Type of Project: Any earth movement may require �'� j A� MCWD review& permits =� ❑ Door(s) ❑ Remodel ❑Water Damage � .� Minnehaha Creek Watershed District(MCWD) � ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ' Deephaven, MN 55391 � �; ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 �� Re-roof Fax: 952-471-0682 � ❑ Fire Damage www.minnehahacreek.orq , �� ' verall Project Description: y� Estimated Construction Valuation of Project(excluding land) $ ��d - ;�� =:,� APPLICANT ACKNOWLEDGEMENT: �_ • Agrees to provide all information required or requested by the Building Department; �`, 3 • 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 alternative ' 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 ge erally cannot be given to the public but can be given to the subject of the �' �� data. Confidential data is information which ge rally cannot be given to either the public or the subject of the data. Our � purpose and intended use of this inf rmation is annually up e our records and records of other governmental agencies re uired b law. If ou refuse to su I the infor tion, the a � tion ma n be issued. ApplicanYs Signature: Date: �/�� <;'. -� � M1.. � Last Updated: 05-04-2009 4 � V f� � ,•r: _ � . S¢ a __3t_,.._ t' _ � ,.�.�..:..�,�_, .� � . C� � DATE TIME �/ CITY OF ORONO � CALLED IN l I—Z'�9 INSPECTION N4�IC/�E'�'�(1 j SCHEDULED 1 I—Z.—[Y�' � PERMIT NO. o`�v ' COMPLETED ADDRESS � � OWNER CONTR.� TELEPHONE NO. lJ �� y `�j�S l •' ��j`7�� DESCRIPTION ��-�-�'�—� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL � SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YE�NO _ � � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � a�\'WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W �C6f�RECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. _% .�� White Copyllnspector's File Canary CopylSite Notice