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HomeMy WebLinkAbout2009 - 00228 - roofing CITY OF ORONO PERMIT NO.: 2009-00228 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 05/14/2009 (952) 249-4600 FAX: (952)249-4616 ADDRESS : 4505 WEST BRANCH RD PIN : 07-117-23-21-0014 LEGAL DESC : GARY LINDGREN ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: REROOF TEAR OFF APPLICANT PERMIT FEE SCHEDULE 162.25 STEVEN MARVIN COYLE STATE SURCHARGE(VALUATION) 4.00 12995 138TH STREET NORWOOD YOUNG AMERICA,MN 55368 TOTAL 166.25 (952)467-2612 PAID WITH CC# 6804 Minnesota State License#:20633103 OWNER LEVY,DAVID 4505 WEST BRANCH RD MOUND,MN 55364 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. i1 2 Applicant Permitee Signature /Date / i / ff/// /C/ Iss i7 By ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ` ' ` City of Orono Building Permit Application Mailing Address: Permit number: .¢,O,? PO Box 66 Q O 1 Crystal Bay, MN 55323-0066 Date received: ?4,. ' Received by: a I :;, :a'� 1 Street Address: 1. X11\'+1• 171 G47 2750 Kelley Parkway Plan review fee: V .0^N w Orono, MN 55356 lkEsfio4 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: Job Site Address: o5- \A-k41- tu-uCit Ab Q(LDUD MPJ 5-5 ,' + Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes gNo 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: ' '1 l 1`1M-'1)M COY L.t State License# '2 O(0 3-_31() 3 Expiration Date: • {Q Phone: q 52 467 417_ (office) 9'52 �k� cio (cell) Mailing Address: 2' Y. .5F Cit : No • . /J ZIP: 5366 Contact Person: *It-It> rntirui tiu7 t t' Applicant is: _ Contrac • / Homeowner (circle one) Email and/or Fax: C©yLt emn/c (? Ain. Grn C PROPERTY OWNER INFORMATION: Name: DA )D L-Ev\f Phone (day): 51 472. (95-67 Address: p 5 inl3T 612A-1,(9a1 l O City: O 20N° ZIP: Ss . 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 18 Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ net. 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. AP' Applicant's Signature: !w/ Dater aoeti DAT TIME CITY OF ORONO CALLED IN INSPECTION NOTICE ?�CHEDULED ` 4 4 PERMIT NO.p 9-dO2A000MPLET D p /U•'dc> ADDRESS /--44 OWNER CONTR. 5.1/1._ (a-1 TELEPHONE NO. " 95-R S0-() DESCRIPTION / 4, ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/'ADING/FILLING • ❑ FRAMING ❑ MECHANICAL FINAL 0 LAKESHORE/WETLANDS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION • ❑ 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 OWNERICONTRACTOR TO MEET YOU: YE NO o COMMENTS: CCW O CC O U. W CC W W CC L .KI WORK SATISFACTORY:PROCEED /PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C) 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY u BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED 0 STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractgr} sjC Inspector. �� White Copy/Inspector's File Canary Copy/Site Notice CJ ATE TIME CITY OF ORONO CALLED IN i/ /t� ti INSPECTION NOTICE SCHEDULED ((c'/ //0q' 0 PERMIT NO. oZ CCP—0022e COMPLETED ADDRESS "4/45o 5 G1 , f l j/k1 1 OWNER CONTR. TELEPHONE NO. 95g -('ffOp 2& O • DESCRIPTION Q a_442_.- oda L ❑ FOOTING ❑ MECHANICAL RI EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL 0 LAKESHORENVETLANDS y 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • 0 WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP 0 PROGRESS • ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP LU 0 PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU. YES_NO yo COMMENTS: cc CC O CC O W CC W W Ct A3NORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑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: (41 ag—C Inspector. White Copyllnspector's File Canary CopylSite Notice