HomeMy WebLinkAbout2008-00286 - roofing r CITY OF ORONO PERMIT 1v0.: 2008-oo2s6
2750 KELLEY PARKWAY
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ORONO, MN 55356- DATE ISSUED: 10/15/2008
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1700 SHORELINE DR
PIN : 10-117-23-14-0014
LEGAL DESC : UNPLAT'TED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 44,749.00
NOTE: TEAR OFF AND REROOF CARETAKER HOUSE#2,LARGE GARAGE AND GUESTHOUSE. MISCELLANEOUS REPAIRS ON
MAIN HOUSE.
APPLICANT pERMIT FEE SCHEDULE 628.00
LES JONES ROOFING INC. STATE SURCHARGE(VALUATION) 22.37
941 W 80TH STREET
BLOOMINGTON, MN 55420- MAIL-IN FEE 1.50
(612)881-2241 TOTAL 651.87
Minnesota State License#:6560
OWNER
ETAL,IRWIN JACOBS
1700 SHORELINE DR
WAYZATA,MN 55391
AGREEMENT AND SWORN STATEMEIVT
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 conswction 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 conformance wit#�the State Building Code.This permit may be
revoked at any time fQr due cause.
�%�-c'/ (�'L— / / / /
Applicant Permitee Signature Date Issued By Si ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE.
From:LES JONES ROOFING 952 881 7009 10/09/2008 12;11 #514 P.0021003
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Total Fee: � ��� �/ Date Rece,ived: /O v o
Entered By: Perwit#: /��''- DD oZ B'.h
CITY OF ORONO-BUII.,DING PERMIT APPLICATION
All informatiom m�st be submftted in fuU before pl�n review wi�be aterted.
(please psint all�nformatitton)
THE APPLICANT IS: (ctrcle ourt) OWNER OR NTRACTO
JOB SITE ADDRES$: � G C» -��v�-O�) ��� . ZIP: .5�3 GI I
Will thit be a P e of Homay Remodeler�Sbow�case Home or otLer Display Home?
❑YeS Ijyea,a special evuit patintt�s r�ud ed wlth Police Deparbnantand C3ty Comcil approval
60 daysprior tolhe ev� Shtdt[e bus servica wtll ba t�eqsrfiodunlats appltc�att denwrrstraAGt
sr�'tetent on-sita park/ng!s availabla Non�ftted eva�ts will not be allowed. �
NAML OF OWNER: �✓'c`�i n- ���a b s PHOIVE: (home) GTS�- � 70-�'�eZ�
MAILINGADDRESS: 17'�c �'ta�r��.0�y CI1'Y: ��o�'-v C�Z1P: �53�7/
CONTRACTOR �..�5��+-P-����-i� �,�.� - PHONE: Q'S,� -�87-��-��
CONTACT PERSON: MOB � AGER:
MAILINGADDItESS: CITY: a�. ; S'� �
STATE LICENSE: # (��-l�o EI�'IItATION DATE: 3-3�f -d 9
ARCAITECT/ENGINEER ��_ PHONE•
MAILING ADDRESS: CIT'Y: ZIP:
NA1N�: REGLSTRATION: #
TYPE OF WORK: New Home Additian Accessory Sh�uct�u�e
Move Home R�modeUAlterarion(ie: Siding,Windows)
Any earth moveme may require MCWD reviaw and permite!
PROPOSED WORK cribe�n de�ru'n. � � e-�-r�,r-
2 G�r'
�9�(.:-5� �"�c�;�-� � s� _
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOM3: GARAGE STALL3: ATTACSED DETACHED
ESTIIVIATED CONSTRUCTION VALUATION(ezcluding land): S �I''�-�� ~I� �'-�O
I hereby spply for a bu�ding permit and I ac�caowledges that the informatian above is complebe and accurate;
tbat the work will be in conform,ance with ti�e ordinancee and codes of the City•and with the State Building
Code;that I understand this is not a permit and work is not to start without a permit;aad that the work will be
ia accordanca with the approved plan.
APPLICANT'S SIGNATURE: ATE: I� - q—d �
31
m:LES JONES ROOFING 952 881 7009 10/09/2008 12:11 #514 P.003/003
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6ea13.04 AIGH1'S OF SUBJ�CTS OF DATA
Sabd.1.Typo of dete. The rigbb oPin�vidael oa�vbom ffie dale is e�ored ot to be dored aheri be e�aet foa�in this wotion.
8ubd2.Iafa�nuimieq�uiedtobei��indlviduaL Aniodivi�alaflrodtoeapplypeiva0oarcamfidamtialdaa�aocam�6imtelf�hallbe
int'artnoed ot(s)the p�upo�e andinEaoded aae o�tl�e requesled da?a within the oo�actia6��6'�Y.Politied�abdivi�iao,ar st�wide�YsEsn�;(b)
p�v���oam�8a�a.��i-,lm�d(��i�� or������.,�����Led�l���ve`m`e��zbi.�m`�ply
not app�wLem�m mdividaal is esked to supplY imve�i�ve dats.Piaw�t to�ecda�I3.82,subdividoa S.to a law�offic�. �
'Ibe coom�ioeer of tevmm mav nlece the nodce rmotted under this aubdivi�QR jp the L+����a+��a�p�y�y t��t��
iast�actl�s ioewd of m thon foxme.
Subd.3.Aooees to detabyiodivi�i.11Paa�qu�tm at�tPo�ibba�ha�hY�eaiadividual�II I»iofomm�dwh�tl�isb abj�aR of
aaed d�o�iodivlda�L.end wLefLarit u clu�ified ae pnbHG P�vate�cooBAmtid.Upaa hit fartharreque�t,an iadivldael who i�4u�abjeot a�
sfared psivab«ppbUo dsb m individueL shaU be�Dmvn tho dde wiffiout e�y o6�e W Lim md.if be deaita.ahs�be iafo�ed offfie oontent ead
mamio�ofthse d�h.At�ot an iadivtdwl ha bem�howa the privste dus and i�!'aamed ofih a�oin�,ffie dafa ueed naR be disotoxd t0 him fac si:
mmths�unleas a diipute a�aceimporwame to 9�seodon u paodm�or�ddtdoml daa an tbe iadiri�el hi�u bam cblleatad ac ctested.The
�P°O���4��P►�►���P�����P����bY the individml w�ject ofthe dda.Ths�epoo�ibls wffiodty
mq'iequiro the reqaestio�Pecwn to psy tl�e aotoel ca4 ofaukiog,cattifyio�.�nd ca�mp�iog d�e copia.
The�'��h�00��5'�r.ifro,.+b1e.wi��w��cm�p�w�e w+hi..nbdivitiam,or.vitlnns.ro aQy.of
aba��me��.��.s����r�.�'����.�c�b.��c�►�r.�.m�
whhia�t tima he�tlaiofamma�udividwl.aodmryh.ve m addtflomlavs day�wtffiiawhichtoaamp�+wiOtLereq�wt,aacoludina S�hv�ds�
Smdayr ond fegal holidaye.
Subd.4.Pe�oadu»wlwudwi�aot�oa�naaroomplea�.Aaindividualm�yoamrtacmeaooma�yaeamplKmeesof�bBaaepdvatedata
oonoemimghiordL Toa�aevieeffiis.rl8pt.anindividndeballaotiiyinwtiting�ezerpawibbaumoritydaaeibios6uaapuea�tbsdite�to�nt Tbe
tayoaa�ble authail.Y ihW withip 30 dsy�aitl►ec: (a)ooaoot ffia de�a found t�ba io�cauate or iacampie0e and atte�qrt to aotllY P���
ia�wr.a or 9uoo�a�alete d�Er,�olp�ns roo�imt+m�odbr�e mdivifiw:«N)amifYmo i�ivlaoel thabebexevesmo aat.to be oo�med.n�siu
dirpuoe�6�IL be msdasad aoly if�e iadividmPs ststa�ant of die�oemaot is iacluded w�ith ffie di�c�aad dsts
The aeD�mti�of die ra�pmabk wthazity mq ba sppe�led poawant to the provlaoa.o��e edmini.h�liv�e prooeaiae.ac�to
oaateWed anas.
DATA PRIVACY ADVISORY
In accordeace with M.S.13.04�3ubd,2,"Rights of Qubjcct�of deta",we would liloe bo info�n yon that yo�r raquest
for a permit or licease�+o�the City of Oromo or aay of ita depattmemts msy require you to fiunish cerlain p�ivate or
con8denubel infornostion.
You ara notified eha� : _
1. The iafaama�ioa you fiunieh will,be vaed to determine your q�alification�o�the peamit ot licenae
recNoated.
2. You may refiiee to supply dsta.but refusal may require that the City da�qy the penait or licenee.
3. The information may bo sbared with other local, stata or fedeisl sgwciae fo the ext�t aaxsa�y bo
pz�oces9 the pezmitd�licaoae.
4. If your reqnested pesmit or license requines Council action to app�mve�some infor�mntion may become
public.
S. You have certaia rl�hts under M.3. 13.04(available upon iequest)to review pzivate data on yqurselE
6. Yoar fiill naa�e is required to proces�ti�is applicarion or pe�it.
Ftrst Middk Lut
Addrea
Cl�y 8t�te Z�p Pho�e
I anderstand my riehb ar atated above.
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