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Home My WebLink About2011-00544 - roofing ' CITY OF ORONO PERMIT NO.: 2011-00544 . 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 06/29/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4740 BAYSIDE RD PIN : 31-118-23-33-0007 LEGAL DESC : LJNPLATTED 31 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 15,000.00 APPLICANT pERMIT FEE SCHEDULE 265.50 THREE PINES CONSTRUCTION STATE SURCHARGE(VALUATION) 7.50 2876 MIDDLE STREET ST PAUL, MN 55109- TOTAL 273.00 (763)244-9199 Minnesota State License#: 20598207 OWNER IVERSEN, ROSEMARY C 2835 CASCO PT RD WAYZATA, MN 55391- 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 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 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 assuring all required inspections aze reques d in conformance with the State Building Code.This permit may be rev d at any ti e for due ca se. �� / / ( � �� ipli t Permi e Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ,: � City of Orono�� Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �� Q'S O�,�,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: J� ,� �� Received by: ''��-+� �, Street Address: �',�n ' 'A'� Gti�' 2750 Kelley Parkway Plan review fee: ��ESHO�`� Orono, MN 55356 � 7� Total Fee: p�73,�(J 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: �� 1 ��;q�� i� Will this be a Parade of Homes, Remo lers Showcase Home or other Display Home? ❑ Yes �-ftto !f yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICA T INFO ATION: Name: � � � U ,� �� State License# � � Expiration Date: 3� �'�f . Lead Certification Number: ��o —��_ � Expiration Date: (for work on homes that were construct�prior to 1978 Phone: � �—G (office) ��—�'��- �� (cell) Mailing Address: � � City�j, g��/ ZIP: � c� Contact Person: ��.�C`yJ � Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: �j'��"„�C��@ ��,•j-�� PROPERTY OWNER FORMATION�,^ Name: _ .., `= l �y" �D.� Phone (day): �j� .- �+ �— `7/ Address: ��' � G�? �s�r —��/ City:1,?j �y� ZIP: � �' Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Sid'ng ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 Re-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project (excluding land) $ /`G'j, 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 th' information is to annually update our records and records of other governmental agencies re uired b law. If ou refuse su I the information, t e a lication ma not be issued. Applicant's Signature: � Date: i�"l� Last Updated: 03-01-2011 � �� "�� .DATE TIME �/ ( CITY OF ORONO CALLED IN �� INSPECTION NOTICE G SCHEDULED � PERMIT NO.�C>I� ��`�� COMPLETED ADDRESS �� .� ��F—' � OWNER TELEPHONE NO. �� -�� ' CONTRACTOR �TG1�C'�' � l YI�S ,--.„ >'; DESCRIPTION `�� L� � ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILL.ING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS h 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FIN� ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W k � GW ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED � SSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE�UIRED.CALlTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. / �. � White Copyllnspector's File Canary Copy/Site Notice �� ATE TIME �/ CITY OF,ORONO CALLED IN Z `/ INSPECTION NOTICE SCHEDULED PERMIT NO. ` "� OMPLETED ADDRESS � �- OWNER T EP NE NO. 51 J��b� �` �l CONTRACTOR � >; DESCRIPTION � "� ✓� � ❑ FOOTING ❑ PLUMBING FIN L ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALI ❑ MECHANICAL ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICA�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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � �RK SATISFACTORY:PROCEED , 6ROJECT COMPLETE W ❑CORRECT WORK 8�PROCEED :; ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN �NSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on s'te: , Inspector. White Copyllnspector's File Canary CopylSite Notice