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Home My WebLink About2011-01087 - roofing , CITY OF ORO O PERMIT NO.: 2o��-oios� 2750 KELLEY PAR WAY ORONO, MN 553 6- DATE ISSUED: 09/20/2011 952 249-4600 FAX: 95 249-4616 ADDRESS : 4465 BAYSIDE RD P[N : 06-117-23-21-0006 LEGAL DESC : JOHNSON WHEELER 1ST ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING -UNDEFINED ' VALUATION : $ 6,000.00 NOTE: VALUATION OF PERMIT: $6000.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INS ECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING T E TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT F E SCHEDULE 132.75 INCLINE EXTERIORS INC STATE SU CHARGE(VALUATION) 3.00 26175 BIRCH BLUFF RD SHOREWOOD, MN 55331 MISC FEE 0.00 (612)471-9065 TOTAL 135.75 Minnesota State License#: 20168831 OWNER CARLSON, ROBERT 4465 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 gran[permission for additional or related work which requires separate pern�its. All provisions of laws and ordinances goveming 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 l80 days of the date of issuance,or if construction is suspended for period of 180 days at any time after work has commenced. The applican is responsible for assuring all required inspections are requested in onformance with the State Building Code.This permit may be rev t y time for due cause. � ��/ ��/ ( � �/O��/ G� App rmitee Signature Date Is By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. . City of Or no Building Permit Application for M intenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �O /— �j,0� PO Box 66 Q �a O ,, Crystal Bay, MN 55323-0066 Date received: � ,� �-s� ,, � Street Address: Received by: � " � ti�' 2750 Kelle Parkwa ��t v t `'"� � Y Y Plan review fee: 9kESH�� Orono, MN 55356 � Total Fee: /��,�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.oro o.mn.us This application form must be completed in full and all r quired information must be submitted. Incomplete applications will be ret rned. (Please print) GENERAL INFORMATION: "`� �— � Job Site Address: _ ` � i� Will this be a Parade of Homes, Remodelers Showcase Ho e or ther Disp ay Home? ❑ Yes ❑ No � If yes, a special event permit is required with Police Department and City Council prova/60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is av ilable. Non-permitted evenfs will not be allowed. CONTRACTOR/AP�ANT INFORMATION: , Name: -��, - ;�-r �-� State License# �v � � � Expiration Date: �--��---lf Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: �j;� �-J �•� b � (office) (cell) Mailing Address: �� City: �l� �;�tw,,a� ZIP: j�� Contact Person: �� Applic nt is: �ntrac�r / Homeowner (Circle One) Email and/or Fax: ' — PROPERTY OWNER INFORMATION: Name: `�� ; ��c. �,�� Phone (day): Address: City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) �Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description: �'z��, Estimated Construction Valuation of Project(excluding land) $ p APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Buildin Department; • Certifies that the information supplied is true and correct to the bes of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being a are 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 thi 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 iven to either the public or the subject of the data. Our purpose and intended use of this inform on is to annually updat our records and records of other governmental agencies re uired b law. If ou refuse to s I .t information,the a licati n ma not be issued. � '�� '-z � �- l� ApplicanYs Signature: Date: Last Updated: 08-09-2011 I I