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Home My WebLink About2011-01409 - roofing ' � CITY OF ORONO PERMIT NO.: 2011-01409 2750 KELLEY PARKWAY ORONO, MN 55356- DA7'E �SSUE�: 1U07/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1760 CONCORDIA ST PIN : 17-117-23-22-0027 LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,170.00 NOTE: VALUATION OF PERM['I':$6170.33 ROOFING PERMITS ISSUED WI1'I IOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 147.50 SIMON CONSTRUCTION 12366 RIVER RIDGE ROAD STATE SURCHARGE(VALUATION) 3.09 BURNSVILLE, MN 55337- MAIL-IN FEE 2.00 (612)861-7000 TOTAL 152.59 Minnesota State License#: 20593656 PAID WITH CC# 1521 OWNER WOLD, MR& MRS 1760 CONCORDIA ST WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not gran[pennission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 date of issuance,or if construction is suspended for a period of l80 days at any[ime after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be rev � any time for d cause. � � � � � � / i � � �� V � '�t��'L / li i / licant Permitee ignature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NOV-07-2011 14: 15 From: 6785736615 To:9522494616 Pa9e: 1�1 � C�ty of �rono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit numbe�: :��'i/- �'� '� O.�Q �1�O PO Box 66 `w Crystal Bay, MN 55323-0066 Date received: �� Street Address.� Received by; - � ! � � 2750 Kelley Parkway Plan r'eview fee� t,,��o�i Orono, MN 55356 �—� ��C, Total Fee: ` � -� , �-J/ Mein; 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 INFORMA710N: /► / Job 5ite Address: f7 (_,�vt-Grx `�- Will this be a Parade of Homes, Remodelers Showcase Home or othe�Display Home? Yes ,� No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the evenk Shuttle bus service will be required unless applicant demonstrstes sufficient on�ite parking is avallable, Non permitted events will not be allowed. CONTRACtOR/APPLICANT INFORMA710N: Name: � ,� �n. vr� C.�+� State License# �0 S9 . 6 S�a Expiration Date: 9 2 Lead Ce�tification Number; Expiration Date: (for work on homes th t were constructed prior to 1978 Phone: �/2 � $ j- 7ooe (office) (cell) Mailing Address: /�-�(o(o �� '�.� City; ��s�� ZIP: ;�5�� _ Contact Person: � � Applicant is: Contractor / Homeowner (Circle One� EmailandbrFax: �n� ,� S�r�,��,rc��e� �-e �.�-- PROPERTY OWNER INFOR ATION: � Name; �,.��+2 L✓o Phone (day): 9SZ- 7/� 7 Z8 / Address: d ,L �� City: „L� ZIP: S`�' 3 � Email and/or Fax PROJECT IN�ORMATION: Type of Project; Any earth movement may require MCWO�eview g permits: ❑Door(s) ❑ Remodel ❑ Fire Oamage Minnehaha Creek Watershed District(MCWD) .[+]�Re-roof, asphalt [�epair [�Storm Damage 18202 Minn�tonka Blvd Deephaven, MN 55391 ❑ Re-roof, cedar ❑ Restoration ❑Wat�r Damage Phone; 952-471-0590 ❑Re-roof,other(specify) [�Siding ❑ Other. (specify) Fax: 952-471-06$2 ❑Wndow(s) ' www•minnehahacreek.orq Overall Project Description: �"�✓-p�F � ��/D� Estimated Const�uction Valuation of Project texcluding land $ ! D - � 3 APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; . Certifies that the information supplied is true and wrrect to the best of his/her knowledge. The applicant recogn¢es 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 p�ovide on this application is classified by State law as either private or cnnfidential. Private data is information which generally cannot be given to the public but can be given to the subject of thg data, Confidential data is informaiion which generally cannot be given to either the public or the subjed of the data. Our purpose and intended use of this information is to annually update our records end records of other governmental agencies re uired b law. If ou refuse to u I the information,the a lication ma not be issued. . . ., ,. ., ... n G,l � �^�,.- �l/�� /� // D � TIME CITY OF ORONO CALLED IN INSPECTION NOT n �f SCHEDULED � -�2�� PERMIT NO L/ r COMPLETED ADDRESS �7�U �.L�� i'L� OWNER TEL PHONE NO� -°2�`5�v �✓� CONTRACTOR � - �� - � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALI ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL O FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � � GW ❑WORKSATiSFACTORY:PROCEED �OJECTCOMPLEfE � ❑CORRECT WORK&PROCEED i�' ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. � �'� � White Copyllnspector's File Canary CopylSite Notice