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Home My WebLink About2010-00233 - roofing � � CITY OF ORONO PERMIT NO.: 2010-00233 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 04/15/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3850 SHORELINE DR PIN : 17-117-23-33-0006 LEGAL DESC : UNPLATTED 17 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 14,000.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 250.75 NEW FINISH REMODELING STATE SURCHARGE(VALUATION) 7.00 2011 GOLDEN VALLEY ROAD TOTAL 257.75 MINNEAPOLIS,MN 55411- (763)639-4877 Minnesota State License#:20633028 OWNER HENSLEY,JAY&BARBARA 3850 SHORELINE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed acwrding 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 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 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 requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ��--� y ��S � �� /.5-/ /D AppLcant Permrtee Signature Date Issued ignature Date SEPARATE PERMITS REQUIRED FOR WORK OT R THAN DESCRIBED ABOVE. ' � * City of Orono Building Permit Appiication for Internal Work (windows, doors, siding, re-roof, etc.) �O� Mailing Addiess• PO Box 66 Pemiit number. � Q Crystal Bay,MN 55323-0066 p��N�: � Stieet Address: Received by: 2750 Kelley Paricway Plan review fee: �� Orono,MN 55356 Main: 952-249�60p Fax: 952-249-4616 www.ci.orono.mn.us Total Fee: �� "7 � This a�lication fiprtn must be c�ompleted in fuil and all requir�ed ir�formation must be submitted. Incomple�e appNcations wiil be r+etumed. (Please pri�►t) GENERAL INFORMATION• / Job Site Address: �,�� ,�,/,C !i � ��v� WII this be a Parade of Homes, Remodelers Showcase Horr�or other Display Home? Yes No 1f Y'�,a spec;ia!et�►t permit is�qulnsd w�lh PdiQe Depan�nt and City Courra/app�va!60 daYs Prtor to the event. ShuKle bus � iequired unless appl'�t darnor�t►ates suA�nt a►-site paAdng is availab/e. Non-P�mi�events will iwt be al/owed. CONTRACTOR/A ANT INFO T1QN- Name: .��- , �� State Lioense# �� /� Phone: - ��a� e: .� Mailing Address: : o�� C . �� , ZIP: � �I Contact Person: . / ��t� plicarrt is: Contra or / H eowner Email and/or Fax: �ar�.a»l PROPERTY OWNER I FORMATION: C„!�e � Name: o Phone(day): Address: a h �!/i��/� C' ; �id ZI P: Email and/or Fax PROJECT INFORMATION: Type of Project: Any�rlh movement may require ❑Door(s) ❑Remodel MCWD revisw S permiCs ❑Water Qamage ❑Window{s) �R�� Minnehaha Creelc Watershed District(MCWpj ❑Storm Damage 18202 Minnetonka Blvd ❑Siding ❑Restoration ❑Other.(speafy) �Phaven,MN 55391 Phone: 952-471-0590 Re-roof Fax: 952-471-0682 ❑Fire Damage www.minnehahacreek ora Overall P Descrlptipn: Estlmated Consbuction Valuatbn of Project(excluding land) ; APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all iniormation requined or requested by the Building DepaM�er� • Cerafies tt�at the information supplied is true and oomect to the best of hislher knov�Aedge. The applu�nt reoognizes that they ar�e solely►+esponsible for submit6ng a complete applir.ation being awane that upon(ailure to do so,the staff has no altemative but to r+ejed R urrtil it is complete; • Some or all of the informatlon that you are asked to provide on this application is dassified by State Iaw as either private or confidential. Private data is information which generalty cannot be given to U�e public but can be given to the subject of the data• ConfideMial data is infortnation which generally cannot be given to either tl�e public or�e subjed of the data. Our purpose and irrtended use of this information is to annually update our records and reoords of othe�govemmental agencies uired b law. If u refuse to su I the infortnation the a lication ma not be issued. ApPlicant's Signature: �„—b--� — D�: �ast updacea: o�-oa_2oos 7� ` DAT TIME � CITY OF ORONO CALLED IN ��<�� INSPECTION NOTICE SCHEDULED �!o'LD �Q -�"� PERMIT NO.��/O- ��33COMPLETED ADDRESS "3�`�� S��-'��'�� // OWNER TELEPHONE NO. �lZ �� `��a CONTRACTOR /�/eW ��'jLi � � DESCRIPTION /'�-��T" . '� T�Gu L��7�' � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y ❑ FRAMING O MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTtON Q ❑ RADON SLAB ❑ WATER HOOK-UP p PROGRESS � ❑ FINAL � SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING L ❑ FOUNDATION/REMOVAL � OWNER/ NTRACTOR TO MEET YOU: YES NO ti COMMENTS: � W C j O a � O � ti � Q � 2 W � W � � W /�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITNIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next ins tion 24 hours in advance. (952) 249-4600 Owner/Contractor site: Inspector. White Copyllnspector's File Canary CopylSite Notice J � � DAJ E TIME " CITY OF ORONO CALLED IN S `� INSPECTION NOTICE SCHEDULED — �� PERMIT NO.sZO/Z� -�da3.3 COMPLETED ADDRESS �R•SD �S` ' �� OWNER � TELEPHONE NO.Cr!-E ��Z-�O/- y�EO CONTRACTOR /"��5/� /��G��G'�i/cQi /e06%t >; DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O >. � O � W � Q � 2 W � W � � � ❑WORKSATkSFACTORY:PROCEED �ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED '� SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContractor on site: Inspector. / . �� S � White Copylinspector's File Canary CopylSite Notice