HomeMy WebLinkAbout2014-00884 - roofing � CITY OF ORONO * 2 0 1 4 - PJ P1 8 S 4 *
2750 KELLEY PARKWAY DATE ISSUED: 08/13/2014
l ORONO, MN 55356-
� (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3360 SHOREL]NE DR
PIN : 17-117-23-44-0101
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 005 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOF[NG-OTHER
ACTNITY : O/S BUILDING - UNDEFINED
VALUATION : $ 6,100.00
NOTI?: S�fF;EL ROOF
APPLICANT PERMIT FEE SCHEDULE 147.50
STATE SURCHARGE(VALUATION) 3.05
Navarre Service Station TOTAL I50.55
KOEHNEN, LEROY Payment(s)
3360 SHORELINE CHECK 19249 150.55
NAVARRE, MN 55392-
OWNER
Navarre Service Station
KOEHNEN, LEROY
3360 SHORELINE
NAVARRE, MN 55392-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfonned according to
the approved plans and specifications,applicable City approvals,and the
Statc Building Code. This permit is for only thc 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 specified herein.This permit will
expire and become null and void if construction authorized is not
eommenced 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 assuri all required inspections are
requested in confornia ce with the Stat� Building Code.This permit may bc
revoked at any tim or ue cause.
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Applicant Per ' ee gn ture Date Issued Bv Si ture Date
City of Orono �g2`��
Building Permit Application for Maintenance / Replacement / Renovation
• (No structural expansion. Only windows, doors, siding, re-roof, etc.)
�O�O MailingAddress: Permit number: / —D�$
PO Box 66
Crystal Bay, MN 55323-0066 Date received: �'�02--/
Street Address: Received by:
y� � 2750 Kelley Parkway �3�� Plan review fee:
� L Orono, MN 55356 /s-U. S
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Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �,�c �>s�.Q
This application form must be completed in full and all required information must be sub ed �a or�r
Incomplete applications will be returned. (Please print) � F,^.a`
GENERAL INFORMATION: .
Job Site Address: � � � i�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes o
If yes,a special event permit is required with Police Deparfinent and City Council approval 60 days prior to the event. Shuttle bus s ice will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATI N:
►vame: �-,�-(�.v�/ /�2,6/'-ryl�qL[
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) (office)
Mailing Address: City: ZIP:
Contact Person: .� /c Applicant is: Contrac or / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �
Phone (day): �- �
Address: ' Clty: ZIP: �r�
Email and/or Fax: � � '7 �
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
_����- ❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ -
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 atl 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 annuafly update our records and records of other governmental agencies required by law. If
ou refuse to su I the information,the a lication ma not be issued.
ApplicanYs Signature: Date:
Owner's Signature: Date:��l (��`T
Last Updated: 03/06/2013
DATE TIME /
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED
PERMIT NO. a���y'�QS'S� COMPLETED �3—/6-/b—
ADDRESS 336 a 8 �ia r���.� �0� �
OWNER Le✓b� �..� TELEPHONE NO.
CONTRACTOR �
� DESCRIPTION �� "�'�6{' ���� '
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAI FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v �EINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�.� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ��,OJECT COMPLETE
W ❑CARRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERINC, PERMANENT
❑CORRECTUNSAFECONDITIONWRHIN HOURS. p p�{pTOTAKEN
INSPECTOR N1{LL REfURN ❑CITATtON ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (g52 j 249-4600
OMmedContractor on site:
Inspecto�I �- �
White Capylinspecto�'s File Canary CopylSiM Notice