HomeMy WebLinkAbout2011-00497 - roofing �, CITY OF ORONO PERMIT NO.: 20��-0049�
� 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 06/2U2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4215 FOREST LAKE DR
PIN : 07-117-23-12-0026
LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN
: LOT 004 BLOCK 003
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTIVITY : O/S BUILDING - UNDEFINED
VALUATION : $ 10,682.18
NO"I'E: "I'F,AR OFF REROOF HOUSE,GARAGG AND SHED
APPLICANT PERMIT FEE SCHEDULE 206.50
WALKER ROOFING CO., [NC. STATE SURCHARGE(VALUATION) 5.34
2274 CAPP RD
ST PAUL, MN 55114- MAIL-IN FEE 2.00
(651)251-0910 TOTAL 213.84
Minnesota State License#: 4229 PAID WITH CC# 4291
OWNER
LOUGLIN,JOHN& RUTH
4215 FOREST LAKE DR
MOUND, MN 55364
AGREEMENT AIVD SWORN STATEMENT
The work for which this permit is issucd shall be peribrmed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This pemiit is for only the work describcd 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.'�his 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[ime atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conYormance with the State Building Code.This permit may be
revoked at any time f due cause.
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Applicant Permite ignature Date Issue By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
JUN-20-2011 02 :57 PM WALKER, ROOFING 6512510916 P. 01
__.._. .a . ... ...�� �pr�r���ai�vi� ��� ����ernal WOI'K
•► (windows, doors, slding, re-roof, etc.)
4 ��•==��•— MelllnpAddr�ss:
�g�� PO 6ox 66 Permlt number; 026//- pZ� 7
� . � Cryetal Bey, MN 55323-0066 Date received:
�
� � ;°t:. �� Stre6tAddress.• Received by:
/
2750 Kelley Parkwey Plen review fee;
�+�� � Orono, MN 55356
.Main; 852-249-4900 Fax; 952-249�816 www,ci,ornno.mn 1A TotelFee; � ��� j�
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This epplication form mu�t be completed in full and aii required information m�st be ubmitted,
Incomplete eppllcatlo�a wfll be returned. (P/ease print)
GENERAL INFORMATION:
Job Site Addreas; 2 I � ' T
WIII thia be a Parade of Harries, Remodvlers 8howcase Wome o�other Dlsplay ome7 Yes o
N ya*, e speclel swnf pemrlt la roquirod w/fh Pollce Department end Clty Councll epproval QO days pnar to the event. Shuttle bus servlce wUl be
requlred unle8s eppl'icanf demonstretes suAYclent on-sl�e perkinp is evallable, Non-pemrittod eVenta wlll nof be ellowed.
CONTRACTOR!APPL�CANT INFORMATION;
Name: � � �y,
State Licenae# �,�'�f� Expir�tion Date: /2
Lead Certificatlon Number: .- — - �V Expir�tion Date�
(for work on homas that wsro consbucted prior to 1678 ,� 07�ZS
Phone: ��� ( .- ',��,t � u q t 0 (office) ��
M�iling Addree�; 2 u Q�D � Clty: c,,� Z�p; '
Contact Person: Applic�nt is; nt�a / liomeowner �c�►��e o�a�
Emall andlor Fax; �,tif � , �
PRQPERTY OWNER INFORMATION;
Neme: � N �
Phone(day); 51 � � -
Address: t Its 1' L�►.,� �. CitY; ��e►J ZIP; �� (a l�
Emeil and/or F�x
PROJECT INRORMAYION;
Type of Projoct: Any oorth movemant may requlre
❑ Door(s) ❑ Remodel ❑Weter Damage MCWD roview 8 permlts:
Minnehwh�Creek Wetershed District(MCWD)
❑Wlndow(s) �&epair ❑ Storm Damage 16Z02 Mlnnetonke Blvd
❑ Siding ❑ Restoretlon ❑ Other, (spacly) Deephaven, MN 55381
,►�Re-roof ❑ Fire Damege Phone; 952-471-0590
v —
Fex� 962-471-0882
�kY,frilLlnehahacreek ora
_Overall ProJect Descrlptlon: �-�p�L. �� �}.�/,p �� �C a.� �„�„ „ y�j L,,�p,�py�„Er SN�.
Estlmeted Constructlon Veluatlon of ProJact(excluding land) $ � �p �$�, I �
APPLICANT ACKNOWLEDGEMENT:
• Agreee to provida ell information required or requeeted by the Bullding Depertment;
• Certlfles that the inform�tlon supplied Is true �nd correct to the best of hia/her knowledge. The eppllcant recognizea thet they
are solely respohsible For submitting a complete �ppllcation being �w�re thet upon fallure to do so, the staff h�s no alternative
but to reJect it untll It le complate;
• Some or ell of the inFormetion that you ere asked to provide on thla epplicatlon le clessifled by Stste law ae elther prlvete or
confldentlal. private dete la information which generally c�nnot be given to the public but can be given to the subJect of the
dete. Confidentl�l date la Informetlon which generelly cannot be given to either the public or the subject of the data, Our
purpoee and intended use of this informetlon ie to annuelly updete our records and records oF other governmentel �genciea
re uired b lew. If ou refuse to eu I the)nform�tlon the a lic�tlon me not be Iseued,
Applicent'e Sfgnature� Date; v � �
Laat Updaled� 03-01-2011
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DATE TIME , /
CITY OF ORONO CALLED IN V
INSPECTION NOTICE SCHEDULED
PERMIT NO. �alL-OD�/Q� COMPLEfED �
ADDRESS f�/S Fa r��� L,e, pr.
OWNER TELEPHONE NO.
CONTRACTOR ��k�/ /loo�'�S
a DESCRIPTION U�-e-rQo� .
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
� ❑ INSULATION ❑ WppD BURNER/FIREPLACE ❑ SITE INSPECTION
❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. �FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERfCONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ROJECT COMP�.EfE
W ❑CORRECT WORK 8 PROCEED ❑ ISS ERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46�0
OwnerlCorttractor on site:
Inspector. C�s�►..,-'--�C
White Copyllnspector's File Canary CopylSite Notice
C���� DAT � I I TIME �
CITY OF ORONO CALIED IN -
INSPECTION NOTI E SCHEDULED —
PERMIT NO.��� �" ���� � COMPLETED
ADDRESS T°�� 5 �G U//-Lf /v�L�
OWNER TELEPH NE NO. 1(03 7 TZ 3�-S�
CONTRACTOR �/�'��'�/� �
� DESCRIPTION �1 �'� /�'�d 1
� '
l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORE/WETLANDS
�
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 ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORK SATISFACTORY:PROCEED P JECT COMPLETE
W ❑CORRECT WORK&PROCEED r I UE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
� INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
Owner/Contractor on site:
Inspector. '�'
White Copyllnspector's File Canary CopylSite Notice