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Home My WebLink About2013-00924 - roofing CITY OF ORONO II 1 I III III II II 0111 1 11 II . * 2 0 1 3 - 0 0 9 2 4 2750 KELLEY PARKWAY DATE ISSUED: 09/09/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4765 WATERTOWN RD PIN : 31-118-23-22-0002 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 : $ 14,950.00 NOTE: VALUATION OF PERMIT:$14950.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 265.50 HOLMBERG CONSTRUCTION&ROOFING STATE SURCHARGE(VALUATION) 7.48 3275 ADAIR AVE NE BUFFALO, MN 55313- TOTAL 272.98 Minnesota State License#: 20217161 OWNER SCHULTZ&JENNIFER TVRDY,MICHAEL 4765 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 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 are requested in conformance with the St.te Building Code.This permit may be revo.r. at any time for e ause. i�/ 9 / / O►-� �, 9, 9• �3 ppltc Per tee Signature Date Issue./iy Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �OA1 Mailing Address: Permit number: 40/ Cry r Box 66 Crystal Bay, MN 55323-0066 Date received: y Street Address: Received by: / l4/(-(5 yF`� 2750 Kelley Parkway Plan review fe . Orono, MN 55356 � Total Fee: 7 - 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: S ��1 � 12�� (/,a e /Q�//'I/ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Ho ? ❑ Yes SIN° 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: o/ %rte K517-7z /-1J0' State License# Expiration Date: • Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) —7 2j_ 7 / 2 (office) 263— Mailing Address: X275-� ..,11v-e- ?, f City: /5„,77.76.1/4 ZIP:. ---57?/3 Contact Person: G,,y /o%, j./1 Applicant is:�t:ZSTttractaD I Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: e"/ U//� Phone (day): — Address: 971 /., �� ,- �,� City:%4 /;/, : Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: 2/Re-roof,asphalt 111 Repair 1:17 Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding IEOther: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ /4;9c0 9 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 you refuse to supply th-i formation, _ - applicatio• may not be issued. Applicant's Signature: r!%/`L Date: 9� Owner's Signature: Date: Last Updated: 03/06/2013 ATE 2 TIME 1 CITY OF ORONO CALLED IN —✓ INSPECTION NOTI/ E �p SCHEDULED - - i► PERMIT NO.cl 'GlJ%1� ED ADDRESS 7�5OOMPL %'� OWNER /�%� EPHO NO. -7D/-724/ CONTRACTOR ' • DESCRIPTIONett , • ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL LI MECHANICAL RI ❑ LAKESHORE/WETLANDS " ❑ FRAMING 0 MECHANICAL FINAL LI TREE REMOVAL • 0 INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q 0 RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT 0 FOLLOW-UP 0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO c.)• COMMENTS: CC CC 0 W CC Q W CC IQ0 WORK SATISFACTORY:PROCEED er4PRoiiigCT COMPLETE El CORRECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY O El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN El CITATION ISSUED ElSTOP ORDER POSTED.CALL INSPECTOR 0 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