HomeMy WebLinkAbout2011-00282 - roofing � CITY OF ORONO P�Rm�T No.: 2oi1-oo2s2
• 2750 KELLEY PARKWAY
; ORONO, MN 55356- DATE ISSUED: OS/03/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 751 BOULDER DR
PIN : 33-118-23-11-0073
LEGAL DESC : STONEBAY THIRD ADDITION
: LOT 001 BLOG{ 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 6,000.00
APPLICANT PERMIT FEE SCHEDULE 132.75
MIDWEST ROOFING
6541 SYCAMORE CT N STATE SURCHARGE(VALUATION) 3.00
MAPLE GROVE, MN 55369- TOTAL 135.75
(763)427-9696
Minnesota State License#: 20637010
OWNER
BOWMAN, WILLIAM &CYNTHIA
751 BOULDER DR
LONG LAKE, MN 55356-
AGREEMENT AND SWORIV STATEMENT
fhc���urk lur���hich this permit is issucd shall be performcd according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. fhis pernut is for only dic��rork described and does
not grant pennission for additional or related work which rcquires separate
permits. All provisions of la�vs and ordinances governing this type of work
shall be compicd���ith whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced�vithin 180 days of the date of issuance,or if co��struction is
suspended for a period of l80 days at any time afier work has commenced.
The applicant is responsible for assuring all required inspcctions are
requested in conformance with the State Building Code.This permit may bc
revoked aE any ti for due cause. _
_� / ��
_ l� l �I . � T _( �.' `,-�'y.."�'�''�i .CAd � `r/-=%'" /r
A plicant Permitee Signature Date �
Issued B�� gnature Dale
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:
O�O,�.O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
� �� ' Received by:
a :`_ �, Street Address:
�',�, ' '��� �ti`�' 2750 Kelley Parkway Plan review fee:
'�•q� og� Orono, MN 55356
ESH
- Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.a.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: ` 5� ;I.����C�� �- i/'Z
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
lf 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
�quired un/ess applicant demonstrates su�cient on-site parking is availab/e. Non-permitted events wil/not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
�� Name: Jrj,(��c✓fSr- �'���:r ,1��y S:c��� l,✓rh�G'!� L,�C
State License# �C�E%/��a 7 7 Expiration Date: �3/�l,�� E,%��
Lead Certification Number: Expiration Date:
(for work on homes that were construcje�prior to 1978
Phone: 76 .�—�/� �7'q %'(v (office) 7� ; ���Q— / 3� � (cell)
Mailing Address: (� ,S`� �" (�+�T� C�- City: YIQi�I�' (,�,r��i C. ZIP: j'r'j ;j �;�(
Contact Person: �inny �„�t�i�'b,,� Applicant is: ont�actor / Homeowner (ClrcleOne)
Email and/or Fax: ��;_:3 - y�.� �- y�>>,/
PROPERTY OWNER INFORMATION:
Name: �, I( (jGt,✓w,u.�
Phone (day):
Address: �51 �,� e� Q;,U� City:�prr�'L�:yic� 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
, ❑Siding ❑ 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 P�oject(excluding land) $ ����`�
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
'I re uired b law. If ou refuse to su I the information,the a lication ma not be issued.
�� - ___.____.___.__�__ _ � � �(
ApplicanYs Signature: � Date:
Last Updated: 03-01-2011
�
D E TIME �
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE p�-� �SCHEDULED �
PERMIT NOv�!/—�D�O� COMPLETED
ADDRESS �J` � �/�j�l��/�--i
OWNER TE PHONE N07�3-� Sb'I� �.
CONTRACTO ��-S -
�; DESCRIPTION `�-A-✓-
�
� ❑ FOOTING ❑ PLUMBING FINA ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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
J �2 ❑ COMPLAINT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. ` � ❑ FOLLOW-UP
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL r�� `� ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��ORK SATISFACTORY:PROCEED [_ FiOJECT COMPLETE
W ❑CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call tor the next inspection 24 hours in advance. (J52) 249-46��
OwnerlContractor on site:
�
�
Inspector. `� 1- � �� � �
White Copyllnspector's File Canary Copy/Site Notice