HomeMy WebLinkAbout2011-00937 (roofing) . CITY OF ORONO PERMIT NO.: 2011-00937
, 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 08/25/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3965 BAYSIDE RD
PIN : OS-117-23-23-0004
LEGAL DESC : AUDITOR'S SUBD.NO. 203
: LOT 057 BLOCK 000
PERMiT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTIVITY : O/S BUILDING-LJNDEFINED
VALUATION : $ 6,500.00
NOTE: VALUATION OP PERMIT: $6500.00
ROOFING PGRMITS ISSUGD WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES 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 147.50
ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUATION) 3.25
5145 INDUSTRIAL ST
SUITE 103 TOTAL 150.75
MAPLE PLAIN, MN 55359
(763)479-8700
Minnesota State License#: 20631575
OWNER
FELDMANN, GUY
3965 BAYSIDE RD
LONG LAKE, MN 55356-
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 Iaws 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 issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revo time for due cause. � / `i
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ermitee Signature Date Issue Si nature Date
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SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, City of Orono
� Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
� MailingAddress: Permit number: c��l/—� ,3�
�,0,�. PO Box 66
� Crystal Bay, MN 55323-0066 Date received:
� �' �3� � Received by:
,� ��� Street Address:
,� �����y-
,�, ° �ti 2750 Kelley Parkway Plan review fee:
,/ Orono, MN 55356 _
L9'kESHOg'
= Total Fee: �JTQ `7�
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 applications will be returned. (P/ease print)
GENERAL INFORMATION:,
� Job Site Address: ��(o� ��S� A� �.{�
� 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 demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CO AC O� /APPLICANT INFORMATION:
Name: �`_�T�� �1 S-t�2.�, � t�-e�
State License# �.�� � l S'-7� Expiration Date: � 3 j ZJ,�
Lead Certification Number: �/�7_ (� ����, � Expiration Date: -7 ?� �c ��'-
(for work on homes that were constructed prior to 1978
Phone: '7�,3 _�7�- �''�� o (office) (cell)
Mailing Address: ��C�� ..lMI�uST`ie�JarL Sf- City: /L9i �. L�,N ZIP: S-�� S�
� Contact Person: �C� Applicant is: Qntractor� / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATIOf�I:
Name: �-�� �L:Z-f�ru,�F,��
Phone (day):
Address: ��'�5 ,�-��t�C �F) City: �nc�r. -� ZIP:
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.orp
Overall Project Description: •TC=Y�fL py r -- /�e-o�!'
Estimated Construction Valuation of Project(excluding land) $ � S� �--'
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 ref to su . I the information,the a lication ma not be issued.
ApplicanYs Signature: � -z- — Date: � 2� Ze //
Last Updated: 08-09-2011
�� � D E TIME V
CITY OF ORON CALLED IN f%`�
INSPECTION O ICE ry SCHEDULED
PERMIT NO. � �—GY�,J 6 COMP TED
ADDRESS
OWNER LE O E NO. ��� g�'S—�Z�
CONTRACTOR �L�
�; DESCRIPTION � D
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
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Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARO COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑�(5'SUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CQRRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 tor the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. t�.(_ , � ��
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