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Home My WebLink About2009 - 00244 - roofing CITY OF ORONO PERMIT NO.: 2009-00244 ' 2750 KELLEY PARKWAY I ORONO, MN 55356- DATE ISSUED: 05/20/2009 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 170 WEAR LA N PIN : 33-118-23-34-0015 LEGAL DESC : ROLLING MEADOWS 3RD ADDN : LOT 002 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT VALUATION : $ 9,000.00 0/5 II cl J APPLICANT PERMIT FEE SCHEDULE 177.00 INCLINE ENTERPRISES INC STATE SURCHARGE(VALUATION) 4.50 26175 BIRCH BLUFF RD SHOREWOOD,MN 55331 TOTAL 181.50 (612)471-9065 Minnesota State License#: 20168831 OWNER BERKEY, SCOTT 170 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 fo a period of 180 days at any time after work has commenced. The a.'lie,. t is responsible for assuring all required inspections are re..este.1 c.• : ance with the State Building Code.This permit may be itp woke. tim for due cause. 3726 / 09 /, • .plican ''ermite- Signature Date Issued Byj natureDate SEPARATE PERMITS REQUIRED FOR WORK OTHE' HAN DESCRIBED AB E. City of Orono Building Permit Application Mailing Address: Permit number:‘V‘, 0 Cr Box 66 Crystal Bay, MN 55323-0066 Date received: 1 Received a a Street Address: by: �-4- ,i �r `" otiti 2750 Kelley Parkway Plan review fee: ��.,'tr,�� Orono, MN 55356 kESH� • 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: , _• x I Job Site Address: W L4-)£- r- /kJ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 7 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/APPLIcAN.T INFORMATION: _ Name: -71 c-(f,1A --cryc'rcc State License# Zo/ S3 ( Expiration Date: -;_- l _Ij Phone: 45"Z 1'0%4 Ri,QOS (office) (cell) Mailing Address: ) c/>f/3,�-c( / [_/L City: wac✓ ZIP: ,T3-73 } Contact Person: Applicant is: ontractor / Homeowner (circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: 5c o 1-:- L et.? Phone (day): 'ra. -c 1- - /7/ I Address: ,54,1.,x. City: 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 Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Xf Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ .b Gl(Do b r 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 su•ply the information,the application may not be issued. Applicant's Signature: di, Date: J r ',""t A TIME CITY OF ORONO CALLED IN INSPECTION JOTJED / SCHEDULED 6.1:—/e9 19 PERMIT NO 7, COMPLETED , / ADDRESS / 70 w�a-C_ '� �v� OWNER CONTR. l C�1 � TELEPHONE NO. 1s2- �7 9 • DESCRIPTION /e. L ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS • ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: er CC O CC O ti W CC Q W W CC � AAJJ L ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY • BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR CI 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. File White Copyllnspector's Canary Copy/Site Notice