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Home My WebLink About2011-01361 (roofing) � CITY OF ORONO PERMIT NO.: 2011-01361 2750 KELLEY PARKWAY ORONO, MN 55356- DATE 1ssuED: 10/3U2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4045 BAYSIDE RD PIN : 06-117-23-14-0022 LEGAL DESC : BAYSIDE RIDGE : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 13,000.00 NOTE: VALUATION OF PERMIT:$13000.00 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 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 COMPLGTGD THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 236.00 AC CONSTRUCTION& RESTORATION SERV STATE SURCHARGE(VALUATION) 6.50 12510 FLETCHER LANE SUITE L TOTAL 242.50 ROGERS, MN 55374- (763)682-0770 Minnesota State License#: 20634132 OWNER BOON, HENRICUS&CORNELIA 4045 BAYSIDE RD MAPLE PLAIN, MN 55359- 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 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 l80 days at any time afler work has commenced. The applicant is responsible for assuring aIl required inspections are reques[ed in conformance wi[h the State Building Code.This permit may be revoked at any'�time for due cau ,\ � `-'��-L--' �� 1 / � - ? � � ' ' � /a � � Applicant Per itee Signature Date ssue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. � - City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number. ��-�/ C �v�,� PO Box 66 /� Q Crystal Bay, MN 55323-0066 Date received: /Q � �:v ' 3;�,�. �,a -.��,� �, � Street Address: Received by: �� t 'z� �� 2750 Kelley Parkway Plan review fe t9'kESH�4� Orono, MN 55356 Total Fee: � � �O�_ 5 � 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 appfications will be returned. (Please prinf) GENERAL INFORMATION; � -, Job Site Address: %��}-� �� , >�y;�,�s__,("�(� f-:.L� Will this be a Parade of Homes, Remodelers$ owcase Home or other Display Home? ❑ Yes �� No If yes, a speciaf event permit is required with Police Department and City Counci/approva/60 days prior to the event. Shutfle bus'service wil/be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wil/not be allowed. CONTRACTOR/�;PPLICANT INFORMATION: Name: � 1 � � �,, ��, ,_i� a <,, State License # .��; / �� 2� Expiration Date: Lead Certification Number: Expiration Date: (for work on homes fhat were constructed prior fo 1978 Phone: �; .., ��=; �"i�� (office) (cell) Mailing Address �- ' �- � -�. ; � City: .'_ ��..�: � ZIP:� < � ,_ � Contact Person: ,� j , '�,. . Applicant is: Contra� / Homeowner (Circle One) Email and/or Fax: - PROPERTY OWNFR INFORMATION: i Name: ��.` ,; �_I�.��6�� (,i� Phone (day): Address: �-( ��'� � ��: �� 1 City: �� '�� ti �l� ZIP.�"-�_� .��C.� Email andlor Fax _ PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door s ❑ Fire Damage MCWD review& ermits: O ❑ Remodel � Minnehaha Creek Watersh d District(MCWD) �Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 I ❑ Re-roof, other s ecif Phone: 952-471-0590 ( p y) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 � ❑Window(s) www.minnehahacreek.orq � Overall Project Description: >, �; Estimated Construction Vafuation of Project(excluding land) $ ��i APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all informafion 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 informafion is to annually update our records and records of other governmental agencies re uired b law. If vou refuse to su I the informafion, the a fication mav not be issued. ,� ApplicanYs Signature: � - �- � ` Date: �i�:�/l( ( �ast Updated: 08-09-2011 ' � � �� TE TIME V CITY OF ORONO 3 ��— INSPECTION NO ICE SCHEDULED o?•� - PERMIT N0. d��l-�� C PLETED ADDRESS � ` OWNER T EPHONE NO. �� CONTRACTOR � >; DESCRIPTION B� � � ❑ FOOTING ❑ PLU G FINAL ❑ EXCAV/GRADING/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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUM ❑ SEP C FINAL ❑ FOUNDATION/REMOVAL Z NER/CONTRACTOR TO EET YOU�YES_NO � COMMENTS: � W 0. o w�-�' c�c-� �.1�1— �- �� C� �J G�✓ �� Q � z W � W � � GW �WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK E�PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 Owner/Contractor on site: Inspector. �{ White Copyllnspector's File Canary CopylSite Notice � �: �A�� TIME CITY OF ORONO CALIED IN � INSPECTION NOTICE / SCHEDULED � �� PERMIT NOQ�D /� D��(�/ COMPLETED ADDRESS � �`� OWNER TELEP NE N07�3-�� ' <<� CONTRACTOR S u � �� DESCRIPTION �� ' %�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADiNG/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE�NSPECTION 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: � W a j � �-� r �� 2i_ �- �'C� �it,c�i O � ,�- -s- �S .1 �J�' �vti`�`- /'CIti � r d � e�� Q� � T .�-�!G� ,S _.�. e� /'� Q � z W � W � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � �RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BE ORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WiTHIN HOURS. ❑ pHOTO TAKEN INSPECTOR W4LL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on ite: Inspector. � White Copyll�spector's File Canary CopylSite Notice