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Home My WebLink About2011-00269 - roofing CITY OF ORONO PERMIT NO.: 2011-00269 � � � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE �ssuEu: 05/02/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 120 CHEVY CHASE DR PIN : 36-118-23-41-0037 LEGAL DESC : HILL O'WAY MANOR : LOT 003 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ ] 1,000.00 NOTE: 7'EAR OFF I2�R00}'-6° ICG 13ARRIF,R-30 YL;AR'rIMBERLINL' APPLICANT PERMIT FEE SCHEDULE 206.50 PLYMOUTH ROOFING & [NSULATION STATE SURCHARGE(VALUATION) 5.50 17525 CTY ROAD 24 PLYMOUTH, MN 55447 TOTAL 212.00 (763)473-3397 Minnesota State License#: 5358 OWNER CASWELL, MR. & MRS. 120 CHEVY CHASE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The�vork for��hich this permit is issued shall be performed accordinb to tl�c approved plans and specifications,applicable City approvals,and the State Building Code. "f'Ihis permit is for only Uie work described and does not�rant pemiission for additional or mlated work��hich requires separ�te permits. All provisions of laws and ordinances governin�this type of work shall be compicd with�vhether or not specitied herein.'Chis 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 a period of I 80 days at any time aiter work has commenced. "I'he applicant is responsible tor assuring all required inspections arc requested in c nformanee with thc State B�iilding Code.This pcnnit may be revo��d a iy t� or c�Ee c �s r � , ' %'.. _ ;'' ,S' / � /�� - G�- �i o2 i / Applican P rmitee Signature -� Date Iss E3y Signature Date SEPARATE PERMITS REQUIRED POR WORK OTHER THAN DESCRIBED ABOVE. City of Orono � j ��' Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) �-� Mailing Address: Permit number: p�/�� O�v 0,� PO Box 66 O Crystal Bay, MN 55323-0066 Date received: � / I ��° � , Received b I a f�''� �F:.^% s, � Street Address: Y� ��'�,n � ' �'�' ti�' 2750 Kelle Parkwa Y� wG Orono, MNy55356 Y Plan review fee: `�kEssot� ` Total Fee: �a�� 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is repuired with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be repuired unless applicant demonstrates sufficient on-site parking is avarlable. Non-permitted events will not be alfowed. CONTRACTOR/APPL NT INFOR�ATIQ1V: �s Name: �f3/Dv>" �Oc� i��' State License# _!y�� "'� Expiration Date: �� Lead Certification Number: � ;�- ;�_ L ,��s S�'//C��,7 L'�Expiration Date: 3 y-�s-�oil� (for work on homes that were constructed prior to 1978 Phone: �� ,_ — (office) (cell) Mailing Address: 3 � � �c� City: ��,�? ZIP: s"sl�� Contact Person: � � - ��.f� Applicant i� Contr cto �/ Homeowner (Circle One) Email and/or Fax: _� � ��, , /-� , � �.. � �� i� C��i� � � PROPERTY OWNER INFORMATI N: • Name: �i2� C�CIS'1�� Phone (day): �j' _ __ 3�� Address: � l e�� se /�r'(/z. City: ��,- �; ZIP: s� �/ / Email and/or Fax i 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 ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 [�f2e-roof Phone: 952-471-0590 ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Pro'ect Descri tion: ��=�t,_�.�1 ;�.y,:-�,,, -� -� � p �� / 2- f% >C� vc<sy ;i,=�-�i�,�,,',e-� Estimated Construction Valuation of Project(excluding land) $ //�`��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 this information is to annually update our records and records of other governmental agencies re uired b law. If ou refuse to I t inf atio�, e a lication ma not be issued. # Applicant's Signature: � '' / _ Date: ,j "o�� Last Updated: 03-01-2011 AT TIME V CITY OF ORONO CALLED IN �- /� INSPECTION NOTICE �CHEDULED PERMIT NO. �/l-D� ��o�/cOMPLETED ADDRESS ��U ��-� l,�l L��ZLt/,L� !�� OWNER TEL HONE I�O. CONTRACTOR �� : DESCRIPTION �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C o !UU�T ,2� � � �f � r 7'.� S�� c ..� . � � � �J� � � �i,--� �• � T �^ .�� Q �� 5 � z W � W � j d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED D INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ Owner/Contractor on site: Inspector. �� • r� White Copylinspector's File Canary Copy/Site Notice { � � , / �� D TE TIME V � CITY OF ORONO CALLED W �--� -3�� INSPECTION NOTICE SCHEDULED � '� � PERMIT NO. �C1 (f �C(`��kGf COMPLETED ADDRESS �;�C' �/�� 'c� C.' ,��L.�,1�_��%� �i�� OWNER TEL PHONE NO. �'e� �'�� 'j� CONTRACTOR � ��'�� '� ' ,--. , � � j; DESCRIPTION � ✓�� , � l� ❑ FOOTING ❑ PLUMBING FINAL � ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � 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 FINAL . ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES�NO � COMMENTS: L�IC t-t i.'t.� ._I � c;_r; t' G �`� .l',��-t' W � � J O � � O � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice: