HomeMy WebLinkAbout2009-00418 (roofing) CITY OF ORONO PERMIT NO.: 2009-00418
� 2750 KELLEY PARKWAY
, ORONO, MN 55356- DATE Iss[1En: 07/17/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2400 CASCO POINT RD
PIIY : 20-117-23-12-0024
LEGAL DESC : NAVARRE
: LOT 027 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
VALUATION : $ 1,400.00 �/s �u'�'�d�n�
APPLICANT PERMIT FEE SCHEDULE 54.25
RABAGO, BRUCE& SUSAN STATE SURCHARGE(VALUATION) OJO
2400 CASCO PT RD
WAYZATA, MN 55391- TOTAL 54.95
OWNER
RABAGO, BRUCE& SUSAN
2400 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfottned 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 specified 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 ass all required inspections are
requested in conformance with tJre St Building Code.This permit may be
revoke�i t an time for e caiise �
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App�cant Permitee Signature Date Issued By � nature te
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
�
, City of Orono
, Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
� Mailing Address: Permit number:
// � PO Box 66
,�
, � ��,
/� Crystal Bay, MN 55323-0066 Date received:
I' O e^il\� O\\�`
� �a� . II
�� �� � �, a ! StreetAddress: Received by:
��' '�� ��,'�'u�,^� �! 2750 Kelle Parkwa
� Y Y Plan review fee:
\LRitE�H~���' Orono, MN 55356
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 prinf)
GENERAL WFORMATION: ` �
Job Site Address: �� �-Y� � � � � �'✓� �vi� �.�v.�IG; S'�� "
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o
/f yes, a special event permrt is required with Police Depar7ment and City Counci/approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is avarlable. Non-permitted events will not be allowed.
CONTRACTOR/APPLI�`N�T INFORMATION:
Name: ��`�yH f U!.l�.'J�
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: Cit : ZIP
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATIO .
Name: ,.----� � f3,'1�-»�
Phone (day): IL �.`• : --- U�
Address: ;,� ' u� 4�G�1 '�C)� .,/� � Cit : ��r�/�1� ZIP: ��� � �
Email and/or Fax ��„�,� f�-� p ,�r��.� _ �c,.,,,,�
/ _ __ ___
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits
❑ Door(s) ❑ Remodef ❑Water Damage
Minnehaha Creek Watershed District(MCWD) ,
❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
� Fax: 952-471-0682
e-roof � ❑ Fire Damage � www.minnehahacreek.orq
Overall Project Description:
Estimated Construction Valuation of Project (excluding land) $ � C�
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 annu date our records and records of other governmental agencies
re uired b law. If ou ref o I the information,th lication ma not be issued.
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ApplicanYs Signature: �,�1"��� � "� Date: ��T �
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Last Updated: 05-04-2009