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Home My WebLink About2010 - 00820 - roofing s CITY OF ORONO PERMIT NO.: 2010-00820 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 09/10/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1849 WEST FARM RD PIN : 27-118-23-43-0026 LEGAL DESC : N/A : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 34,000.00 APPLICANT PERMIT FEE SCHEDULE 509.75 TIMBERLINE EXTERIORS, INC. STATE SURCHARGE(VALUATION) 17.00 7026E FISH LAKE ROAD MAPLE GROVE,MN 55311- MISC FEE 0.00 (651)329-6916 TOTAL 526.75 Minnesota State License#:20633887 OWNER CERNY,JOSEPH&INGER 1849 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 respo ible for assuring all required inspections are requested in confo nce iih the State BGilding Code.This permit may be revoked at an- M for cause. / / ' 7 . ///() / /6 %... / / Appli P rm a Signa ur Date Issued By SI ature SE ARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O�,ok. PO Box 66 Crystal Bay, MN 55323-0066 Date received: 40' - Received by: A vitw'lt Street Address: 1.t4 .Ai 41 Gtiti 2750 Kelley Parkway Plan review fee: �� 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: /Y1/9 /OM Il,� V�� . Will this be a Parade of Homes, Remodelers howcase 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: wC.1/J6Z rce .E /,C..i4 o v State License# ,;26(s) 3 3 828-7 Expiration Date: 5/3 / l/L Phone: /- 35 3- 5 L/ (office) (cell) Mailing Address: D,9 E . -, _ Zc Cit : - / ypv'ZIP: "---r----- Contact Person: /---e517/pi , /� 67/ 7�„L.,4,-7 Applicant is: Contracts' / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: . -�y'/7 /N " v i Phone (day): ; — 9 — aG Address: 4-l-/'7 j 'Li-- q I_7 Dckd City: ();%/'t-C) ZIP: 55 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 Re Fax: 952-471-0682 roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: pae_..4,- U t r-_e_4-66 7 Estimated Construction Valuation of Project excl ing land) $ � , e)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 the information, t application may not be issued. Applicant's Signature: 717, i Date: ��) Sy,' 1 ,>e/lj Last Updated: 05-04-2009 DATE TIME CITY OF ORONO CALLED IN /� INSPECTIONNOTICE SCHEDULED '7 `/D 4)1� PERMIT NO.0/D/O- 6ep opo COMPLETED "� ADDRESS /& H �,� FGA�'�►t lCd OWNER TELEPHONE NO. CONTRACTOR �fnber/l n e DESCRIPTION W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING ❑ POURED WALL ❑ MECHANICAL RI CI LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL El TREE REMOVAL ❑ 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 ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: W j cc 0 us cc z cc GW ❑WORK SATISFACTORY:PROCEED I OJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN CISTOP 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. Lt./ i .2 S White Copyllnspector's File Canary Copy/Site Notice