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Home My WebLink About2011-01129 - roofing � , CITY OF ORONO PERMIT NO.: 2011-01129 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 09/28/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4160 FOREST LAKE DR PIN : 07-117-23-11-0003 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOF[NG -ASPHALT ACTNITY : O/S BU[LDING-UNDEFINED VALUATION : $ 8,000.00 NOTE: VALUATION OF PERMIT: $8000.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICG, PRIOR TO WOKK BGING STARTGD) MUST PROVIDE COMPLETE SET OF PICTURES OR A PINAL INSPECTION MAY NOT[3E ISSUED. SIGNS-ADVERTISING S[GNS MAY ONLY BE ON THE PROPERTY DUR[NG THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 162.25 JENSEN CONSTRUCTION SERVICES LLC STATE SURCHARGE(VALUATION) 4.00 2620 GRANGER LN TOTAL 166.25 MOUND, MN 55364- (952)472-7223 PAID W[TH CC# 3589 Minnesota State License#: 20639601 OWNER GOLDEN, LYNN &TIMOTHY 4160 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AIVD SWORN STATEMENT I�he work for which this pennit 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 pennits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuancc,or if construction is suspended for a period o1�I 80 days at any time at[er work has commenced. The applicant is responsible for assuring all required inspections are requcsted in conformance with the State Building Code.This permit may be revoked t any time for due cause. V� � � � 2 `3�'��/ �/ Applicant Permitee Signature Date Issued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . � City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: �,�.\ PO Box 66 Permit number: / 1 , 0 �. � 1 Crystal Bay, MN 55323-0066 Date received: ' �"'- Received by: l,� `,� � ,:r�,_ �, � Street Address: �,�y �,�, d`'� �ti 2750 Kelley Parkway Plan review fee: t9'�ESH�4� Orono, MN 55356 Total Fee: �/�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �•l� 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: `� � �U �U u�� .� r" • Will this be a Parade of Homes, Remodelers Showcase 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 demonstrafes sufficienf on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: Name: �e(nSQ-�/l �u ,�15 -� - S�:'' ✓ ��..c� S � �� State License# aC�(0 3 W � Expiration Date: 3 - 3 ) - �c� ! 3 Lead Certification Number: N � Expiration Date: (for work on homes that were consfructed prior fo 1978 Phone: �I S� - a- 1��1 "J �-t� (office) (cell) Maifing Address: �� (� ✓'c.-�n • �„ _ City: � cth �( ZIP: s'';S-> G Contact Person: j2c 5 5 ,7'-�y�-� S{,� Applicant is: o or_.._.L� Homeowner (Circle One) Email and/or Fax: —�e r s �� , �e✓�� e.✓, C� /(C , � o� PROPERTY OWNER INFORMATION: Name: 'T��v�t �=�. /c� �-v� Phone (day): Cp C� _ �fSG — 3 3 y b Address: L/�� c ��',-��5-{- 1K �� r _ City: c,r c��b ZIP: ��s 3� �� 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) [�Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage , Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description: _ Estimated Construction Valuation of Project(excluding land) $ $'' QC� c� � 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 ctassified 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: �_�.- � � Date: �' ��"1� `= /� Last Updated: 08-09-2011 DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED rF�_3=�l PERMIT NO. ��-D �� COMPLETED � ADDRESS `7�(¢�Z�Y�L��`t �1 / OWNER TELEPHONE NO. g��' �-�d �7� CONTRACTOR J�11-5� �-�-� �SS >: DESCRIPTION � � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP Q _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � 2 W � W � � GW WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CO RECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner/Contractor on 'te: Inspector. L White Copyllnspector's File Canary CopylSite Notice DAT TIME V CITY OF ORONO CALLED IN l6-� INSPECTION NOTICE C� SCHEDULED 1��- 7 �/ � PERMIT NO.o��ll�'O/�� / COMPLETED ADDRESS Zl�d �Ore�f L`�- /o/� _ OWNER _ TELEPHONE NO. 95Z ZlD �l�7� CONTRACTOR E�"'� �� >; DESCRIPTION �� /`�GJ � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q � TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W 0. o -- - �--� �iJ � �S �(�J � �� 0 � W � Q ti Z W � W � � d W L'Ftld6RK SATISFACTORY:PROCEED [� PROJECT COMPLETE � ❑CORRECT WORK&PROCEED — ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CAIL FOR REfNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-46�Q OwnerlContractor on site: Inspector. Qsl.� White Copyllnspector's File Canary CopylSite Notice