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Home My WebLink About2010 - 00650 - roofing CITY OF ORONO PERMIT NO.: 2010-00650 2750 KELLEY PARKWAY ` ORONO,MN 55356- DATE ISSUED: 08/02/2010 952 249-4600 FAX: 952 249-4616 ADDRESS 2845 WEAR CIR PIN 33-118-23-34-0009 LEGAL DESC ROLLING MEADOWS 2ND ADDN LOT 003 BLOCK 002 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 11,100.00 APPLICANT PERMIT FEE SCHEDULE 221.25 AMERICAN BUILDING CONTRACTORS STATE SURCHARGE(VALUATION) 5.55 2960 JUDICIAL RD#100 BURNSVILLE,MN 55337 MISC FEE 0.00 (952)707-6959 TOTAL 226.80 Minnesota State License#:20169383 OWNER JOHNSON,SUSAN&KLEIN 2845 WEAR CIR 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 revoked at any time for due cause. Applicant Permitee Signature Date Issued Bygnatur Date 2 �V SEPARATE PERMITS REQUIRED FOR HER TI-IAVESWJ13ED ABOVE. ( 3z3� City of Orono Building Permit Application Mailing Address: Permit number: 0,j�O Cr Box 66 Crystal Bay, MN 55323-0066 Date received: a, Street Address: Received by: 2750 Kelley Parkway Plan review fee: r9$E$H0¢�+G Orono, MN 55356 Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.ma 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: (,/S I/Vca-r C ^Y'� Job Site Address: l Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes allo /f 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/APPL{CANT INFORMATIO : Name: /4n)f,r ,-CU acc M g= C;,n$mC-&df3 State License# p Expiration Date: ! - It - Phone: (office) cell Mailing Address: 6 Dud I cc ot C City: rtr,-5V r rG ZIP: Contact Person: Applicant is: Contractor / Homeowner (circle one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: S tnS �n S Phone(day): — Q30-0600 Address: `!5 [Aver. C,Y, City: O'k n ZIP: S5 337 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 Deephaven, MN 55391 ®Siding 8 Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Re-roof ❑Fire Damage www.minnehahacreek.oro Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ I , 100 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 the information,the application may not be issued. Applicant's Signature: Date: TD –10 /D TIME CITY OF ORONO CALLED IN INSPECTION OTICE SCHEDULED PERMIT NOyCOMPLETED ADDRESS Cf�S Gt, A.A_ U.0i OWNER -TELEPHONE NO. CONTRACTOR a DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ❑ 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 Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a cc J O a cc O W W cc Q 2 W z W cc tAj Dm IVORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN 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 onsite, Inspector. .,I White Copy/Inspector's File Canary Copy/Site Notice "tel ' T � TIME CITY OF ORONO CALLED IN INSPECTION N TICE ��p�SCHEDULED PERMIT NO. /O—�1''�COMPLETED ADDRESS OWNER TELEP O. CONTRACTOR 3Z DESCRIPTION tW ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL O F1 TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ElFINAL ElSEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W Q. O O cc O W W Q 2 W W cc O Cl Ljj ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE 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: Inspector. I 6 White CopylInspector's File Canary Copy/Site Notice