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Home My WebLink About2012-01113 - roofing CITY OF ORONO * 2 0 1 2 - 0 1 1 1 3 * 2750 KELLEY PARKWAY DATE ISSUED: 1UOU2012 '� � ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 1700 SHORELINE DR PIN : 10-117-23-14-0014 LEGAL DESC : UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : M1NOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-RUBBER ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 10,000.00 NOTE: VALUATION OF PERMIT:$10,000.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 191.75 BROWN ROOFING INC. STATE SURCHARGE(VALUATION) 5.00 4003 MORNINGSIDE ROAD TOTAL 196.75 EDINA,MN 55424- (952)848-0367 PAID WITH CC# 5527 Minnesota State License#: RR634083 OWNER ETAL,IRWIN JACOBS 1700 SHORELINE DR 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 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requeste ' confo ce with the State Building Code.This permit may be revok at y tim due cause. �1 � � � Z' / /?� / Z Applicant ermitee ignature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ' �;�:. , � ra. �t�� -�� g€�� ,��c� ��- �a�� f �er�Q�� `��.�. '` - ��i�a��, �ic►ar�, si�ir�g, ��-rac�f, �cc.} �� Mailing Aadress: Permit number: p��a- G�� %' '-�-y�v�.�- PO Box oo � /� �.,j �\ Crystal Bay, MN 55323-0066 Cate rrecei�ed: �f`�/-�� , ��, � ��-� s, � Street Address: �� Received by.:�� \\'�� , µ"�� 2750 Keliey Parkway Planrreview fe �;' �`��.ri�H�� Orono, MN 55356 � To�al Fee: / ' Main: 952-249-4000 Fax: 952-249-4010 www.ci.orono.mn.us / ��{� �� This appficaiior rorm must be completeo in rull and all required information must be submitted. incompiete appficaiions wil! be returned. (Please print) ��t�=E2A� INFORM�,TIO�: Job Site Address: I 7�`�� o�i,�� , k' Will ti�is be a Parade of Homes, Remodeiers Snowcase Home or other f�isp6ay Eiome? �I Yss ❑ P�o 1f yes, a special event permit is required with Pofice Depanmen�and Crty Council approva!6G cays prior to fne even'.. Snuttie bus service wi!!be required unless applicant aemonstrates sufricient on-site par!<ing is availabie. Nor-Qermrtred events will not be aliowed. t �. - CON�RACTOR!APPLICANT INrOP.MATI �:� Name: �� 7�.,��, i " S;ate License # �xpiration Qate: ' �j �"; y Lead Certification Number: � A ��' ,`' -- - xpi�ation Qat,,: .�� ` (ror work on homes ffrat were constructed prior io 1 S78 — „ M Phone: (ofiice) � Z QS � (c�ll) <� Maiiing Address: � , City: ' ZIP: � � ' Con,act Person: Apoiicant is: � l '� � �... �ow� Contra..tor ' / Homeowner (Cirde One) s,� � cmail and/or Fa>;: K ;�;< ,: � f,, �, PROP�RTY OWN�R INrORMA�I�t�: ; �'� Name: � 9�✓�. C� �; G`� Phone(day): . Address: � � < j� (�. Cify: (�/11 ZfP� �' �,; �mail and/or Fax �,; �-; � r PRC3J��T INr-�RMlaTl01�: ; " Type of Project: � Any eartn movement rr�ay require I ❑ Door(s) ❑ Remodel � o i MCWD review&permits: ` ❑ Fire �amag., � j Ninnehaha Creek Ub'atersned District(MCW D) '` � ❑ Re-roof, asphalt ❑ Repair i ❑ Storm Damaqe I 15202 �inneionl:a Bivd `� � � ❑ Restoration � Deephaven, MN 55391 � Re-roof, ceaar � � ❑VVater Gamage Phone: 952-471-Q590 �, Re-ro f, other(specify) ❑ Siding i ❑ Other: (specify) Far 952-47�-Do82 �� ❑Window(s) i www.minnehahacreek.orq � �.�� Ove�all Froject Descripfiors: �siirnatecE CoRstruciion �'afuaiion os ?roiect (�xciucfing ;and) � I�� ' A?PLI��AP�T �CE�NOVIlL�a:z�IVl��i i: �, � Aqrees to provid� ali inrorma'tion required or requested by tne Buifding Depariment; 'k : � �'. • Certir'ies tnat the iniormafion supp(ied is true and correct to tne besf of his/ner knowiedge. Tne applicant recognizes trat they '� ��; are solely responsible for submitfing a complete appiicafion being av„�aro that upon �ailure to do so, tne siaff has no alternafive � but io rejec't it until it is complete; �, • Some or all of the informafion that you are asked to provide on tnis appiication is ciassified b� S;ate iaw 2s eitner privat� or j ; confiaeniial. Private data is inTormation wnicn generali}� cannot be given to the pubiic but can be given to the subiect of the � � S;: I da"ta. Confideniial da;a is information which qeneraliy cannot b� giver to eitner tne public or the subiecf of tne cata. Our j �',` I purpose and iniended use of this inrormaiion is te annually update our records and records of otner govemmen;al agencies I � ' reauired b�� law. If vou reruse to the infor arion.the anafication mav not be issued. `t '-z= Applican`.'s Siqraiure: Daie: � l _ �ast Updated: D�-OS-2011 /9,AT TIME � CITY OF ORONO � CALLED IN II'Zv �Z INSPECTION NOTICE SCHEDULED `/-Z/-/Z� /.�_�Q PERMIT NO. �Ol D/�� COMPLETED� ADDRESS �7D b ��l�ld/�,l�,(�t� OWNER ��' LEPHONE NO.��✓� -�d 5-�� CONTRACTOR � �� ; DESCRIPTION � � � ❑ FOOTING ❑ PLUM G AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS � ❑ 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUM ❑ SEPTI FINAL ❑ FOUNDATION/REMOVAL � OWNE RACTORT ETYOU�YES_NO � � COMMENTS �l�4 O / �C�C/�/ W —� � e � � O � �,1'� -f < c,�l 0 � W � Q � Z W g W � � a W� ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-4600 � Owner/Contractor on sites Inspector._�a ll,''"�7��5'°� White Copyllnspector's File Canary CopylSite Notice