HomeMy WebLinkAbout2011-00355 - roofing � 4
CITY OF ORONO PERMIT NO.: 2011-00355
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISS[1ED: OS/18/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 791 BOULDER DR
PIN : 33-118-2�-11-0012
LEGAL DESC : STONEBAY
: LOT 009 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 8,000.00
NO�'E: TEAR OFF REROOF
APPLICANT
PERMIT FEE SCHEDULE 162.25
M[DWEST ROOFING STATE SURCHARGE(VALUATION) 4.00
6541 SYCAMORE CT N
MAPLE GROVE, MN 55369- TOTAL 166.25
(763)427-9696
Minnesota State License#: 20637010
OWNER
SCHWARTZMAN,JON&JANE
425 OXFORD RD
LONG LAKE, MN 55356-
AGREEMEIYT AND SWORN STATEMENT
Tl�e work for which this permit is issucd shall be perfonned according to
the approved plans and specitications,applicable City approvals,and the
State E3uilding Code. This permit is I'or only the work described and does
not grant permission�or additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be eompied with whether or i�ot specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of thc date of issuance,or if construction is
suspended for a period of l80 days at any time atter work has conunenced.
The applicant is responsible for assuring all required inspcctions are
reques[ed in conformance with the State Building Code."1'his permit may be
revoked any time for due cause.
_ � 1 �� �� � /
Ap icant Permitee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
I S" / �/ �
ll/L/
City of Orono
Building Permit Applicatlon for Internal Work
(windows, doors, sidi , re-roof, etc.)
�� Permit number: r�0��-��.�.5
O�O�O CrysW Bay,MN 55323-0086 DaLe roceived: J���l��� �
SCr�eetAddnss: R��by� —T'�'� �
� � 2750 KeNsy ParkvreY Plen rovisw fee: '
Orono,MN 5�356 ,�`���02�
Total Fee: '
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This appOcatlo�torm must bs complstsd in fuM and aU requfred inbrmatfo�must be submit�ed.
Incompl�b appliatlons will b�roturn�d. (Pleese print)
GENERAL INFORMATION: ' , -� ,_ � _
Job Sta Addnss: � �'�- (�;�./ ; `
WIII thb b�s Parad�of HarMs.R«nod�N�s Shoviress�Honw or oth�r Dbphy Hom�? Y�s No
N y.s.e aW.�dd.,�.nc v�+���b��+��«+���r��+pr�r��a�ro a�s sNnc snufw a,s s.rvlcs wia ne
rep�N�d unN�ss�pp/�nx d�no�n�babs tt�llkNrK on.tMs pnklr►p fa avsNebls. Non-p�+►r�ktsd ewnts wi not bs eMoweC.
CONTRACTOR/APPLICANT INFORMATION:
Name: /t1;��/l S�'- oOf-, S�� 1.�►3�0(,.� LnC
state l.ioense# p O/p a 7 7 Expi�ation Date: p 3/3� a O�a.
l.e�d CertNicstbn Number: Expiretion Date:
(l�or w�orlc on hon�s tlat w�rs cvnstruo�plor 1�1l7d
��: �b 3-�a �-9�q� c�� 76 3 0�80- 13 � c��q
Maiiin9 Address: 5' �.�- c`f� c�tr• A'� v� ziP: 3 6 q
Cor�ct Peraon: /�n,y Ir'jndlS4� APP�nt is: / Homeowner �c�a.o�.i
Email andlor Fax: ')63 — y �7� QDO� --
PROPERTY OWNER W��RMATION' f z`"�^
Name: _.)�-, �C �t�✓ '
Phone(day):
a�r�: _ �q l ����� Q� city: ��y 4�,�e ziP:
EmaH and/or Fax
PROJECT INFORMATION:
Typ�at Pro� My�srth mov�nt m�y n4uin
❑D���) ❑R�wdsl ❑yy��amape I MCWD r+wNw 3 pMnits:
Minnehaha Creslc Wa�ershsd DisMct(MCWD)
� ❑Window(s) ❑Repair ❑Stortn Damage % 18202 MM1�e�onke BNd
� ❑Siding ❑RssLoratb^ ❑Ofher.(aped�Y) � ��^�MN 55391
V , Phone: 952-471-0590
(' 'Re-roof ❑Firo Dsmeps � Fax: 952-471-0682
www.m i n nehaha c ree k.orq
i
ONlf'SQ PrO��NCf��Ofi:
Estlmat�d Constructbn Valuaeton ot Pro�cc lucdudlnp land) i f �0� _ -
APPLICANT ACKNOYYLED�iEMENT:
i ,qpr,es�o provws aN Inl�onnttlo�nquk�d a roq�abd bY ths suUdirq�eperansnc:
'� � CertlBes that ths ir�onnation wPPfbd is Uue and correct to the best of hislt�er knowledye• The aPP�M�o9nizss that they
aro solNy rs�ponsibN for wbmittln�a�mpls�s aPD��^bsing aware that upon fdluro to do so, u,s sm�nas r,o a�ter�an�re �
� but to rojec:t ft uMN it is car��ls�e;
Some or aN d fhe iniartratlon lhtt y�ou aro adted L� provide on this applicatbn is dassHisd by Stete law as efthar private or
' ooMidentid. Privats dati is inbrtntfbn which fler�aMY cannot be given to the public but can be given t� the subjecx of the
� dets. Co�Adentld d�ta Is kdOni�tlOn Whk�h �neraMY Cannot be giren Uo eilf�the publfc or the sub�ct of the data. Our
I purpose and inbsnded we o(this iMortn�tion ie �o enn�Y uPdaos our reconls and recads of other govemmental agencies
� reQuired bY ItW I(YOu nWsA tiD stKK�Y Cte in�Orrt»tlOn fhe aPP��'►aY nOt be issued.
A►PPlicant's Signature: Date: _,�"�.1�y� �
�sc uvaa�sa: os-o�-zo»
� �� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.o -�4-3SsCOMPLETED
ADDRESS 7 9/ ��
OWNER TE PHONE N��3-�8l0'��
CONTRACTO ��'�Lt —
j: DESCRIPTION / �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED `SSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECQVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. � / �j � �
White Copyllnspector's File Canary CopylSite Notice