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Home My WebLink About2011-00566 - roofing CITY OF ORONO PERMIT NO.: 2011-00566 � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEn: 07/OU2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4195 FOREST LAKE DR PIN : 07-117-23-11-0005 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 006 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCT[ON TYPE : ROOF[NG-ASPHALT ACT[VITY : O/S BUILDING- UNDEFINED VALUATION : $ 7,200.00 NOTE: IF AN ON-SITE INSPECTION IS NOT DONE WITH A 1'F;AR-OFF,MAKE SURF,TO LEAVE PICTURF,S ON-SITE IN BAG W/ ORGANCE INSPECTION CARD. SIGNS ADVERTISING WORK-CAN ONLY BE PLACED ON FRONT LAWN DURING THE"I'IME THE ROOF IS I3E[NG DONE, MUST C3E REMOVED AFTER JOB IS DONE. APPLICANT pERMIT FEE SCHEDULE 16225 JENSEN CONSTRUCTION SERVICES LLC STATE SURCHARGE(VALUATION) 3.60 2620 GRANGER LN MOUND, MN 55364- TOTAL 165.85 (952)472-7223 PAID WITH CC# 3589 Minnesota State License#: 20639601 OWNER BLOMS, GERALD&NANCY 4195 FOREST LAKE DR MOUND, MN 55364 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 responsibic tor assuring all required inspections are requested in conformance with the State Building Code.This permit may be � � �� revoked at y time for due cause. //f .^ _ , �� l-� �� Appl�cant Permitee Signature Date Issued By Signa ure DaCe SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono � E, Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �� —�-�� O4v�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: a �'�`� �+ �, StreetAddress: Received by: �'� � �� ti�' 2750 Kelley Parkway Plan review fee: t`�gESHo�`'� Orono, MN 55356 Total Fee: �� C'' � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �� = � This appfication 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: q� ` r�S � tr- Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes , o !f yes, a special event permit is required with Police Department and City Council approva160 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: �.P_11�5 �-�'� �Gtrl S-}Y'�- vU'� .�j�"�IJI�C�S State License# a(J��ct(� Q Expiration Date: 3 - 3 � —aG� 3 Lead Certification Number: Expiration Date: (for work on homes that were consfructed prior to 1978 Phone: � � � - �72 -�a-3 (office) C�_S� - o'Z ! � - Y� '2-O (cell) Mailing Address: ��',o2G �,/�o-v. t� �„� . Cit �-._ �`y� c�tih ZIP: y�, N Contact Person: � 5 sZ�S e v, Applicant is: Co�C�ctor� Homeowner (Circle One) Email andbr Fax: d �� 5 � , ��, � PROPERTY OWNER INFORMATIO : Name: �-�5��--1� '�`ati��s Phone (day): ��. ` � �� -- ��,�� Address: ��`� ��p�,et �� , City: � r"r��jC� ZIP: r� 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 ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 �Re-roof Phone: 952-471-0590 ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ �� C� O 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: � .,•- �,� .�—�---'�""" Date: ��l � ;��j � Last Updated: 03-01-2011 � "' � DATE TIME � CITY OF ORONO �'�� _QLLED IN � INSPECTION NOTICE �-y-� SCHEDULED`� --�� PERMIT NO. 21�.11 �w� COMPLETED ADDRESS � I `"I �v �[ :�� 1 . u— �7 OWNER TELEPHONE N0.9 �� 7a�� CONTRACTOR �� 7�/�� /'..-,�v� ..�--- >; DESCRIPTION � � 11� ❑ FOOTING ❑ PLUMBING FINAL CAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ 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 J ❑ PLUMBING RI ❑ SEP I FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO `- C} � COMMENTS�/ �'r ` �`� ��D 1 ��' W C � � O � � O � W � Q ti Z W � W � � � �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContr tor on sit . - Inspector.� � White Copyllnspector's File Canary CopylSite Notice � � � �� ATE TIME � CITY OF ORONO CALIED IN � INSPECTION NOTICE /� SCHEDULED � PERMIT NO. .�/�lI f��lG' COMPLETED �� ADDRESS �`7 :� T �'r�S�K- �� OWNER TELEPHONE NO. 5� � L--� � O CONTRACTOR -�°�'�!� � 1' r1 • 'y /� L^ �%�.C� . �: DESCRIPTION �--�!h[�i. �/ � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP Q ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES�O � COMMENTS: � W 0. � J O � � O � W � Q � Z w � W � � GW/�GVORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE �l ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED O INSPECTIOIV RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contract Inspector. White Copyllnspector's File Canary CopylSite Notice