HomeMy WebLinkAbout2010-00799 - roofing CITY OF ORONO PERMIT NO.: 2010-00799
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/07/2010
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4705 WATERTOWN RD
PIN : 31-118-23-22-0003
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
TURCO CONSTRUCTION, INC. STATE SURCHARGE(VALUATION) 7.50
709 S FRONT STREET
SUITE#5 MAIL-IN FEE 2.00
MANKATO, MN 56001- TOTAL 275.00
(507)720-6110 PAID WITH CC# 4755
Minnesota State License#: 20287552
OWNER
STALOCH,MATTHEW&ROBIN
4705 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 conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
01,,,04,0
PO Box 66
s;,
Crystal Bay, MN 55323-0066 Date received:
\:,_,,-..., Street Address: Received by:
�{ a. ; .
���i►.1.�4� c 04. 2750 Kelley Parkway Plan review fee:
,.o,0t, 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: 4 s c�U.. v -w -1 e - .. I t- ? a }A NJ
Will this be a Parade of Homes, Remodelers Showcase Home or of er Display Home? a Yes i2,. No
If yes,a special event permit is required with Police Department and City Council approve!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 1 APPLICANT INFORMATION:
Name: '17n..rco C o r-,s+v-tAx.1-i iy-)
State License# a c) 2 1 l'i5 a, Expiration Date:
Phone: 5^I -7 C2 1 l 0 (office) (cell)
Mailing Address: I 09 S FYr wrf S4- ch.- 6 City Q A,Q ZIP: („, e..___51__),
Contact Person: I i„1AstI , S„h jgru ca 1.„.5Applicant is: C�6ntrac r / Homeowner (circle ones
Email and/or Fax: tt i --1.) Q Id I Z
PROPERTY OWNER INFORMATION: f
Name: IZobk +-, 51-01 loc.1,1
Phone (day): w 12. z e a M,2011
Address: 4-7p LeiIa-s-e,ra„t ,n 124 City: Motif. 1:21ao✓►r. ZIP:
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
.04 Deephaven,MN 55391
❑Siding 0 Restoration ❑Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
Re-roof ❑ Fire Damage www.minnehahacr,sek.aro
Overall Project Description:
Estimated Construction Valuation of Project(excluding land) $ )C 1 coo. O r i
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 this information is to annually update our records and records of other governmental agencies
required by law. If or`rretus- = -upply the information,the application may not be issued.
Al
Applicant's Signature: O'�- III' - Date: �f�� / `' t 0
Last Updated: 05-04-2009