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Home My WebLink About2011-00319 - roofing CITY OF ORONO PERMIT NO.: 2011-00319 a. ., 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �SSUED: 05/10/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 769 BOULDER DR PIN : 33-118-23-11-0007 LEGAL DESC : STONEBAY : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING -UNDEFINED VALUATION : $ 8,000.00 APPLICANT PERMIT FEE SCHEDULE 162.25 MIDWEST SID[NG ROOFING & WINDOWS STATE SURCHARGE(VALUATION) 4.00 6451 SYCAMORE CT N MAPLE GROVE, MN 55369- MISC FEE 0.00 Minnesota State License#:20010277 TOTAL 166.25 OWNER MELIUS, MATTHEW S 769 BOULDER DR LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performcd according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This pennit is for only thc 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 datc of issuance,or if construction is suspended for a period of 180 days at any time aftcr work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Duilding Code.This permit may be re �ed at any ime for due cause. .�� / <� / /� / / Applicant Permitec Signature Date Issu y ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO City of Orono . � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Og,�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: �g'�"' Received b � -..w�a�. a Streef Address: y� x',�, ' 'A� G�.`� 2750 Kelley Parkway Plan review fee: t�'kESHO�`� Orono, MN 55356 Total Fee: 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: ��y ��L�� i'� �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No !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 sufiicient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLIC�INT INFORMATION: , Name: /�^,,;�c,.!5 T ',�;��,`2 �/� �✓,�tG��/� State License# . �ti�! U a; '�J Expiration Date: e Lead Certification Number: Expiration Date: (for work on homes that were construc ed prior to 1978 � Phone: - �_� �� 7-_��Q� (office) �L'� ��k�'� 'l�� (cell) Mailing Address: (�;, �/ ,S �� (, , Ci � iC �,a� ZIP: �-�'t,-�y� Contact Person: -�.�.2 Applicant is: ontrac r / Homeowner (CircleOne) Email and/or Fax: �--,,G _� -y�7_ �i�>i PROPERTY OWNER INFORMATION: Name: �".?u°�"�j�'�v �..i�;�,"u5 Phone (day): , Address: 7(� �' ��:.:dc�'t�� (�,;�� City:��L�'� 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 'f�Re-roof ❑ Fire Damage Fax: 952-471-0682 � � www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project (excluding land) $ Ci� �-�`" �,_ _ 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 pubfic 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 su I information,the a ' tion ma not be issued. �F f�� `l ` / ApplicanYs Signature: Date: � `� s Last Updated: 03-01-2011 t�ATE TINiE � '�� CALLED 9N h�G��'�e,��s� '�� / SCHEDULED � �7�[��y?�,,�!_ ��G�R�. � - G COMPL ED .__ yr-?�-yr--- t"��Ir�� C� I �GL�/�`�'- J �� K..�� . �� / / �� _ �( � ��f��Te�� '1/�-l'i � ❑ FOOTIh1G ❑ PLUM FINAL ❑ EXCAV/GRADING/FILLING � Cl POURED WALL ❑ MECHAfVICAL RI ❑ LAKESHORE/WETLAPdDS � ❑ FRAMING ❑ f�9ECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION j � ❑ DON SL4B ❑ WATER HOOK-UP ❑ PROGRESS I ,t$�. FIiVAL ❑ SEWER HOOK-UP ❑ COMPLAINT I ❑ DEMO-SITE ❑ SEPTIC MAIIVT. ❑ FOLLOW-UP � ❑ DEMO-FIfVAL ❑ SEPTIC INSTALL ❑ HARD COUER REMOVAL I � ❑ E�LUMBIi�G RI ❑ SEPTIC FINAL ❑ FOUNDAT�ON/REBAOVAL ' '� '�'NiRf p�Bi/��9d7F�,4CYOR"�4)6Ui��f Y�BJ:_Y�S_@�9p � ��o a°`9�. *OLD PERMIT — NO FINAL INSPECTION REQUESTEDo � � � � � �� —� � � ' � _/ i � ! � � o-� � � a� � � � � � ❑WORK S,4TISFACTORY:PROCEED ❑ 6�OJECT COMPL�TE � ❑ CORRECT WORK�PRQCEED ❑ ISSUE CERTIFIC.4TE OF OCCUPAY�CV � O CORRECTlftfORK,CALL FOR REIi�lSPECTIO�1 TEP/IPORARY � �EFORECWERING PERAAAIVENT ❑CORRECT UMSAFE CONDITIOM WITHIN HOURS. � pryOTO TkKEN If�SPECTOR WILL REfURN ❑STOP ORDEft POSTED.CALL IPdSP�CTOR �CITATIOM ISSUED O IPdSPECTIOftI REQUIRED.C�S:.L TO ARRA�dGE�CCESS. ��o�$o��aa��ta��o��, (952) 249�4600 ��ru��/��a��o-��a�6�e: �a�s�s��s: WhiBe CopyllnspecYor's File � C�nan�CopylSi4e WoYoee i