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Home My WebLink About2009-00686 - roofing CITY OF ORONO PERMIT NO.: 2009-00686 '+ 2750 KELLEY PARKWAY " ORONO, MN 55356- DATE ISSUED: 10/28/2009 952 249-4600 FAX: 952 249-4616 AQDRESS : 4305 CHIPPEWA LA PIN : 31-118-23-42-0011 LEGAL DESC : CHIPPEWA : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 250.00 NOTE: REPLACING DEFEC'I'IVE SHINGLES APPLICANT PERMIT FEE SCHEDULE 25.00 CORNICK,JAMES&DEBRA STATE SURCHARGE(VALUATION) 0.50 4305 CHIPPEWA LA TOTAL 25.50 MAPLE PLAIN,MN 55359- OWNER CORNICK,JAMES&DEBRA 4305 CHIPPEWA LA MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is iss�ed 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 describeJ 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 cons[ruction 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are req ested in conformance with the State Building Code.This permit may be �� revo d a[any ti f r due cause. / d'�� `"��Z��C � I� � `6 � �.�� c�--�c�� Applic Permitee Signature ate Issued 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: z�1�'(Z'�c.�j"(� O�v�,j�\ PO Box 66 \ Crystal Bay, MN 55323-0066 Date received: �C� �'� C��' a ��'�� Received by: � �'��.��'; �,' StreetAddress: �'.F, �pa'�� ti�' 2750 Kelley Parkway Plan review fee: �`�kESHo�'�G Orono, MN 55356 � Total Fee: Z� �c' 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 prrnt) GENERAL INFORMATION: // Job Site Address: '7'30� C/�/�/��Wf� � /� Will this be a Parade of Homes, Remodelers Showcase 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 il be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. /APPLICANT INFORMATIO�N:/ Name: � �-L�1 Cp/zN/C�� State License# ,�,,/,Q Expiration Date: Phone: (office) (cell) Mailing Address: Cit : IP: Contact Person: Applicant is: Contractor / omeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: `L%/�2 L'Q/ZN/�� Phone (day): cj��_ 2yy'- 4�oU Address: �_3�5 C/ji�,r�',k,� �iv City: (��Q�f'1(] ZIP: .5 S�3.S� , Email andlor Fax � ,� C�,��, ��,,,�s PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) ❑ Remodel ❑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 ��N Fax: 952-471-0682 Re-roof ❑ Fire Damage � www.minnehahacreek.orq Overall Project Description: wp,N,y,�,�y •/Z£�/a.G£�a.�" o'f Df/-£�T/v£ CfJ��ff�9 Shi��kS Estimated Construction Valuation of Project (excluding land) $ LA�.c dnl•., • s E1 { .5'.S�i�.�'j/�s 7�/'L ,.�' U� APPLICANT ACKNOWLEDGEMENT: �jC)' ' • 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 su I the information, the a lication ma not be issued. Applicant's Signature: Date: ��1 �I v 1 Last Updated: 05-04-2009 • // D TE /.� TIME v CITY OF ORONO CALLED IN INSPECTION NOTIC scHE�u�E� /��n /�n PERMIT NO. Dd "� � c P ETED � � ADDRESS �� OWNER L OCN�O. CONTRACTOR ,� �� , >; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOILOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � i � ' `G-- � �1 v t r G�� ^/� c� 0 � l�/�� c�� t� ��dC�� i��' 0 � W � Q � Z W , � W � � O W� ❑WORK SATISFACTORY:PROCEED � OJECT COMPLETE W �RECT WORK&PROCEED ;'� ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. �G,� White Copyll�spector's File Canary CopylSite Notice