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Home My WebLink About2011-00500 - roofing f w CITY OF ORONO PERMIT NO.: 20��-oosoo 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/2U2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4320 SIXTH AVE N PIN : 31-118-23-12-0009 LEGAL DESC : SHARON HILLS : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 9,000.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 177.00 NEW EXTERIORS BY SMA INC STATE SURCHARGE(VALUATION) 4.50 10701 93RD AVE N,SUITE E MAPLE GROVE,MN 55311- MAIL-IN FEE 2.00 (763)315-8900 TOTAL 183.50 Minnesota State License#:20593875 PAID WITH CC# 6533 OWNER DETERMAN,MR.&MRS. 4320 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 are requested in conformance with the State Building Code.This permit may be revoked at any time for due ause. f�� eZ/� // � � o2J � /l Ap ' ant Permitee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW EXTERIORS, INC Fax:763-315-8908 Jun 21 2011 12:OOpm P001/001 . + City of Orono Building Permit Application for Int�rnal Work (windows, doors, siding, re-roof, etc.) Meiling Add►gss:, Permit rnunber. Og,O�O PO BoX 66 � Crystal Bay,MN 55323-0068 Date�ceived: •S � a� �, I St►�et Address: Received ny: � ` �d�' 2750 Kelley Parkway Plan revi6w fee: Orono,MN 55356 /� Total Fse: �f/ /83� � . Main: 952-249�600 Fax 952-249�616 www.ci.ororto,mn.4�s /� This applicativn form must be completed in full and all required information must be submitted. Incomplete applicatiens will be retumed. (Please print) GENERAL INFORMATION• .3� � �� Job Site Address: �-/6 �11 this be a Parade of Homes, Remodelers Showcase Home or other�isplay Home? Yes o � !!ye�a special ever#perm�is reqWr�d w�th Palice peparbnent and Cdy Counal approwel 60 days prio�ro bhe event ShuMe bus servlae wiq be rsquned unless spplics/K demo,u�es suA�iclent or►�lts parki�is evar7able. Nw►�elmfl�ed events w�71 not be aAowed. CONTRAC70R/APPUCA�I FORMATIO : Name_ � ' j ,� S,NC. � SYate License# 02 '3� � Expiration Date: Z Lead Certification Number. E�iration Date: (�or work oa homes that were eo doi to 1978 Phone: - — � (office) (cell) Maittng Address: � � � ; � ciry: � g z�p: SS36 � Contad Pe�son_ � � qpplicant is: o rac o � / Homeovmer (Clrcle One) Email and/or Fax; 'j(o - ^_ �8 PROPERTY OWNER INFORMATIQN� . Name: D �qµ Phone(day); 3- _ �� Address: �h _ City: • �� ZIP: . S�S.3S �o Email andlor Fax PROJECT INFORMATION: Ty�of ProjeM: Any ealth movement may require ❑Doo�(s) ❑ Remodel ❑Water Damage �C��`��' Minnehaha Creek WaterShed Distrid(MCVYQ) ❑wndow(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd ❑3iding ❑ Restoration ❑Othe� (specc:ify) Deephaven,MN 5b391 Phone: 962-471�0590 Re-roof ❑ Fire Oamage Fax 952�71-0682 www.m i n n eh ah acre e k.o ra Overall Pro"ect D�scription: Estlmatad Construction Valuation f Pro'ect(exc udin land $ APPLICANT ACKNOWLEDC3EMENT: • Agrees tp provide all iMortnation required or raquested by the Building Departnterit; • Certifies that the information supplied is true and correet to the best of his/her knowledge. The applicaM recognizes tttat they are solely r�sponsible for submitting a complete appliCation being aware tltat upon failure to do so,the staFF has no altemative but tp rejecx it until it is complere; • Some or all of the infoRnation that you are asked to provide on this application is classiRed by State law as either ptlV�te or confideMial. Private data is informadon whieh generdlly cannot be glven to the public but can be given to the subjed of the dats. Confiderrtiel data is informaflon which nerally qnnot be given to either the pubfic or the subject of the da1�. Our putpose and intended use of i tio11 ' to annually update our reconds and records of othnr govemmental agencies uir�ed b law, If ou refuse s in rmation,the licaiion ma not be i�sued. Applica�Ys Signature: ' ' Date: ' � � Lsst Updated: 03-01 2011 �� DATE TIME v CITY OF ORONO CALLED W I� II'�� INSPECTION NOTICE �ce� � SCHEDULED �7- �3 ��-n,R/H�� PERMIT NO. � « COMPLETED f�— ADDRESS �f-��J �l��' � ' OWNER �� CONTR. `7Z��J �1� �"�w--� TELEPHONE NO. __ �U-3 �/S� - �Jy�dZ' � DESCRIPTION �� ❑ FOOTING MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q �FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING Ri ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o C �.�c..d �S �n� i� �-�— a � 0 � W � Q ti Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE W ❑CORRECT WORK&PROCEED G I SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. CPHOTOTAKEN INSPECTOR W4LL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIOtJ REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: inspector. � , � � i � � White Copyllnspector's File Canary CopylSite Notice