HomeMy WebLinkAbout2014-01037 - roofing , ' II I I II 1111 II II I I 11111111 11 II
CITY OF ORONO * 20 1 4 - 0 1 037 *
2750 KELLEY PARKWAY DATE ISSUED: 09/15/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 200 WAYZATA BLVD W
PIN : 36-118-23-43-0001
LEGAL DESC : UNPLATTED 36 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 6,800.00
NOTE: VALUATION OF PERMIT:$6800.00
THIS REROOF IS FOR THE SMALL HOUSE NEXT TO THE BARN.
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 147.50
STATE SURCHARGE(VALUATION) 3.40
BERKSHIRE HOME SOLUTIONS TOTAL 150.90
1700 NIAGARA LANE N
SUITE#201 Payment(s)
PLYMOUTH,MN 55447- CREDIT CARD 8840 150.90
(763)432-9855
Minnesota State License#: BUIL-BC631273
OWNER
Wayzata Country Club
200 WAYZATA BLVD W
WAYZATA,MN 55391-
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 State Building Code.This permit may be
revoked at any time for due cause.
9
Applicant Permitee Signature Date Is e By Signature Date
To: City Orono Page 3 of 3 2014-09-11 21:32:35(GMT) From: Andy Filer
14 1
..lLy uI %A um,
Building Permit Application for Maintenance / Replacement/ Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
,..—
Mailing Address:
PO Box 66Pemtit nutttber; t d/�j ?�7
Crystal Bay,MN 55323-0066 D2ite receeivet /�j- !r/
Stroet Address: Reed by: /�2750 Kelley Parkway Plan review fee: ,GOrono,MN 55356krs HO*"
Total Fee: /5t5,0
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
m; -,pplio,,liow fe.w,mug.*b.eemplotc,J u,r..ii anu.ii ,cyubcU In(Vnnc,uVli InUSL be suomlttea
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: - 1 [ t
i Job Site Address: CLOD 4,e.�e`_y,,�ct k lv,L (.3 �5;,1i 1.�,?>�yA..�„�cv �tv `-rte G.hprv�`.
Will this be a Parade of Homes,Remodels Showcase Home or other splay Home? ❑Yes ❑No
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 I AP LICANT INFORMATION:
Name: L-5(.,... —e____. 'u+ 5
State License# J,C 6-SjJ-- Expiration Date: 3//,
Lead Certification Number: " r 5--/ Expiration Date: � //S"
(for--A—,l.v... ,d. vv.:.4 .V/.
4ofii cru pram-ry lam" / //
Phone: (cell) 6(/)- 7 y/5 3 (office) `'
Mailing Address: c.,)i ), f4er� L A....) ct,,+c;�( City: flyv.gp,...{t-,_ ZIP: 5-Sry�
Contact Person. '3 (,s Applicant is: C'"6.... rae`to j Homeowner (circle One)
Email and/or Fax: f,.4'., (R--,,t,� 1 0e-A 5,(arm
PROPERTY OWNER INFORMATION:
Name: (.° �:- ' y Clk-k..( •
Phone(day): /
Address: . a W .,-ta'l&W l...i City:U(:>cq(0 ZIP: 5 S 37(
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement mayalso
❑Door(s) MCWD review& require
0 Remodel 0 Fire Damagepermits:
peRe-roof,asphalt ❑Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD)
(❑Rye roof,cedar 0 Restoration18202 Minnetonka Blvd
El Water Damage Deephaven,MN 55391
❑Re-roof,other(specify) ❑Siding 0 Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
i /
EI Window(s) www.minnehahacreek.org
Estimated Construction Valuation of Project(excluding land) $ 6i Rr9Q�
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 i .i a . all,,'at- . - ords and records of other governmental agencies required by law. If
you refuse to suPpl the r tl s. rr.:tion ma not be issued.
401P-
Applicant's Signature: 4 i Date: , ®7
,
Owner's Signature: Date: