HomeMy WebLinkAbout2011 - 01097 - roofing CITY OF ORONO PERMIT NO.: 2011-01097
2750 KELLEY PARKWAY
ORONO, MN 55356— DATE ISSUED: 09/21/2011
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 85 WEAR LA N
PIN : 33-118-23-34-0005
LEGAL DESC : ROLLING MEADOWS 2ND ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 22,766.97
NOTE: VALUATION OF PERMIT:$22,766.97
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 383.50
SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 11.38
12366 RIVER RIDGE ROAD
BURNSVILLE,MN 55337- MAIL-IN FEE 2.00
(612)861-7000 TOTAL 396.88
Minnesota State License#:20593656 PAID WITH CC# 1521
OWNER
SIEVERT,MICHEAL&GAYLE
85 WEAR LA N
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 c(use.
v'�6
Applicant Permitee Signature Date Issued By S mature / Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED At E.
SEP-21-2011 10:06 From: 6785736615 To:9522494616 Page: 1'1
City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: ')D7 - 6 /09 7
0�Q V0 Cr Box 66
Crystal Bay, MN 55323-0066 Date received: 9'Li —lO
139.5
NE Street Address: Received by:
kOte
O 4' 2750 Kelley Parkway Plan review fee:
t- 1�'1,.� a Orono, MN 55356
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Total Fee: 31a�7• k 4. 2°-'pi''mu-I`43
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: 85 WQp.� L.Q.N�
Job Site Address; l7
Will this be a Parade of Homes, Remodelers Showcase Home or other Display 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/APPLICANT INFORMATION:
Name: St �ytiS�JV`c..�W v1
State License# Z '� (o S Co Expiration Date: 01/11.
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: ¢A,\ A00 (office) (cell)
Mailing Address: X1.3(.10VAsw t i\yc#• City: 2 rASYAk. ZIP; �S'33"�
3,4,„,VContact Person: 3,4, a r�,IL ) Applicant is: ontracto / Homeowner (Circle One)
Email and/or Fax: ,,t,Aa skyr.a.0% c - r a h . Low.
PROPERTY OWNER INFORMATION:
Name: 1a!`CS eSvorV
Phone (day): (\SZ. IkTh t{1Ct�
Address: Wggr 1.a City: Qro ZIP: S$' 3 SL
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ElRemodel ❑ Fire Damage MCWD review& permits;
Minnehaha Creek Watershed District(MCWD)
R'rie-roof,asphalt ❑ Repair ❑v'gtorm Damage 18202 Minnetonka Blvd
❑ Re-roof, cedar ,Restoration ❑Water Damage Deephaven, MN 55391
E
Phone; 952-471-0590
0 Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682
0 Window(s) www.minnehahacreek.org
Overall Project Description: TP.asf'—t 4i4 '. ca..- CA'''
Estimated Construction Valuation of Project(excluding land) $ Wo ,q-'1
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 we 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 wihich 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 inf mation,the application may not be issued.
t /C1 . Y \ ' — fl..e.., Cr I7 1 I I 1
DATE TIME \./
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED o7-11v-I? 3 077
PERMIT NO. 0749' O/0 97 COMPLETED
ADDRESS 8-45-- 2 - >
OWNER TELEPHONE NO. 95c? .D/S
CONTRACTOR 5£-P9)1 (-0-x4
z DESCRIPTION pyLra / O1
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
" ❑ FRAMING 0 MECHANICAL FINAL
TREE❑ REMOVAL
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v 0 DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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CC
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cc
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EWORKSATISFACTORY:PROCEED -uy2ROJECTCOMPLETE
CC
W ElCORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CI CITATION ISSUED
El STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: , i,
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
CALLED TIME J
D
CITY OF ORONO CALLED IN /027 I
INSPECTION NOTICE SCHEDULED /61-18—1/
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PERMIT NO. Dol/-D/D 9 7 COMPLETED
ADDRESS CSS (-eleG—C
OWNER TELEPHONE NO. &/a t / 70-Ce)
CONTRACTOR .51-�yv�
DESCRIPTION I ea41 or F
L., ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
H ❑ FRAMING ❑ 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. 0 FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL
• OWN ERICONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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f70 rAA.ft 1/1/449 t C
fro .5. 46d
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Lu WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP 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: (c--i /�Inspector. ' /1.S
White Copy/Inspector's File Canary Copy/Site Notice