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Home My WebLink About2011-00590 - roofing • . CITY OF ORONO PERMIT NO.: 2011-00590 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE �SSUEv: 07/06/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4265 FOREST LAKE DR PIN : 07-117-23-12-0016 LEGAL DESC : FOREST ARMS : LOT 008 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 10,300.00 NOTE: ROOFING PGRMITS ISSUED WITHOUT ENOUGH NOT[CE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETG SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUGD. SIGNS-ADVERTISING SIGNS MAY ONLY BG ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED TI IF,SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 206.50 CMR CONSTRUCTION STATE SURCHARGE(VALUATION) 5.15 8400 NORMANDALE BLVD#920 TOTAL 211.65 BLOOMINGTON, MN 55437- (763)398-7663 PAID WITH CC# 7444 Minnesota State License#: 20635871 OW1vER KALWEIT, GEORGE&KATHR[NE 4265 FOREST LAKE DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT The��ork for which this permit is issued shall be performed according to [he approved plans and specifications,applicable City approvals,and the State Building Code. �I'his 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 Ihe date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[3uilding Code.This permit may be revoked at any time for due cause. / / �/ � / ` ( Applicant Permitec Signature Date Iss By Signature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. 0.7/06/�011 13:09 5156616336 PAGE 01/01 City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) �-__-� Mailing Address: ///�/ � PO Box 66 Permit number: p2(J�/�bd,.� o� � Crystal Bay, MN 553Z3-0066 Date receivetl: 7 /� I' q��` O ,II . iM . ;��\.� �, �;�,��A;_ �./� SfreetAdd�ess: Recelved by: � �s2, ° � G� � 2750 Kelley Parkway Pian review fee: � '�Rk'� ¢� Orona, MN 55356 , .....�sI�O,., '-�-- � Total Fee: ��. �,��" Main: 952-249�600 Fax; 952-249-4616 www.ci.Qrono.mn,us ; This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: ' y�� '� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No !f yes, a specis!event peimit is required wr(h Po�ice Depa�men!and Crty Counc�7 approval 60 days prior to!he evenl. Shuale ovs se�vice will bo required unlesS appliCenf demonslr�les suKicient on-S�fe perking�s available. Non-permitled even(s viill nol be allowed• CONTRAC70R!APPLICANT INFORMATION: Name: m� � a,� $� �� State License # Expiration Date: Q,3 ' a0 Lead Ceriificatipn Number: ��T�Jc9��.�� Expiration Date: (p �OIS (for work on homes thaf were cor+structed prior to 1978 � --- �— Phone: �5��7(�0,3 (office) i�/a, (ce�i) MailingAddress: �� y• ,�j City� 'b�pm% , h ZIP; 3 Contact Person: �Jn�� Applicant is: Contractor Homcowner �c�r��e o�� Email and/or Fax: .�� J�,�,,y,,.�onsf,.�c�,�r �.�r i cq�. �sa- qa!,-,.,�!_�y PROPER7Y OWNER INFORMATION: Name: --��Pn�UD`�'��L�'2/�' „.. . . . . ac�� Phone (day); 9�� 1��-/�l3(0 Address; C�o7(�S j�Dl2'S�'LC� DY� City: �Oc�n� zIP: �"'j3C�� Email andlor Fax �� PROJECT INFORMATION: 7ype of Project: , Any earth rnovement may require � Door s Remodel MCWD review&permits� ❑ O ❑ ❑Waler Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd �ee haven, MN 55391 � ❑Siding ❑ ReStora(ion ❑Other: {specify) Phone: 952-Q�1-0590 �Re-roof ��j?qf f ❑ Fire Damage , Fax: 952-471-OfiFt2 � � www.rninriehah�cr_ e�,_k.,c,�„,rg i Overall Project Description; y�Q — -- --... . I Estimated ConstrucSion Valuation ef Project (excluding lan,d) $ Jd��} ,., ,,_^__ APPLICANT ACKNOWLEDGEMENT: Agrees to provide all information required or requested by the Building Department; � Certifies thal the information supplied is [rue and correct to Ihe best of hislher knowledge, The applicant reCogniZes that they are Solely responsible for submitting a complete appliCation beinq awara that upon failure to do so, the staff has no alternativo � but t0 reject it until it is complete; � Some or all oi the infOrmation that you are asked to provide on this application is classified by State law as either pri�ate or confidential. Private data is information whiCh ggnerally eannot be given to the public but can be yivrn lo the subject oi the data. Confidential daia is information which generally Cannot be given to eilher the public or the subject of the data. Ou� purpose and intended use of thls IniOrmation is to annually update our records and records of otMer governmenta( agencies re uired b law. If ou refuse fo su� I the information, lhe a lica�ion ma not be issued. Applican�'s Signature: Date: �'/�� Las�UpOatetl: 03-01-2�11 � � �%//��\�' - � �A E / TI M E \ / CITY OF ORONO � CALLED IN � / v INSPECTION N IC SCHEDULED �� -�^ �/ �G�D ___�3"_"7`�� PERMIT NO. COMPLETED ADDRESS '�f�-�D� ��i'`�S � j('��0 L� OWNER TELEPHONE N0. �� - 7�G'IC� CONTRACTOR �_" �� '�' �: DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADI /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 v ❑ PLUMBING RI ❑ SEPTIC FINAt�(' ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOH TO MEET YOU:_YES�\NO 1 � COMMENTS: � W a • r � � '�. ,.� �-� ..� �' ;�'�C"- 0 a � 0 � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED +�PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED '� ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contractor on site: /� ,`. Inspector. ; � T.�� White Copyllnspector's File Canary CopylSite Notice �� Y� 0 '� . / //�,� �J D E TIME / CITY OF ORONO � CALLED IN / � � INSPECTION NOTICE/�� SCHEDULED PERMITNO. ��`�✓�O COMPLETED n \ ADDRESS �T �Q��• OWNER /Z S�EL'tEPHONE NO. 7(03�� C�NTRACT�Rn� � .��,�1 >; DESCRIPTION � Z � � � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � j GW�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED !J ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe t inspection 24 hours in advance. (952� 249-4600 OwnerlContracto o . Inspector. White Copyllnspector's File Canary CopylSite Notice