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Home My WebLink About2010-00903 - roofing CITY OF ORONO PERMIT NO.: 2010-00903 � ,.� 2750 KELLEY PARKWAY ., ORONO,MN 55356- DATE ISSUEn: 09/27/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 4220 SIXTH AVE N PIN � : 31-118-23-12-0015 LEGAL DESC : WINTERS PLENTYWOOD : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 3,800.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 103.25 VERDE RESTORATIONS STATE SURCHARGE(VALUATION) 5.00 553 S. ROBERT ST ST. PAUL,MN 55155- MISC FEE 0.00 (651)290-2222 TOTAL 108.25 OWNER HANNING,ROBERT&JULIE 4220 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 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 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 aze reques d in conformance w' Building Code.This pe it may be oke at any tim or du cause. ' � 9� �7� io Applic t Permitee Signature te Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. C i ty of O ro n o ��-� � . � �� Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: a��0-dG 9� Og,�,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: 9 d U ��,��. ,� �'�'' �4�:i �, Street Address: Received by: '�',�, 2 'e^ Gti�' 2750 Kelley Parkway Plan review fee: t.ykESHog� 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 returned. (Please print) GENERAL INFORMATION: Job Site Address: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPL ANT INFORM ION: � � Name: `� � � �` �1. `2aa � G� 0 State License# a � � p Expiration Date: 3! % Phone: — a. office O � `�`�..� cell Mailing Address: 5 S. - � Cit : S � �c.� ZIP: � / � Contact Pers � J m s Applicant is: Contractor / Homeowner (Circle One) Email and/ Fax: �' S( �� U '— O U S�.S� PROPERTY OWNER IN ORMATI�N: /� � Name: �l41v�vu Gt-r� ,, �v Vj-�',� Phone (day): T / Address: � � a ay �t � City: �S ,Q o/Lo ZIP: s� �� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8�permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 e-roof ❑ Fire Damage www.minnehahacreek.orp Overall Project Description: Estimated Construction Valuation of Project(excPuding land) $ � APPLICANT ACKNOWLEDGEMENT: �— `( ,� • Agrees to provide all information required o equest y the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowle�ge. 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 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 r fuse to su I the information, the a lication ma not be issued. ApplicanYs Signature: Date: � � ` � . � Last Updated: 05-04-2009