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Home My WebLink About2010-01036 - roofing CITY OF ORONO PERMIT NO.: 2010-01036 ' � � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 10/20/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3405 SIXTH AVE N PIN : 29-118-23-43-0010 LEGAL DESC : CRADDOCK LEDSTROM ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT � ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: TEAR OFF REROOF-ASPHALT APPLICANT pERMIT FEE SCHEDULE 162.25 SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 5.00 12366 RIVER RIDGE ROAD BURNSVILLE,MN 55337- TOTAL 167.25 (612)861-7000 PAID WITH CC# 5206 Minnesota State License#:20593656 OWNER SAWYER,THOMAS&NANCY 3405 SIXTH AVE N LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry 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 rype 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 caus . . �`7LtG�K�d /�i �i �� ,c� �d, ,�j�, `p Applicant Permitee Signature Date Issue By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. /33�- s�u� � . ` � ' City of Orono 6uilding Permit Application for Internai Work (windows� doors, siding, re-roof, etc.) �----`,:-, �a;r,�qdaa�ss: �'��T�� PO Box 86 Pe�+�t number, d D - D/D 0� Crystal 6ay,MN 55323-0066 Date reoeived: ' y. {.,� Q ,`� r • iF" � S`/tlW�W��. �IVI�T.fYed�. 1� 0 275tl Keiley Parkway Plen rovlew fee: �`��o'� Orono,MN 55356 � Main: 952-249-4600 Fax: 852-249-4616 .ci.orona.mn.us Totsl Foe: � ( (0 1� � This application form must be campleted in full and ail required infomtation must be submilted_ Incomplete appllcatlons wi11 be returned. (Pleese p��r) GENERAL INFORMATION: Job Site Address: Q/ Will this be a Parade of Homes, Remodelers Sho se Home or other Display Home? Yes No KY'�s�a BPeda/a►rent pen»�is reqaired wlN,PoNae ber,ertmer�r end Ciry Cound�approva160 deYB P�ro the avent Shu(He bus aeivlce will be requl/�d unles8 appJkarlf demonetrstes suNident on-sPoa perking i8 avaN9b/e. Non- Pen►►itfed e�ne►Ke wlNnot be aUowed. CONTRACTOR/APPLICANT IN ORMATIQN: Name; n SEate Licensa# Phone: Expiratlon Date: Mailing qddress: � °ff �II Contact Person: c� � 21P_ Email end/or Fax: APP��nt is: n / Homeowner �ctrde o,,.� PROPERTY OWNER INFORAAA I Name: ' � Phone(day): Address: Ci : �Q s Email and/or�ax ZIP: PROJECT INFORMATION: 7ype of ProJoct; Any earth movement may require ��OpKs� ❑Remodel MCWD revlaw 8 parntlts ❑Water Damage ❑�ndow(s) ❑Repair ❑Storm Damage M�"^�aha Creek Watershed Dlslrict(MCWp) 18202 Mlnnetonka Blvd ❑Siding ❑Restoretlon ❑O��(�� eePhaven,MN 55391 Re{oOf , Pho11e:952-2a71-0662 ❑Flre Damage , wWw, innehah�c ek.or Overall Pro ect Descrt tion: -�� Estimated Construction Valuatlon of P� t excluding land) : �.. oO b. APPLICANT ACKNOWL�DG�MENT: • �es to provide all ir�formaqon requlred o��quested by the Bu(Iding Oepartment; • Cerpfles that the intamation supplied Is bue and oonr�t��t ot hismer kriowledgs. The ePplicent recognizes Wat lhey are solely re�onsible fa s�bmimng a oomplete applicaqon being awaro that upon failuro to do so, 1he stgff haa no alt�,eG� but to�Jed il until it Is complete; � Some or all of the Informafion dlet you are aeked to pp Y coMidandel_ Prlvate data is �nforma6on wh;q� ��e °� � a lication Is dassified b State law as either private ur data. Conflderdial dsta is IMortnation which generelly cannot De gw n�to e�ither the� publlc�or tl�e s bj ct of Ihe dala�tOur P��po�e end intended use of this Infom�adon Is 10 annuslly update our necads and ,mooMs of other govemmental agencies uired lew. If ou�eluse�su I the InMrtnadon Ihe a icaUon not ba Issued. Applicant's Slgnature: � Date: �� t.��upda�ed: 05-04-2ooa ' I �` DAT TIME ✓ CI OF ORONO CALLED IN / • �b INSPECTION NOTICE / SCHEDULED -�� PERMIT NO.�o/O-�/0.3X� COMPLETED ADDRESS�„ 05 ��Ti1[.1`'�t- OWNER T PHONE N `�g�'1��'� CONTRACTOR ' � DESCRIPTION �-�`' � ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOON=UP � ❑ COMPLAINT J ❑ 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 v�, COMMENTS: � W a � J - O � � � W �/'�� Q � 2 , ,r- W � W � � W ❑WORKSAT{SFACTORY:PROCEED �ROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�IERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-46�0 Owner/Contractor on site• Inspector. � �---� � � White Copyllnspector's File Canary CopylSite Notice /�/RAT,E� TIME ✓ CITY OF ORONO CALLED IN ��(J INSPECTION OTICE /�, SCHEDULED v PERMIT NO. — 03+� COMRLETED ADDRESS � S � OWNER � PHON NO. ' CONTRACTOR � >: DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EX /G DING/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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W k � � �fORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT �CORRECTUNSAFECONOITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR 1MLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector. � d � � i,l��,�,5 White Copyllnspector's File Canary CopylSite Notice