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Home My WebLink About2010-01106 - roofing ., CITY OF ORONO PERMIT NO.: 2010-01106 � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 1 U10/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 400 STUBBS BAY RD N PIN : 32-118-23-42-0001 LEGAL DESC : LJNPLATTED 32 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTNITY : O/S BUILDING-LINDEFINED VALUATION : $ 6,000.00 APPLICANT pERMIT FEE SCHEDULE 132.75 GC BUILDERS INC STATE SURCHARGE(VALUATION) 5.00 7170 UNION AVE MAYER,MN 55360- MISC FEE 0.00 (952)457-5303 TOTAL 137.75 Minnesota State License#:20626549 OWNER STUBBS,RICHARD 400 STUBBS BAY RD 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 sepazate permits. All 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 aze requested in conformance with the State Building Code.This permit may be revoked at any tim for e cause. � l l /O l a0/�} ��iY�_ l l ant Pe �ee ignature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . 1 . City of Orono w � Building Permit Application for Internal Work ;� (windows, doors, siding, re-roof, etc.) � Mailing Address: � O��,�.0 PO Box 66 Permit number: K Crystal Bay, MN 55323-0066 Date received: � � � Received by: �� ,� ��..� �, Streef Address: r' '�',�, '� A" �ti 2750 Kelley Parkway Plan review fee: " t�kESH�g'� 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: ,�,f Job Site Address: L/(� ��ib� ��-.� �'�r 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 fo the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wilf not be allowed. CONTRACTOR/APPLICANT INFORMAT ON: /�/ t' Name: �� w��e�S,�r �� ,�ii/Cl+�� z: State License# Expiration Date: �-3� ��i/ 'd Phone: �y5-�C1S�� p� (office) (cell) ;� Mailing Address: �. Cit : � ZIP: � Contact Person: �� Applicant is: ontractor / Homeowner �c��ie o�e� � Email and/or Fax: � � PROPERTY OWNE FORMATI N: � Name: � � �J � Phone (day): - ''�' Address: y� `,h,�,�, � ��r �c� City: �r�j� ZIP: �,'j`z�,� 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 b�' Deephaven, MN 55391 � ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 :;h Re-roof ❑ Fire Damage www.minnehahacreek.orq �� O rall Project Description: � Estimated Construction Valuation of Project(excluding land) $ �a,�-.�_�+�� _ ((� 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 alternative `� but to reject it until it is complete; � a • 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 '� �k re uired b law. If ou refuse to su I the information,the a lication ma not be issued. � � � ApplicanYs Signature: � Date: �pb� jQ �� ,� � ,,;: Last Updated: 05-04-2009 ' w 1 � '.: �-- DATE TIME v CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED /—�D PERMIT NO.o2�/O—Q//Olo COMPLETED �� '` ADDRESS 00 S7'�Zc-66S d � OWNER TEL HONE NO. 95 Z' �5�"530,� CONTRACTOR _ �� !•c-c-Qc�vL� � DESCRIPTION �� /'�-o'�it � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION O 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 MEEf YOU:_YES_NO y COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � d W RKSATISFACTORY:PROCEED OJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORREC}`UNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�0 Owner/Contracto Inspector. White Copyllnspector's File Canary CopylSite Notice