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Home My WebLink About2011-00277 - re-roof �� CITY OF ORONO PERMIT NO.: 20ll-00277 . 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE 1SSUED: OS/03/20ll 952 249-4600 FAX: 952 249-4616 ADDRESS : 795 BRIDGEWATER DR � PIN : 33-118-23-12-0020 LGCAL DESC : STONEBAY FOURTH ADDITION : LOT 009 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDWG - UNDEFINED VALUATION : $ 6,000.00 NOTE: "fEAR O1�F REROOF APPLICANT PERMIT FEE SCHEDULE 132.75 MIDWEST ROOFING 6541 SYCAMORE CT N STATE SURCHARGE(VALUATION) 3.00 MAPLE GROVE, MN 55369- TOTAL 135.75 (763)427-9696 Minnesota State License#: 20637010 OWNER WILLIAMS, DONALD&VIRGINIA 795 E3RIDGEWATER DR LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT Thc�vork for which this pcnnit is issued shall be performcd according to the approved plans and spccifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does nut crant permission for additional or related work ti�hich requires separate permits. All provisions ot�laws and ordinances governing this type oCwork shall be compied��ith��hether or not speciticd herein.This permit will expire and become null and void if construction authorized is not conunenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time aCter work has conunenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[3uilding Code.This permit may bc revoked� y ti� 1or cause. _......�_ / � / /� �/ � / / Applicant Permitee Signawre Date Issue By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . �.�� - C�ty of Orono Buiiding Permit Applicatlon for internal Work ' (windows, doors� siding, re-roof, etc.) r AAailing Address: Permit number. �G�ll�e��17� O.¢0�O PO Box 66 Crystel Bay,MN 55323-006B Date recelved: J� / � � Streef Addresa: Recelved by: 2750 Kelley Parlcw�y Plen review tee: i�� Orona, MN 55356 Total Fee: �3� �� Maln: 952-249-4600 Fax: 85Z-249�61B www.c�mn.us Thls spplication form must be completed in full and all required Informetion must be submlited. Incompla�te appllca ons will be reWrned. (Please print) GENERAL INFORMATION: C� � � Job Slte Addross: ` � WIII thls be a Perad�of Homes�Remodolers Showcase M e or other Olsplay Home7 Yss No Kyrs,a specie/event peimff/s requ►►ed wr�h Po►!ce DePertment and Clry Coundl approvel 80 deys prbr to the evenr, Shuttle bus 8eivice wpl be r@quir�d unlesa appllcant damor►sNates auilJclent en.sile pe�icing Is avaU�ble_ Mon�ermifted events wlll�t be allowed, CONTRACTOR I APPLICANT INFORMATION: Name� /�'I i�G✓�5� om�, Sot� G��l�Bd� L�yC State�icense# � ;�0 D/Q a 7 7 _ Expiratlo� Date' �3,�31 �p�� lead Certification Number: Expirallon Date: (l�or w�o►k on homes that were conatrucbe�p�lor ro 1878 Phone; 7� 3��/� 7-q G q 6 (o�ce) 176 3-o1g0- l 3� � (Ce��) Mailing Address' (p S (�P-�.FIr` �`�' Clty: �t'�p ��t• ZIP: SS3(p Q` Contact Person: �� ,.dQ�G� Applicant is: on ctor / Homeowner �c�io a�.► Emall and/or Fax: '>63 — y a 7� g0o� .._._ PROPERTY OWNER INFORMATION:; ., Name: _(�o�� I.