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Home My WebLink About2014-00445 (roof-asphalt) � � CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 4 - P1 P1 4 4 5 * DATE ISSUED: OS/13/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 100 CHEVY CHASE DR P1N : 36-118-23-41-0030 LEGAL DESC : HILL O'WAY MANOR : LOT 025 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,000.00 NOTE: VALUA"I'ION OF PERMIT: $5000.00 ROOFING PERMI"I'S ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF 1NSPECTIONS. (WE RF,QUIRE 24-48 NOTICE,PRIOR TO WORK f3EING STARTED) MUS"I'PROVIDF.COMPLE"I'F,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 [S COMPLETGD THE S[GNS MUST B�REMOVED. APPLICANT PERMIT FEE SCHEDULE 118.00 STATE SURCHARGE(VALUATION) 2.50 CURT'S CUSTOM DECKS INC TOTAL 120.50 2935 194TH LANE NW OAK GROVE, MN 55011- Payment(s) (763)453-6063 CHECK 8114 120.50 Minnesota State License#: BUIL-BC217388 OWNER BIERMAN, MICHAEL 100 CHEVY CHASE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work fbr which this pennit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State E3uilding Code. This permit is for oi�ly 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 permi[will expire and become null and void if construction authorized is not commenced within 180 days of[he date of issuance,or if construction is suspended for a period of 180 days at any[ime after work has commenced. The applicant is responsible for assuring all required inspections are request��n conformance with the State Building Code.This permit may be revo�d at�any time for due cause. r � � > / / Ap � nt Permrtee Signat re Date Issued By � nature Date � � City of Orono � � �`� Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Marling Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: y� ` 2750 Kelley Parkway Plan review fee: �' Orono, MN 55356 tqkESHO�� '� sD Total Fee: 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. (Please print) GENERAL INFORMATION: / Job Site Address: I �' U C�LeJ'iy (1��;� Q�''- Will this be a Parade of Homes, Remodelers S owcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is required with Police Department and City Council approva!60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wil!not be allowed. CONTRACTOR/APP�.ICANT INF RMATION: Name: � � : 1-�-c D�(c-t ..I�-c-- State License# `� _�� -Z-� ��- Expiration Date: T� �� Lead Certification Number: Expiration Date: � (for work on homes that were constructed prior to 1978 Phone: (cell) ^i�-3 - ' �S - S�c � (office) "�6`�-�}S3-�.u i� 3 Mailing Address: �-� � �S � _ ,�w City: Q �,,,ti ZIP: �p� � Contact Person: � � .—ti , Applicant is Con ra�c o� / Homeowner (Circle One) Email and/or Fax: '"2�,-3._'��- 3�� _._____. ..._=� PROPERTY OWNER INFORMATION: Name� C'� � c�c1 .�� f'�u,�� Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: � �� r Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: �Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 5��o � 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 required by law. If ou refuse to su I the ' formation,the a lication ma not be issued. ApplicanYs Signature: Date: ��3 f i �/ Owner's Signature: Date: Last Updated:03/06/2013