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Home My WebLink About2011-00814 (roofing) CITY OF ORONO PERMIT NO.: 20��-oos�4 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/08/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3850 BAYSIDE RD PIN : OS-117-23-23-0038 LEGAL DESC : BAYSIDE LANDING 2ND ADDN : LOT 002 BLOCK 001 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 15,000.00 NOTE: ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTLJRES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 265.50 PDR STATE SURCHARGE(VALUATION) 7.50 12580 192ND COURT NW ELK RIVER, MN 55330- TOTAL 273.00 (763)633-4737 PAID WITH CC# 3163 Minnesota State License#: 20636655 OWNER MADSON, KAREN E 10950 1ST AVE N PLYMOUTH, MN 55441- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shail be performed according to the approved plans and specifications,applicable City approvals,and the Statc 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 a[any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with[he State Building Code.This permit may be revoked at any time for due cause. l l l// �—�'' �l U l /l Applicant Permitee Signature Date Issue By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � ' City of Orono Building Permit Applic�tion for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: o��-QU Og,��.O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: � a �. Streei Address; Recelved by: �, G4� 275o Kelley Parkway Plan review fee: �q�.�,�og'� Orono, MN 55356 T0131 FB6: ��r � 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 epplications wi11 be returned. (P/ease p�int) GEPIERAL INFORMATION: �, �1 Job Site Address: 3°5 v �a S�J� �`_ Will this be a Parade of Hames, Remodelers Showcase Home or othar Dlsplay Home? Yes No If yres,a special eveni perm)t)s rsquired with Pa�ce Deparimant�nd Ciry Council approval 60 days pi1c�to tha evenr. Shuttle bus servi�ce will6e required unless applica�rt demonstrates au1licient onstte parking is available. Non-permhtee events will not be alfowed. CONTRACTOR/APPLICANT INFORMATIOId: Name: j�p 2 Statg License# Zp�,3�� - Expiration Date: � � / Lead Certification Number: /J�j'� �qOyQ� / Expiration Date: (�ar work on hom�s ihat were constructed prior tu 1978 Phane: �3-(��-y�� (office) Co rZ� `�f�'j--2.[�S� (Cell) Mailing Add�ess: /ZS'F36 � 4`2"� �-F� �ar/ City� 1,� �V'�,/ ZIP: 5;�3 U Contact Person: 7�,,,� p�,��-��,-�' Applicant is: ractor / Homeowner (C��eie0ne) Email and/or Fax: y�w� � �t{l rr�n • Nts1-� �G3- �33�-9�� PROPERTY OWNER INFORMATION: Name: {�aXey► N�A�S�v� Phone (day): (,��2- gro _ D�4S Address: 3550 s�c��e 2 CitY: (�rr�,n� ZIP: j j S�o Email and/or Fax }��Q�Se�,1 �°a�Cas(; �rle PROJECT INFORMATION: Type of Project: Any earth movement may requtre ❑ Door(s) ❑ R�model ❑Water Damage MCWD revfew&permits: Minnehaha Creek Watershed District(MCWD) ❑W)ndow(s} ❑Repeir ❑Storm Damags 18202 Minnetonka elvd ❑Siding ❑Restoration ❑Dther. (specify) Deephaven,MN 55391 Phone: 952-471•D590 [�Re-roof ❑ Fre Damage Fax: 952-471-0682 www,(pinnehahacreek.orq Overall Project Description: �e � o-� Estimeted Constructlon Valuation of Pro'ect(excluding Iand) S /5 00 5 APPLICANT ACKNOWLEDGEMENT: • Agr�es to provide all information required or�equested by th�Building oepartment; • CeRifies that tt�e 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 eware that upon failure to do so, the staff has no alCematNe but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is cfass'rfied by State law as eithe� private or confidentiai_ Private data is information which generally cannot be given to the public but can be givsn to [he subject ot the data. Confidential data is information which generally cannot be given to either the public or the subject of th� data. Our purpose and intended use of thia infurmation is to annuall pdate our records and records of other govemmental agencies re ulred b law. If au refuse to su the info on lication ma not be issued. Applicant's Signature: Date: � 5 Lasl Updated: 03-U1-2011 Z�Z:a6ed 9T9b6bZZS6:ol :tuo.�� Z�:SZ ZTOZ-SO-�Jfld � � TE TIME ✓ CITY OF RONO CALLED IN `/ INSPECTION NOTICE SCHEDULED PERMIT N0. O�� GY�� C MPLETED ADDRESS OWNER T EPH E N . ��' �lT� CONTRACTO 0� L �-s • �� >'; DESCRIPTION � lt� ❑ FOOTING ❑ LU G FINAL ❑ EXCAV/GRADING/FIL�ING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h 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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C o (� '`(�� (�� /t � ��'�� ✓� � �� c��, � �f u�� .ts�� ; �-c'_ � �� ',�.�, .-f— � � _��-> > �-t.c � z 1��= ��- �,�� l� � ," l l [� � � ��UP�,/ W � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIOtJ REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contractor on site• ° Inspector. �. ��,�;�,� � White Copyllnspector's File Canary CopylSite Notice