✓�� I i Q�..5 _ .: Phone(day): Adaress: -7 45 �,-,-�l�r�.i� /�"'• c�ry:LD�� '. ziP: Emall and/or Fax PROJECT INFORMATION: Typs of Projact: Any earth movement may require Q Door(s) ❑Remodel ❑Water Damage , MCwD rsvlew 8 permlls: Minnehahe Creek Watershed District(MCWD) ❑Window�s) [] Repeir ❑Starm Damage 18202 Minneto�ka Blvd Deephav�n,MN 55381 ❑Siding O Restoration ❑Other: (apecify) Phone: 952�71-0590 �Re-rooi ❑ Flre Damsge Fax: 852�171-0682 www.minriEhahy�,cLrp�k.or�c Overall Project Descrlptlon: Estfmated Constructlon Valuation of ProJect excluding 18nd) S _�,_.. APPLlCANT ACKNOWLEDGEMENT: Agrees to provide all informetbn raquired or requested by the Bullding Depertment; Certifies thet the i�'ormation eupplied is true and correct to It�B best of hlslher knowledge. The applicant recognizes tltet they are solely responalble t�or submitting a complete epplicatlon being aware thai upon hallure to do so, the steff has no alternative but W reJect it u�til ii is complete; Some or ell of the informaUon thet you are asked to provide an thls appllce6o� is classfied by State law as either prlvate or confldential. Privete data is inivrmatton whfch generally cannot be given to the publle but can be given to the subJect of the daCa. Confldentlal data is infortnadon which generelly cannot be given to elther the public or the subJect of the data_ Our purpose and Intended use of thls Infomtiativn is to annualty update our recards and records of other governmental agencles ulred b law. (f u refuse to su the informetlon the a licatlon ma not be issued. ApplicanYs Signeture: .�.-�'� Date: ,��,� V !( Leel Updated: 03-01-2011 DATE TIME � ��'�� CALLED If� 8��R� ��I�B�� SCHEDULED �S��B'�� aQII'G�o��7 COMPL�ED �'7'I� �'�� f� IGJ r'/CX4l A/�/ ��. ��6�� `�I�LI��O��iV�[� ��. (��lt"6��8�� /I'Ir�u�as� IP6a�h.�- — j: �D��E31�`�9�6�N �G�-rGO-� _ � � ❑ FOOTIPJG ❑ PLUMBItdG FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ �1AECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FFiAMIfVG ❑ UIECHANICAL FINAL � ❑ TREE REMOVAL � ❑ I(JSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTiON � ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS y,$„ ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT '�' ❑ DEMO-SITE ❑ SEPTIC NIAINT. ,��OLLOW-UP � g ❑ DENVO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUNIBI(�G RI ❑ S�PTIC FINAL ❑ FOUNDATIOfJ/RE�hOVAL � �LDi,`�Rt�E1/�O�'Tf1AC��Fd'��WR�tia G`l�CE:_Y��_4�9G�_ � ��'e /10 �E4r �d�T /dS��te�lQ/t„ f'CG��G/ � � *OLD PERNIIT - NO FINAL INSPECTION REQUESTEI � � � — . � �IG I/L'n�r�!c`�t�-i,, ,,7/'bv!(1 e a 0 � � � .�id[ � lcOD�4 r f Cd wc/J IG�C � � � — ��/Nt��i �/T��d� °a1 Ce m � G � ❑WORK S,4TISFACTORY:PROCEED �RAdECT COMPLETE � ❑CORRECT�/JORK E�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � C CORRECT WORK,CALL FOFi FiEiNSPECTIOf� TEMPORARY � �EFORECQVERIf�G PERMANENT ❑ COFiRECT UNSAFE COfVDITrON VtlITHlN HOURS. �,� PHOTO TAKEN lNSPECTOR VI/ILL RETURPJ ❑ STOP ORDER PaSTED.CALL iIVSPECTOR ��TATIO�d ISSUED ❑ IMSPECTION REQUIRED.C.",:.L TO ARRANGE ACCESS. ��6��th��a��4 a�a��a��4�o�r��m��a-u�o (�SZ� Z�g��6�0 c��rr9��u�ra�4�a'�a��'s�i�e 6�s��3��: Q!.....-- 7� WhoYe CopylVnspecror's Fsl� C�roarr�CopylSiYe filo4ice e