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Home My WebLink About2011-00568 - roofing CITY OF ORONO PERMIT NO.: 2011-00568 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 07/05/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3245 WATERTOWN RD PIN : 05-117-23-11-0001 LEGAL DESC : AUDITOR'S SUBD.NO.203 : LOT 002 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,480.91 NOTE: TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 132.75 SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 2.74 12366 RIVER RIDGE ROAD BURNSVILLE,MN 55337- MAIL-IN FEE 2.00 (612)861-7000 TOTAL 137.49 Minnesota State License#:20593656 PAID WITH CC# 1521 OWNER RHAME,CARL 3245 WATERTOWN RD 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 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 are requested in conformance with the State Building Code.This permit may be revoke at any time for du cause. 71 ,5111 Applicant Permitee Signature Date IssueAy Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. JUN-30-2011' 13: 18 From: To: 19522494616 Pa9e:2,2 City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) .�O� MaibPO Boxr66 Permit number. O 0 Crystal Bay,MN 55323-0066 Dale received: / Street Address: Received by 2750 Kelley Parkway Plan rev' ee: �' Orono,MN 55356 To I Fee.. �, Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono,TD u This application form must be completed in full and all required information mus . Incomplete applications will be returned. (Please print) GENERAL INFORMATION: �� Job Site Address: Will this be a Parade of homes, Remode ers Shawcase Home or other Display Home? Yes b4 No N yes',a special event permit is required with Police Department and Cit'Council approval 80 days prior to the event. Shuttle buss ice wX Do required unless applicant demonstrates sufclent on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 17IA49AI State License# [ 7,3 P Expiration Date: Lead Certificatlon Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: Itp 4 . �/• 71M (office) (cell) Mailing Address: City. yw ZIP: Contact Person: �L/G � Applicant is: ntract / Homeowner lcimia one) Email and/or Fax: �� iyy, yli�h, e4ol-I PROPERTY OWNER INFORMATION: Name: 19-1V11t�if� Phone(day): -&41- 240• 62a Address: JX-,5 ' �j -,-y/ City. 14U/L/7) ZIP: � Oe Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑Door(s) ❑Remodel ❑Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑Repair Q Storm Damage 18202 Minnetonka Blvd Siding ❑Restoration ❑Other. (specify) Deephaven, MN 55391 Phone: 952-471-0590 Re-roof 0 Fire Damage Fax: 952-471-0682 www.minnehahacreek.cm Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ 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; • 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 th 'nformatio is to annually update our records and records of other governmental agencies required by law. It you refuse 6 suP6, th nformay9n,ffiR application may not be Issued. � Applicant's Signature: �,21Date: JUN-30-2011 13:18 From: To:19522494616 Pa9e:1-12 S- IMON CONSTRUCTION -ft D� d,� From I= • �l ' TrY��y Pages; Phone • O'er 7 ' `�Yliyy Data � D Urgent 0 For Review C3 Please Continent O Please Reply O Please RoWcle e Comments: , r Jam/ ��=�e ��S G��7�,�Y✓�l/' � SIMON CONSTRUCTION 146 61ze61.7000 office 612A73A6151ax wwwSlmonConstmcftn.com MN General Contractor 0 20583656 r 00 City of Orono �'t�E8Ko4�p 2750 Kelley Parkway P.O. Box 66 Crystal Bay, MN 55323 (952) 249-4600 Fax: (952) 249-4616 FAX TRANSMISSION COVER SHEET Da 7// Date: //Z ., - To: 1 Fax: (6,52� al� - 5-) Re: Pfi-MA � Sender: ( A C Cl y YOU SHOULD RECEIVE PAGE(S), INCLUDING THIS COVER SHEET. IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CALL (952) 249-4600. Confirmation Report — Memory Send Time Jul-01-2011 08:46am Tel line : +9522494616 Name CITY OF ORONO Job number 075 Date Jul-01 08:45am To 6125736615 Document pages 002 Start time Jul-01 08:45am End time Jul-01 08:46am Pages sent 002 Status OK Job number 075 *** SEND SUCCESSFUL *** oma-o�o Ci t-y of Oy-c�n o 3750 Kallay Pcrrkway P.O. Box 66 CrysYol Bay, Af2V 55323 (952) 249-4600 Faac: (932) 249-4616 PAX TRANSMISSION COVER SfIEET Dara: -7l1 To: S-2 --3 Ra: Srrsdar: 4Q N_C c__:ea—a— YO U SXO UZD RECEIVE U^L, PA GE(S), INCL UDIIVG THIS COVER SHEET IF YO U DO NOT RECEIVE.4LL THE Pel GES, PLEASE CALL 49.52) 249-4600. Iti1-f— -A M D E TIME CITY 711RI/Iyl\' CALLED IN / INSPECTION NOTICE L,��SCHEDULED I PERMIT NO. C�-00556&MP--LEET�T,ErrD,, ADDRESS al `t�J� �Qta-,� OWNER TELEPHONE INO1 - F(al-70O-0 CONTRACTOR vim - �' y�L�-IL wI ✓ . > DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti ❑ FRAMING ❑ MECHANICAL FINAL Q El 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 ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W Q. cc O cc O U_ W cc Q 1 Z W z W cc Z) O LuORKSATISFACTORY-PROCEED 11PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copy/Inspector's File Canary Copy/Site Notice DA�r TIME CITY OF ORONO CALLED IN / ' INSPECTION AJOTI��E vSCHEDULED -� -� PERMIT NO.6e o!!' DU 7&O COMPLETED ADDRESS —tj, ll Al- OWNER TELEPHONE NO. �Z -Rol CONTRACTOR L5_10z An DESCRIPTION FM�ZJ 407L ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO v0, COMMENTS: cc W 0. J O cc O 0. W ac Q Z W Z W d W ❑WORK SATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Ci BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: AI Inspector. White CopylInspector's File Canary Copy/Site Notice