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Home My WebLink About2011-00215 - roofing CITY OF ORONO PERMIT NO.: 2011-00215 2750 KELLEY PARKWAY • ORONO, MN 55356- DATE ISSUED: 04/12/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4545 WATERTOWN RD PIN : 31-118-23-24-0004 LEGAL DESC : UNPLATTED 31 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 15,000.00 APPLICANT PERMIT FEE SCHEDULE 265.50 TIMBERLINE EXTERIORS, INC. STATE SURCHARGE(VALUATION) 7.50 7026E FISH LAKE ROAD MAPLE GROVE, MN 55311- TOTAL 273.00 (651)329-6916 Minnesota State License#:20633887 OWNER BROLL,MR&MRS JEFF 4545 WATERTOWN RD MAPLE PLAIN, MN 55359 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 conforma •.wi the ta- Building Code.This permit may be 'revoked at any t' - d ,Caus- ' Applic /'er i Signatu� I.te Issued By ture Date S PARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOV City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Og, 0 CrysPO tal 66 Cstal Bay, MN 55323-0066 Date received: .r by: A cII _^" ;., s, Street Address: Received ��, )(Al Gtiti 2750 Kelley Parkway Plan review fee: `�kEsso4`4,0 " 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: 2/545b(r)a....&11-71V1.(—)i'7 '( 4;,,,,,,,:., Will this be a Parade of Homes, Remoders Showcase Home or other Diay Home? ❑ Yes j2No 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/APPLICANT INFORMATION: Name: -71,vt.b.c4.4c.et,-Q, QY[GY'j Me • State License# Lo 33W''7 Expiration Date: 3 . i 1• _ Lead Certification Number: /1/4441— y y37c - ( Expiration Date: 5 - g-46 - (for work on homes that were constructed prior to 1978 Phone: (office) 4%5/` 3 - gFre/a. (cell) Mailing Address: 7tv(, F' F,5h Ll_ rd City: (i 6,,,ev,c ZIP: 5531 Contact Person: (,.15/ . 9-6,,91 e,;, Applicant is: Contra or'-) Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: 52.,04_ eYe)L-L Phone (day): � Address: •ri/54/5 In xtCY 1.U,-1 Thi City: 7--) (....,,i--6 ZIP: 5$ ' 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 grStorm Damage 18202 Minnetonka Blvd ❑ Siding /Restoration ❑ Other: (sp cify) Deephaven, MN 55391 Phone: 952-471-0590 /rRe-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.org Overall Project Description: 7, y ee,� Estimated Construction Valuation of Project(e ding land) $ i5; 6 d 6 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 pannot 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 required by law. If you refuse to supply th infor ation,t application may not be issued. / . , Applicant's Signature: C/ Od ,(,� Date: /( - ( 6// Last Updated: 03-01-2011 `?)-2.e,v\ 4/( 'ATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICESCHEDULED Affir /.44 = - PERMIT /- 190 21.5 COMPLETED ADDRESS 95 *5 iLk ll��. OWNER TELEPHONE NO. — Z -b9/.7 CONTRACTl// >; DESCRIPTION " /✓��V L W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING cr cr ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP -C ❑ DEMO-FINAL CISEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W Q. cc J 0 cc O W Q W W Elpf?y2) YORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN O STOP 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 si Inspector_ I% R White Copy/Inspector's File Canary Copy/Site Notice ei DATE TIME ( CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED i/ PERMIT NO.(:::: :)//-Z510 /-) CO/MPLETED ADDRESS x5-e-45- /Aeze -/ OWNER TELEPHON NO. CONTRACTOR // ��3� fir DESCRIPTION Lij 0 FOOTING ❑ PLUMBING FINAL E V/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP 0 COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP -C ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: W CC O CC O U- W CC W W CC ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W CC ❑CORRECT WORK&PROCEED ❑ UE CERTIFICATE OF OCCUPANCY • ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP 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: ��/ /je_S Inspector. White Copy/Inspector's File Canary Copy/Site Notice