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Home My WebLink About2011-01427 - roofing ` CITY OF ORONO PERMIT NO.: 2011-01427 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE Iss[1E�: 1U10/20ll 952 249-4600 FAX: 952 249-4616 ADDRESS : 980 COX FARM RD PIN : 27-118-23-33-0012 LEGAL DESC : SHADOWOOD FARM : LOT 009 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 16,138.33 NOTE: VALUATION OF PERMIT: $16138.33 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR"fEAR OFF INSPECTIONS. (WG REQUIRE 24-48 NO"I'ICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SE7'OF PICTURES OR A FINAL[NSPECTION 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 295.00 SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 8.07 12366 RIVER R[DGE ROAD BURNSVILLE, MN 55337- MISC FEE 0.00 (612)861-7000 MAIL-IN FEE 2.00 Minnesota State License#: 20593656 TOTAL 305.07 PAID WITH CC# 1521 OWNER WILLSON,CHRIS& SARAH 980 COX FARM RD LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and [he S[ate f3uilding 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 commenced 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 inspec[ions are requested in conformance with[he State Building Code.This permit may be revoked at any time for due cau C� ( ' �� ' ' � c° �% �_r;u�— �� o � i� Applicant Permitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NOV-10-2011 08:05 From: 6785736615 To:9522494616 Page:1�1 t � City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mar'ling Address: Permit number. c��//-�/ 7 O�,�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: / - /D - � � a, Str�etAddress: Received by: ��' 2750 Kelley Parkway Plan review fee� �y��.xo¢O Orono, MN 55356 � Total Fee: �D 5. O� Main: 952-249�600 Fax; 952-Z49-4616 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 printJ GENERAL INFORMATION: �, Job Site Address: � dQ,r'vi� Will this be a Parade of Homes, Remodelers Showcas� Home or other Display Home? ❑Yes o lf yes,a special event permit is requtred with Police Department and City Council approval 60 days prior to the event. Shuttle bus s ice wi/l be requfred unless applicant demonstrates su�clent on-site park/ng is available. Non-permitted events w/ll nof be ellawed. CONTRACTOR/APPLICANT INFORMA710N: Name: �$ ,�vw�n �6�u�rL.�� State License# �q��,�_�( Expiration Date: y f�� Lead Ce�ification Number: Expiration Date: � (for work on homes that were constructed prfor to 1975 Phone: ��- '�oD� (office) (cell) Mailing Address: �` �;,P„� ��6 �.�,�_ City: �� ZIP: 5�33 � Contact Person: ,�J .��,�� Applicant is: on �ct� / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: Gl�,r`rs G✓�'�L J'n 7 Phone (day): �� _ 3g��.8�� ' Address: qg D C� �,�M ��. City: Ql�r� ZIP: S'"'s' 3,S'� Email and/ar Fax ' -' PROJECT tNFORMATION: Typ�of Project: Any earth movement may requlre ❑ Door(s) ❑ Remodel ❑ Fir Damage MCWD review 8 p�rmits: Minnehaha Creek Watershed District(MCWD) [�e-roof,asphalt ❑Repair Storm Damage 18202 Minnetonka Blvd � ❑Watsr pamage Deephaven, MN 55391 ❑ Re-roofi, cedar estoration Phone� 952-471-0590 ❑ Re-roof, other(specity) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek ora Overall ProJect Description: Estimated Construction Valuation of P�oject(excluding land) $ / , 3 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 applicent recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altsrna6ve but to reject it until it is camplete; • Some or all of the information th�t 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 giveh to the subject of the data. Confid�ntial daia is Information 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 and records of other gov�rnmental agencies re uired b law. If ou refuse to s . I th�informati the a lication ma not be issued. Annliranf'eCinn�+��ro l _\ � 1� � r�,.i... f� / �U J