HomeMy WebLinkAbout2012 - 01144 - roofing CITY OF ORONO I 1111101101111111111111111111111111111111
' 2750 KELLEY PARKWAY * DAT1 2 - 0 1 > 4 4
DATE ISSUED: 11/09/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1930 WEST FARM RD
PIN : 27-118-23-43-0021
LEGAL DESC : THE FARM AT LONG LAKE
: LOT 022 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 13,750.00
NOTE: VALUATION OF PERMIT:$13750.00 TEAR OFF CEDAR AND REPLACE WITH ASPHALT SHINGLES
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 250.75
CUSTOM CREATIONS REMODELING STATE SURCHARGE(VALUATION) 6.88
1321 ANDOVER BLVD NE
SUITE 112 TOTAL 257.63
ANDOVER,MN 55304-
(763)441-5907
Minnesota State License#:20586285
OWNER
LYONS, MICHAEL&DEBRA
1930 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 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. �,p
l / (7W 9 //2
Applicant Permitee Signature Date Issued to.e Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
4 Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
/ a\ Mailing Address: c
Permit nurriber: 020I..1--b/r! C
l
PO Box 66 /
(� ON Crystal Bay, MN 55323-0066 Date received:, I L --9-1 /
a : ,—/' a� Street Address: Received by:.
\� it el o~ 2750 Kelley Parkway Plansreviewfee:
�EgH04� Orono, MN 55356
Total Fee: ) 6„..5..
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 7
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: 1 el 3 O Wf
C- -- av c / 1-6 f,. ? L4, lGe /1-44-( S-S 35
Will this be a Parade of Homes, Remodelers Showcase Home or otheh 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: I'�vs-/- C-v&'.- J•-i S �.wca�C �'vt., �h C
State License # &C Se 0.6 B Expiration Date: ?.,/^s/ / aD Pi
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: "")(a/_ L/L/1— 5 I o --) (office) -26 - 2 2J - 371- '1, (cell)
Mailing Address: 132 j /Q-waL.Jc_ g j„tel AIL !/L City: Ain odr,c.x._ ZIP: 5-s3 0
Contact Person: Ry a (A-1--s GL, Applicant is: cniitraCT5D / Homeowner (circle One)
Email and/or Fax: r4 cc-v- p,,t,L'rn e • U S
PROPERTY OWNER INFORMATION:
Name: De,to ¢ 041ee.. Lyvh.5
Phone(day): (p SI- S3--)- 3(/Q S
Address: is q 3 0 lc./c-;-F- 7----1 -..-z R-64. J City: t,,-71 L.4 ke ZIP: ,5r3 S 4
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
Minnehaha Creek Watershed District(MCWD)
yt Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
1=1 Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
Phone: 952-471-0590
❑ Re-roof, other(specify) E Siding ❑ Other: (specify). Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Overall Project Description: el-it,....- Oc C iota— Stw & 4 i`,,.t iz j(
ccsoG�z 1 f S 1,.:.5,lCl
Estimated Construction Valuation of Project (excluding land) $ 13, 7--D
APPLICANT ACKNOWLEDGEMENT:
e 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 b law. If ou : . - . 1.. e infor tion,the ao lication ma not be issued. /
Applicant's Signature: �--� _ Date: i! 1
q 2
Last Updated: 08-09-2011
TeAA—
/ DATE TIME
CITY OF ORONO CALLED IN � ` — —)2�
INSPECTION OTIC'E1SCHEDULED / 1—//Z
PERMIT NO. T COMPLETEDP2'e (/
ADDRESS 3 6
OWNER - T EPHONE O. ,
CONTRACTOR /WS /'Y
DESCRIPTION
W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADI /FILL G
❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOR: ETLAN'.
y
❑ FRAMING ❑ MECHANICAL FINAL 0 TREE REMOVAL
• 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP LI PROGRESS
• 0 FINAL ❑ SEWER HOOK-UP 0 COMPLAINT
0 DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP
0 DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL
0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
cc
W
cc
0
cc
O
W
W
CC
Q
W
W
CC
7• ,14VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C ❑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:�� �U S
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
ATE
CITY OF ORONO61-11/ CALLED IN l(�z'� TIME
INSPECTION ICE SCHEDULED 1(-2-- --47---
PERMIT NO. o1 "�//! *COMPLETED
ADDRESS 19,d /L2 *} ,1fr/ /e4-/
OWNER e(./t
0_1,_EPH NE N0 7 3- 7 -)ZCONTRACTOR S7`eYYI
DESCRIPTION 2-(- frtAL d--efl
IQ D FOOTING ❑ PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS
y 0 FRAMING 0 MECHANICAL FINAL
0 TREE REMOVAL
Z
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
v 0 DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP
LU ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
v ❑ PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
<---- OWNER/CONTRACTOR TO MEET YOU:_YES_NO
a COMMENTS:
cc
W
Q..
cc
0
a
cc
0
LiW
CC
Q
W
Z
W
CC
LU ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CZI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. El 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:
6;Inspector.
1
S
White Copyllnspector's File Canary CopylSite Notice