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Home My WebLink About2010-01068 - roofing �r CITY OF ORONO PERMIT NO.: 20�0-0�068 t 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 1 U0112010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2140 SIXTH AVE N PIN : 27-118-23-31-0026 LEGAL DESC : PHILLIPS WOODLAND TERRACE 3RD ADDN ' : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 20,000.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 339.25 GARRY D. OLSON COMPANY,INC. STATE SURCHARGE(VALUATION) 10.00 5701 KENTUCKY AVE N CRYSTAL,MN 55428- TOTAL 349.25 (763)535-2484 PAID WITH CC# 4616 Minnesota State License#: 20633479 - OWNER PHILLIPS,PAUL&MARY PO BOX 755 LONG LAKE,MN 55356-0755 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. Alf 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 co ormance ' e State Building Code.This permit may be revoked a y ' e for e c �� v � � ' ant e e Signature Date Issued By nature SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A O . i� . City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O�,�,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: �, Street Address: Received by: �,�r �titi 2750 Kelley Parkway Plan review fee: .�.�o�,� 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 retumed. (P/ease print) GENERAL INFORMATION: Job Site Address: Z14b Cbu,�, �Q.aad (P Will this be a Parade of Homes, Remod lers Showcase Home or other Display Home? Yes � No /f yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wi//be required unless applicant demonstrates sutficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: GA122`I D • OLSoN �omP�a �`! State License# 2Olp�?� ') Expiration Date: 3 31 �12�. Phone: -.535- y o�ce '1 t�3- l0 0 -51 O 1 cell Mailing Address: 0� n� e. N Ci : (' STR�- ZIP: S�4 Z Contact Person: I}Q� DLSo Applicant is: ontractor / Homeowner (ClrcleOne) Emailand/orFax: Fr-►x : �(c - 3S-b`�Z �N►a�� •, �c' U-�� ol50�,�o .CaM PROPERTY OWNER INFORMATION: Name: Phone(day): Address: City: 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 ❑SiSJing ❑Restoration ❑Other:(specify) Phone: 952-471-0590 / Fax: 952-471-0682 v[�Re-roof ❑Fire Damage www.minnehahacreek.ora Overall Project Description: Estimated Construction Valuation of Project(excluding land) $Z.D}600• D'C� 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 altemative 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 ref I the information the a lication ma not be issued. ApplicanYs Signature: - Date: %� Z�l /D Last Updated: 05-04-2009 � �DATFj_ � D TIME � CITY OF ORONO CALLED IN � j �� ,, INSPECTIO��1C�/D�� SCHEDULED �� PERMIT NO. � COMPLETED ADDRESS a��D �� OWNER TELEPHONE N0.�6 3 S3 S ZS�� CONTRACTOR ��Q�� °� D l��'' � >; DESCRIPTION ` �� J � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � Z W � W � � a , W `'R,WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED � INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: - ' Inspector. �L/ �� White Copyllnspector's File Canary CopylSite Notice ✓' �/ D T TIME CITY OF ORONO CALLED IN INSPECTION OTICE SCHEOULED / - �/D �J PERMIT NO. �� COMPLEfED ADDRESS a�yo �y�G��l �C�� OWNER TELEPHONE NO.��-� 3�� -�lD/ CONTRACTOR ( �2�1 ��nJ � DESCRIPTION � � � 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � � W ❑WORKSATISFACTORY:PROCEED � PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR 1MLL RETURN ❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor site: Inspector. �,�,l/`/ !. White Copyllnspector's File Canary CopylSlte Notice