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Home My WebLink About2010 - 00649 - roofing CITY OF ORONO PERMIT NO.: 2010-00649 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 08/02/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1810 WEST FARM RD PIN : 27-118-23-43-0017 LEGAL DESC : THE FARM AT LONG LAKE : LOT 018 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-CEDAR ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 40,000.00 APPLICANT PERMIT FEE SCHEDULE 574.25 TIMBERLINE EXTERIORS,INC. STATE SURCHARGE(VALUATION) 20.00 7026E FISH LAKE ROAD MAPLE GROVE,MN 55311- MISC FEE 0.00 (651)329-6916 TOTAL 594.25 Minnesota State License#: 20633887 OWNER ADAMS,TIMOTHY 1810 WEST FARM RD 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 r-sponsible for. suring all required inspections are requested in con'o : ce wi e State Building Code.This permit may be revoked at , , •m> 'or du= ..use. /,: /� / / " . O�a /v Appli`'� ••e r' ee Sig at Date Issue;:y Signature Date / SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: 0 Cr Bax 66 Q 0�, Crystal Bay, MN 55323-0066 Date received: ` Received by: vs, �I (4;., �� ; Street 50 Kelley Parkway t4 Os o / Y Plan review fee: <1_ ') :: Orono, MN 55356 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: /P)) /1J,64/ y:z/ti-?-2 iil Will this be a Parade of Homes, Remodelerhowcase 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: •7i .GL G 47I.e.y/0/"� State License# ,-,?D/o 35L ?7' Expirati•n Date: 3/3,/// Phone: Co5I- 353- ga '/.2 / (office) 'Li brbve - (cell) Mailing Address: 7Z) 6, E. F7.51-7 f Cit : : _�� ZIP: �53 y/ Contact Person: ` > A� kJ h Applicant is: antra- b / Homeowner (Circle One) Email and/or Fax: 7,(p3- -54 U,- 7E60 PROPERTY OWNER INFORMATION: Name: , of 5 Phone (day): 92 is/1'2, - */'---64 ` Address: /f'/t ( ) cLr�yl j City: ,4yrc� I .e ZIP: 5j�''5 Email and/or Fax J 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 II)Siding Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 -roof ❑ Fire Damage www.minnehahacreek.org Overall Project Description: -7,--_,2„-t, - ,L �/�� y� jp Estimated Construction Valuation of Proje t exclbiting land) $ .!/Cr e_ 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 t 'e informatio the application may not be issued. 4 Applicant's Signature: e 11' ' / Date: / /./ p-(7676 Last Updated: 05-04-2009 a D TIME CITY OF ORONO CALLED IN DA INSPECTIONO� CHEDULED PVI PERMIT NO.01 � SCOMPLETED �/ ADDRESS ? / /C� ?'Jt&' ,iyZ 'Y feed-- OWN ER All TELEPH E 0.P5i1� � CONTRACTOR /(&" C � e DESCRIPTION "e- ` 'v�d' .7e4 - • ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q• ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS CI) ❑ FRAMING ❑ MECHANICAL FINAL 0 TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP 0 COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP IQ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: cc W CC O CC O W CC W W CC LWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE (/❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ 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: Inspector. (J „16-7136.3 White Copy/Inspector's File Canary Copy/Site Notice O— DAT TIME CITY OF ORONO CALLED IN Z� INSPECTION NOTICE //C�® SCHEDULED 67-3/-4 PERMIT NO. /O �D 6/., COMPLETED ADDRESS i3' aled,Cal-471 OWNER TELEPHONE NO. 07329947 CONTRACTOR - ` 41— DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • El INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL El FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU: YES NO a COMMENTS: cc w CC 0 u. z IQ ❑WORK SATISFACTORY:PROCEED 1.->gkOJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑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 sit:: Inspector. 111 White Copy/Inspector's File Canary Copy/Site Notice