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Home My WebLink About2010-00996 - roofing � � CITY OF ORONO PERMIT NO.: 2010-00996 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUEv: 10/14/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 765 SPRING HILL RD PIN : 36-118-23-22-0002 LEGAL DESC : iJNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,861.25 NOTE: TEAR OFF AND REROOF POLE BARN. APPLICANT pERMIT FEE SCHEDULE 147.50 GRUSSIN ROOFING, INC. STATE SURCHARGE(VALUATION) 5.00 4305 SHADY OAK RD HOPKINS,MN 55343 MAIL-IN FEE 2.00 (952)935-0557 TOTAL 154.50 Minnesota State License#: 9212 PAID WITH CC# 6799 OWNER WINSTON,FREDERICK&ELANOR 765 SPRING HILL RD WAYZATA,MN 55391- 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. 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 requested in conformance with the State Building Code.This permit may be revoked at anX time for due c se. �� ?� �D /�i / i /O Applicant Permitee Sig ure Date Issue Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 2�10�-�3 05:05 GRUSSING 9529356514 » +9522494616 P 2/3 � City of Orono � Building Pe�mit Application for Internal Work windows, doors, siding, re-roof, etc_) -_7 --- Mailir�g Addrsss; Permit number: - Q 9b �'¢r�.�Q� PO Box 66 1 Cryatal Bay, MN 55323-0066 Date received: /(7 � . �„l S(/eet Addros�.c: ReCeived by: . �% 2750 Keliey Parkway Pla��eview fee: '� ��,,� Orono,MN 55356 � - -� Totel Fee: !� / �5D Main: 952-249-4600 Fax: g52-249-4616 www.ci.orono.mn.us �6P-� This applicstion form must be completed in full and all requir�d informatian must be submltted. ! leoomplete applications wlll be retumed. (Please print) GENERAL INFORMATION• Job Sit�Address: � �0�J /y�' .�, Will this be a Parade of Homes, Rem dels Showcase Home or other Di�play Home? Yes o /fyes,a special svent pBrinJl 15/Eqf1/Ie�Wilh PpliCe DepeRmellt 2nd C/ry COunCil epprov8160 days prior fo the ewint. Shuttle bus sen•ice wi/I 60 , required unlass epplicant de►nonsMalea sufl'�cient on-site parking is eveilebla, Non permttted events wi/I nor be allowed. CONTRA`CTOR/qPPLICANT INFORMATION: Name: : S/h� � ..YI�1C. State License# Expi�ation Date: 3 31 1 � Phone; .� C 55 ? oifiee) ,,�.-3(m - �! y (cell) Mailing Address: � Ci : ZIP: Corttact Perspn: Applicant i�; C / Homeowner (Cllclo Ona) �mail and/or Fax: �,r � ri,t tsi/rJ /�v •r vj �� PROPERT�'OWNER INFORMATION: Name: � �o�.w►hs-{gy� PhonB(Cay); � L/ _ �./fl Address: : , .S Sr��-�n� l�-Lf i2,�. c�ty: 0o-�r,rZ_ _ zIP, 5.��9 Email and/or Fax PROJECT INF�RMATION: Type oi P ject: Any Qarth movatner�t may reqwrc ❑boor(�) ❑Romodel MCWD r4vigW g Pe�;�� I ❑Water DamaSle � Minnehaha Creek Wstershed aistrict(MCWD) Q vVlndovJ�(s) ❑RQpair ❑Storm Dsmage 18202 Minnetonka BIvC Dee aven.MN 55391 ❑S' ing � ❑ Restaration ❑Othe�: (speGi� Pha��iw: 95a-471-0590 � FaY: 85Z-471-0682 Re-roof� ❑ Fire Damage www.mir�pg� .or Ov¢rall P�'oject Descriptlon: . 0 ' �,�r l��C'—VdD-� P!7��f' tiyv�.. . Estimated Construction valuation of ProJect(excluding land) S �o�lo� � v�•S' APPLICA;NT ACKNOWLEDGEMENT: • AgPees to provide all information required or requested by the 8uildinp Deparlment: - Cekrtes that the information supplied is Nuc end corr�ect to the best of his/her knowledge. The appllCant recognlZes thet they ar�solely responsible for�ubmiffing a complpte applicstion beiny awurc that upon f8iluro to do so, the statt has no altemative bu to rejeG i[until it iS COmplete; • 3o e or all of the IntOrm2tfon that yoU are asked to provide on this applicat4on is dassified by State law as �ither pnvate o� co �dcntiel. Pr�vate data is information which generar�y cannat be given to the public but can be given to the subject of the d . Confidential deta is information which generdlly callnot b6 glven to either the public or the subject of the data. Ou� pu ose and int4nded use of this infom,stior� io to onnually update our recorqs antl reoorcls of other goyemmental agencies reauired by law. If au rafuse fo su I the ir�formatlon,the app�jcetion m�y flot bc i9aued. I _ I Applicant's;Signature: Date: ) � (3�� _ . , Laat UpAatetl:�05-0�2D09 " v `� � ATE TIME � CITY OF ORONO G(/K�CALLED IN � �- �� INSPECTION N TIC /�S,CHEDULED f -Z� PERMIT NO. 1�� J�OMPLETED ADDRESS OWNER TEL N4. ��7 7 CONTRACTOR �� DESCRIPTION � — � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS 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 ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W a � � • " -� L• J�� S ,� /Ll i� }.� ' .. .� a � O � W � Q � 2 W � W � � � ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY p ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours irt advance. (g52) 249-4600 Owner►Contractor on site: Inspector. � �f �� -) White Copyllnspector's File Canary CopylSite Notfce