HomeMy WebLinkAbout2010-00965 - roofing � CITY OF ORONO PERMIT NO.: 20�0-oo96s
� 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 10/07/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2240 SHADYWOOD RD
PIN : 17-117-23-42-0001
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 008 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,200.00
APPLICANT pERMIT FEE SCHEDULE 132.75
CARSTENSEN CONSTRUCTION INC STATE SURCHARGE(VALUATION) 5.00
2410 BRIDLE CREEK TR
CHANHASSEN,MN 55317- MISC FEE 0.00
(612)840-2607 TOTAL 137.75
Minnesota State License#:20165907
Pd by CG
OWNER
FREEMAN,CHRISTINE
2240 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 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 sepazate
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 I 80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State de.This permit may be
revoked at any time for
� � / /
App ic t Permitee Signature ate Issued By Si ure te
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOVE.
� City of Orono
' Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
.�,�,�. PO Box 66
O � O Crystal Bay, MN 55323-0066 Date received:
s�-a Received by:
� � �,�,�,�, �, Street Address:
,�, � Gti 2750 Kelley Parkway Plan review fee:
r�kESHO�`'� 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;✓� v S�� �� !�
Job Site Address: G� � '
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 Counci/approva/60 days prior to the event. Shuttle bus service wi/l be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: C� S"7�EtiS�E�ti ��i�S�
State License# �/L•S`qv 7 Expiration Date: � �
Phone: �/Z ��o-2�`0� (office) - (cell)
Mailing Address: 2�!/n ts'2/D�E' C:2/C-`� 72 City.0 l�4vl�,�3�'�-z ZIP: �� ���_
Contact Person: =�0:�,0 �'f12srE-�F� Applicant is: on / Homeowner (Circle One)
Email and/or Fax: fiopp c,92sTE.�s'E�@ M C�;K'.r C:c M
PROPERTY OWNER INFORMATION:
Name: l'�ri�%����= FflF_�'��9�/
Phone (day): � i Z �[�; � 7c��jq
Address: 2 2 r��p �f�•�?yc�c�c� ✓z�� City: C��c�.�-c� ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
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
Fax: 952-471-0682
Re-roof ❑ Fire Damage www.minnehahacreek.orq
Overall Project Description: �j�',gj� � fl� c�- �'�'l',9LC .�/��' �-�.i
Estimated Construction Valuation of Project(excluding land) $ ,S-kj�
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 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 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 governmental agencies
re uired b law. If ou refuse to su I the information,the a lication ma not be issued.
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ApplicanYs Signature: � Date: �G� G�
Last Updated: 05-04-2009'
� ' '� �CDATE.� TIME ✓
CITY OF ORONO CALLED IN � I
INSPECTION NOTICE SCHEDULED - �'� ��
PERMIT NO.�010-DQ�6S COMPLETED
ADDRESS
OWNER T PHONE NO. ��a ��`� aL�7
CONTRACTOR L� . C�'�
� DESCRIPTION �-
� ❑ FOOTING ❑ PLUMBING FINAL ❑ /GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP p 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
� OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.GALI INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector. n .� -i�� - __
White Copyllnspector's File Canary CopylSfte Notice
C� AT TIME ✓
CITY OF ORONO CALLED IN � ��� �� �
INSPECTION N ICE SCHEDULED � C �� _CS�;,�`�
PERMIT NO. ,�jCOMPLETED
ADDRESS
OWNER TELEPHO E O. Cp���`r�'"��� 7
CONTRACTOR } i'�I��"1,����L�YY)I- •
� DESCRIPTION `I"I/�(,� � - ��;��I
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
❑ 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
J ❑ PLUMBING RI ❑ SEPTIC FIN ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES�.NO
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W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Caii for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site: %
Inspector. � I%v
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White Copyllnspector's File Canary CopylSite Notice