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Home My WebLink About2009-00523 - roofing �. - . CITY OF ORONO PERMIT NO.: 2009-00523 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: O8/25/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 1115 COX FARM RD PIN : 27-118-23-32-0016 LEGAL DESC : SHADOWOOD FARM : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOF[NG-ASPHALT VALUATION : $ 11,000.00 APPLICANT PERMIT FEE SCHEDULE 206.50 BRAD'S ROOFING LLC STATE SURCHARGE(VALUATION) 5.50 12310 CROWN HILL CT BURNSVILLE, MN 55337- MISC FEE 0.00 (612)839-7533 TOTAL 212.00 Minnesota State License#: 20634042 OWNER KOSTIAL, BRADFORD& SARAH 1]15 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 specifica[ions,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 goveming this type of work shall be compied with whether or no[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 a[any time after work has commenced. The applicant is responsible r assuring all required inspections are request n co formance h[he State Building Code.This permit may be revo d [an e for cause. / / / / A plicant it ignature Date Issued By Si ture Da - SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCR[BED AB t � � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) � Mailing Address: ! Permit number: �4v�,�j\ PO Box 66 �� Crystal Bay, MN 55323-0066 Date received: � s;:__,, �� ,�s-';� s,';I Sfreet Address: Received by: �' 2750 Kelle Parkwa �'�' „ �' `�. o'` � Y Y Plan review fee: t9,kESH�� 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: �rf� �� L�n-- '�Zt� 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 Counci/approval 60 days prior to the event. Shuttle bus service wrl'�I be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �'(Z.b��S ��'iN � C�-c' State License# ��i�(� 3yv�l� Expiration Date: �-3i -/� Phone: (office) �l:�-?331-7"S` -� � (cell) Mailing Address: /a3lO �2Uu�,u j-1� : i City: C��;�v�S`v�cc.E' ZIP� .5�5 3y�_ Contact Person: �� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: � 12-r4a7 �T/!9� Phone (day): 5„� — 7 — -�b Address: /IIS CD�C �',�c. �Z� City: Q�yLtrj�p ZIP� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel MCWD review&permits ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair I ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Re-roof Fax: 952-471-0682 ❑ Fire Damage i www.minnehahacreek.ora � Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ ��'�,,� 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 al� 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 public but can be given to the subject of the � data. Confidential data is information which generalfy 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 to su I the information, e a lication ma not be issued. ApplicanYs Signature: Date: �j '—� �r�9 � Last Updated: 05-04-2009 - D� TIME CITY OF ORONO CALLED IN INSPECTION NOTICE 2 SCHEDULED - - PERMIT NO. ��) COMPLETED ADDRESS �«� �C2�� /�' OWNER CONTR. ��I TELEPHONE NO. � � a ��3�- 753 3 � DESCRIPTION ` �� O� / � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O a � O � W � Q � Z W � W � � d � ' WORK SATISFACTORY:PROCEED C i PROJECT COMPLETE W ❑ ORRECT WORK 8�PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: tnspector. c_.-l� '7 .� / \� White Copyllnspector's File Canary CopylSite Notice