HomeMy WebLinkAbout2011-00323 - roofing CITY OF ORONO rERM�T No.: 2oii-oo323
2750 KELLEY PARKWAY
� � �` ORONO, MN 55356- �ATE IssUEu: OS/1U2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 754 BOULDER DR
PIN : 33-118-23-11-0014
LEGAL DESC : STONEBAY
: LOT O11 BLOCK OOl
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTIVITY : O/S BUILDING - UNDEFINED
VALUATION : $ 8,000.00
NO"I'F,: 'I'EAR OFF REROOF
APPLICANT PERMIT FEE SCHEDULE 16225
MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.00
6541 SYCAMORE CT N TOTAL 166.25
MAPLE GROVE, MN 55369-
(763)427-9696
Miilnesota State License#: 20637010
OWNER
LUKE, DUANE&NANCY
754 BOULDER DR
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
I'he work for which this permit is issued shall be performed according to
the approved plans and specitications,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 specitied herein.This permit will
expire and become null and void if construction authorized is not
commcnced 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 are
requested in coniormance with the State Building Code.This permit may be
revoked�1 �'any time for due cause. _� � � ��
l , ,
Ap icant Permitee Signature Date Issued By i nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, � City of Orono
Bullding Pernnit Application for tnternal Worlc
(windows� doors, sidi , n-�oo�f� etc.)
A�ha Ada�rera: P�it nun,Der: o�f��/— C�03
0�OsrQ Crystal BaY�IiM 55323-0066 Date neoeivsd_ J"� / �
� � ��P��y Reoeived by_ ....�1
276D Plen review fee:
bono.NW SS9.S6
To�el Foe:
Meln: 952,2�4�1800 P�c 932-249-�616 www.ci.orono.mn.us
11�ls appNcatlo�fbmi must b�compi�ed In fu1�nd ad requbsd intorrr�ati�or►must be submicted.
�p��PP�iaatlons wNl b�nturn�d. (PYaeBe prtr►t)
GENERAL INFORYATION: c /�
Job Sid Adclr�ss: ,J� ��dls��b�.� f/'/`rr
Wlil tfils b�a PwncM o�Harrs, 8how�as�Ho�e�o�ot1t��Dbphy Han�� Y�s '-�No�_.'-
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CONTRACTOR/APPLJCANT IIii�01�11ATIpN: �/
Name: IfJ�d GJ�S� O � SG i I.A�Gl� Ln�
s���� 2 vav o a �7 ��aor, �: _Qai 3� a o�.�
Lead Certiflc8tlon Number. F..�iration D�De: --
(1br wve#an Aonws dnt�� 1�1�7A _""
�,o�� �6 —k� �- � c�� �6 3 a8o— �3 � c��n
MeiUng Address: r-►.air- G`I- C[ti: vG ZIP: 3 6 4
Co�act PeBon: n, 4n AppiicaM ia: / Homeowner �cra.o►�.�,-..
Emall and/or Fax: _ � 63 - �/ ?�- 00
PRCPERTY OWNER 1"� TION• ,
Name: , C✓c�.n,� L.vf`�
Phone(day): �
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Address: _ 5�, , t'1L` Q;��� City: -��:�l-����- ZIP:
Email andlor Fax
PROJECT INFORMA110N:
TYp��'1 R�� ! My NAA n�ewnMnt mq n�quln
i ❑Daorla) ❑R�nwdsl Q W�sr Damepe MCWD e�rvNw�pKmlls:
� Mlnnef�Ne Creek WsO�+ed Dl�trict(MCYVD)
i ❑Window(s) ❑R�epel� ❑SEorm Datnege � 18Z02 Mlnne�onka 81vd
� ❑Slding ❑Ra�or�tlon ❑Ott�er.(sped�Y) ' ��,MN 5639�
IPhone: 962�71-0590 f
�Re-roof ❑Flre DeA'feps � Fe�c 952�471-0862
I w�r+n.mmnehahacr,�k.ors�
owrau pro�ct o..�iptlon:
Esturubd Constivctlon Valwtlon o�f P��Ct(�coludin�I�nd) s � �'�'� _„.T�
APPLICANT ACKNOWL.�D�i�YENT:
� a�w4 m prw�ds.N f�rtnNior�rnq�.d or requssesd by ms BuOdinp�epertmenr
�
� Certlfi�d�at C�e In�pnrotion
euppNed I�true aM tmtreCl DG Ib besc of hiBIF►et lonowf9dpe. The sppYc,ant recopnl�ms tnel tney �
� are soWy ntpa�sbl�f�wbmittln0 a oompie�aRP���9 owaro that upon tailu►�to do to, !hs atslf hse no altemative ;
� nut w rejed n w�lll n is c«nple�s; ,
� Sorne or sq ot 4w irtfonnetlor� thtt you are aslo�C L�provi�ds on ihis epplk�tlon Is dstsflfed by SCsto lew as olt�er prtvaLe or :
; aorsliOentW. F�rivab dad h irdortn�tlion wld�per�eraly cennot bo given to the p�lic but nn he 9iven to the subjed of t�e ;
� deta. connd«�la� ds� 4 infam�llon wh�h �snerdly caruac bs glven tti eltlwr the p�Nc or u,e sut�cc ot a,e dara. our
i purpoae�nd b�Osrid�d u�s of thb Irrbrt�nfbn f� oo annually upds�e our recads and reoonds of otl�er go�emmental agenc�es �
reCuirod b�►lew. If 7R�u re�iras 10�ur�Dly ths infortnv110e�fhs sooYosliOn m9Y not b�Iesued. y
APPIIcanCs Signature: f�"`� Dat.: �t�"'/�•'(�
�,u�ea: o�o�,zot�
� 3�3 ,j DATE TIME �
CITY OF ORONO �� CALLED IN
INSPECTION NO ICE ✓scHeou�E�
PERMIT NO. ' COMP ETED � '� ���-�J�
ADDRESS �02� �cS� �
OWNER T EP E NO.
COt�TRACTOR
>: DESCRIPTION
�
� ❑ FOOTING ❑ PLUMBI INAL ❑ EXCAV/GRADING/FILLING
q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETI.,qNDS
� ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INS ATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ DON SLAB ❑ WATER HOOK-UP
❑ PROGRESS
� FINAL � SEWER HOOK-UP ❑ COMPLAINT
� EMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a *OLD PERMIT - NO FINAL INSPECTION REQUESTED.
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� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.Cf,LI_TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (J52� 249-46�0
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice