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Home My WebLink About2011-00279 - roofing , � CITY OF ORONO PERMIT NO.: 2011-00279 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE tss[1��: OS/03/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 780 BRIDGEWATER DR PIN : 33-118-23-12-0024 LEGAL DESC : STONEBAY FOURTH ADDITION : LOT 013 BLOCK 001 PERMITTYPE : MINORALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCT(ON TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 8,000.00 NO l�G: "I1:AR OFF REROOI� APPLICANT PERMIT FEE SCHEDULE 162?5 MIDWEST ROOFING 6541 SYCAMORE CT N STATE SURCHARGE(VALUATION) 4.00 MAPLE GROVE, MN 55369- TOTAL 16625 (763)427-9696 Minnesota State License#: 20637010 OWNER PLANK, LOUISE 780 BRIDGEWATER DR LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The�cork for which this permit is issued shall be performed according[o the approved plans and specifications,applicable Ciry approvals,and the State Buildinc Code. This permit is for only the work described and docs not grant pennission for additional or rclated work which requires separate permits. All provisions of la�vs and ordinances governing this type of work shall be compied with whether or not spccified herein.This pennit will expire and become null and void if construction authorized is not commenced wilhin 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. "I�he applicant is responsible lor assuring all required inspections are requestcd in conformance with the State Building Code.This permit may be revoked• any time Yor due cause. S ' 3 ' J� ��2 �S3 � � Applicant Permitee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �J � �� . City of Orono Bullding Permit Appllcation for Internal Work ' (windows� doors, slding, re{oof, etc.) Mailing Addr�ss: Pennit number_ ��`�— (' � O.¢��O PO Box 86 Crystal Bay, MN 55323-0066 Date rsceived: �O� / Streef Addies,s Received by: � � 2750 ICelfey Parkw�Y Plen reviaw fee: �� Orono,MN 55356 Tatal Fee: ��p��S AAaln: 952 249-4600 F�x: 952-249-4816 ��.Q,rono.mn.us This application form must be completed in full and all required Informatlon must be submitted. Incompl�te application�will be retu��ed. P/ease print) GENERAL INFORMATION. �/-� �� G�� Job Slte Address: V WIII thls be a Psrade oi Homes� Remodelers Sh se Home o�other Dlsplay Home? Yes NQ If yss,a speci�/event permit/8 reqWred wlth Pallce Deperh►�enf end Ci�y Coundl approval 60 days prior to the av�ent. ShufNe Du8 BeMce wNl be requlrs0 unlesa applic�rtf demonabales sufllclent on•site parkirig i8 aveilabfe. Non-perm![ted events will not be allowed. CONTRACTOR/APP�ICANT INFORMATiON: Name: %�'1:(�W�b7- �oOF�� l�►�1�P� ,L,�C Stete Licens�# ;.Q p/p a 7 7 Expiration Date: ��/3/,/� f�� Lead Certification Number: Expiration Date: (Ror w��on homes that wens consbuc�prlor tv 19f8 Phone: 76.3- �/a 7-�!6q� co�� ?6 3--�So— 13� � c�� Mailing Address: (p� � C�- Clty: Q��' �c��- ZIP: 3 (p�{ Contact Person: �p.yn.��„�Qr,SG•� Appllcant is_ on ctor / Homeowner (Clrela dns) Email and/or Fax: '�63 -. �I �7= y0 / PROPERTY OWNER INFORMATION: Name: �1(;� Q�(�it_?'� Phone(day): Address� CJ' ��f-� ��. i� �G� l�/� City: �.�r7�i Gd/��: ZIP: Emall andlor Fax PR4JECT INFORMATION: Typo of ProJect: My QaRh movement may�qutro �� ❑Door(s) ❑Remodel ❑Wete�Damage M�0�vlsw�permlis: Minnehaha Creek W�tershed Dlstrlct(MCWD) ❑Wlndow(s) ❑Repeir ❑ Stnrm Damage 18202 Minnetonka Blvd ❑Sidio Oeephaven,MN 55391 g ❑Restoration ❑Other�(specify) Phone; 952�71-0580 (�R�roof ❑ Flre Damage Fax: 852-471-0B82 www.rnlnr�el�ah�CreQk;Q„rc�. Overall Project Descrlptlon: , � Estlmated Conatru�tlon Valuatlo�of Project(excluding land) S � APPLICANT ACKNOWLEDGEMENT: Agraes to provlde all informatlon requlred or requested by the Building Department; Certifies that the Infonnation supplled Is We and corract lo the besc of his/her knowledge. The applicant reCognizes that ihey ere solely responsible for submilting e compiete application being awsre thet upon f�ilure to do so, the steff hes no alternative but to reJect It untfl it is complete; Some or all of the informadon that you ere asked to provide on thls applica6on is dasslfled by Stete lew as either private or confldentlal. Prvvate data is InfortnaGon which generelly cannot be giv�en to the publlc but can be given to the subJect of the data. Confidendal d�ta Is Informadon which 9enerally cannot be giv�n to elther the public o�the subJect of the date. Our purpose and intended use of this informetlon ie tr� annually update our records and records o(other govemmental agencies r uired b law. If u refuse ro su the information the a Ilcation ma not be issued. APPlicant's Slgneture: �'"`'�'�c"'��L'�� '. Daie' �� l� 1861 Updeted: 03-01-2011 �r J DA TIME � CITY OF ORONO CALLED IN INSPECTION N�OT!IlCE/ Ov�7�—/SCHEDULED PERMIT NO. �/�( / COMPLETED ADDRESS v � �� OWNER _ EL HONE NO� 3- �' CONTRACTO — �: DESCRIPTION �-C--Ah- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � J O a � � O � � W � Q � Z W � W � � O � RK SATISFACTORY:PROCEED PROJECT C0141PLETE W ❑CORRECT WORK 8 PROCEED ❑ IS UE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C, pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on s' : Inspector. ,�-�/ �`~ � � White Copyllnspector's File Canary CopylSite Notice . �- ��- � a-�a /' DATE TIME \ / CITY OF ORONO CALLED IN G- ( � � INSPECTION NOTICE SCHEDULED � � - ��'� PERMIT NO. �[�1 I -��-7� COMPLETED ADDRESS � �L �J Y1 I cI i� !�"<a-�-E'_D" �(�_ OWNER TELEPHONE NO. �� - ��'-1�� CONTRACTOR ��l �`F S� ��'}1 i'�^—�, � �. r >; DESCRIPTION �C C�1 C� t' � Iy� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SE C FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W � � J O a � O / � � � W � Q � Z W � W � � GW WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑ RRECT WORK&PROCEED ', ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CAII INSPECTOR � CITATION ISSUED ❑ INSPECTIONRE�UIRED.CALLTOARRANGEACCESS. Cali for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. ,��%2 � White Copy/inspector's File Canary CopylSite Notice