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Home My WebLink About2011-00192 - roofing s ti CITY OF ORONO PERMIT NO.: 2011-00192 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 04/01/2011 952 249-4600 FAX: 952 249-4616 ADDRESS 845 WILLOW DR S PIN 10-117-23-22-0002 LEGAL DESC UNPLATTED 10 117 23 LOT 000 BLOCK 000 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ROOFING-ASPHALT ACTIVITY O/S BUILDING-UNDEFINED VALUATION $ 2,000.00 NOTE: PARTIAL TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 73.75 TSCHIDA CONSTRUCTION STATE SURCHARGE(VALUATION) 5.00 522 6TH AVE E TOTAL 78.75 SHAKOPEE,MN 55379- (952)201-4190 PAID WITH CC# 5109 Minnesota State License#: 20637142 OWNER WILLIAMS,ROBERT&JORDANNA 845 WILLOW DR S MN 55391- 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 conform th the State Building Code.This permit may be revo Ume for cause. A- / ! / (/ Applicant Permitee Signature Dae IssBy Signature Date SEPARATE PERMITS REQUIRED FOR WORK O ER THAN DESCRIBED ABOVE. 4 City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) —_ Mailing Address: Permit number: o —Q "�V_O ' \ PO Box 66 Q � Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: � � �titi 2750 Kelley Parkway Plan review fee: 01 V Orono, MN 55356 V 9kESHo4` <_ 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ER 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 I/NF RMATION: I Name: _7_c _cy�;�cti ��5 1 ry O�'1 State License # 0 `� 71 yo2 Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: �j �/� (office) (cell) Mailing Address: S a (� 11tf_ C City: 5k1' car ZIP: p✓),� Contact Person: Applicant is: c(Zo� Homeowner (Circle one) Email and/or Fax: f Sc�i�cti C' 5� �c bit C' �;c1/�a� •cc��'YI PROPERTY OWNER,1 FORMATION: Name: iCc (�r ,�v^�- Phone (day): Address: /f"5 ��eG� ;i- City: 01-VI-10 ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review& permits: Minnehaha Creek Watershed District(MCWD) ❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd F-1 Siding El Restoration ❑ Deephaven, MN 55391Other: (specify) Phone: 952-471-0590 Re-roof v :� I ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.org Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ 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 up ate our records and records of other governmental agencies required by law. If you refuse to sup'ply t information,the apipAration may not be issued. Applicant's Signature: _ Date: Last Updated: 03-01-2011 OG SJL�- / DAT TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. COMPLETED ADDRESS �LfS [ l ) //r�(_�� Lw S OWNER TELEPHONE NO. 7;5a c_�O 0 CONTRACTOR DESCRIPTION ilia ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ElLAKESHORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL ZElINSULATION El WOOD BURNER/FIREPLACE El -1 INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL El SEWER HOOK-UP El COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:n YES NO COMMENTS: W C J O cc O U_ W QC Q Z W z W a J W ElWORK SATISFACTORY:PROCEED P4,ROJECTCOMPLETE CC k! ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: n Inspector. A White CopylInspector's File Canary Copy/Site Notice rD T TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED —Z m PERMIT NO..2o_1 I— D D I g)�_COMPLETED ADDRESS SYS W1 1162W OP& .S • L/ OWNER TELEPHONE NO. 252-2°/ V/go CONTRACTOR et& TSh/dg � I 3; DESCRIPTION /--�ea_,e ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q F1 TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO Zt co COMMENTS: W LL a 0 W cc Q 12 z W Z W -kWORK SATISFACTORY.PROCEED ❑ PROJECTCOMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR (D 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. l White CopylInspector's File Canary Copy/Site Notice