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Home My WebLink About2010-00834 - roofing CITY OF ORONO PERMIT NO.: 2010-00834 � • 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �SSUED: 09/14/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 4650 CREEKWOOD TR PIN : 30-118-23-33-0006 LEGAL DESC : PAINTERS WOODS : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 15,000.00 NOT�: TEAR OFF RLROOF-ASPHALT SI IINGLES APPLICANT PERMIT FEE SCHEDULE 265.50 PROVIDENCE CONSTRUCTION STATE SURCHARGE(VALUAT[ON) 7.50 16850 144TH STREET N MARINE ON THE ST CROIX, MN 55047- TOTAL 273.00 (612)590-6930 PAID WITH CC# 9386 Minnesota State License#: 20626630 OWNER BJORK, KEVIN &LORI 4650 CREEKWOOD TR MAPLE PLAIN, MN 55359 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall bc performed according to the approved plans and specitications,applicable City approvals,and thc 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 governing this type of work shall be compied with whcther or not specified herein.This permit will cxpire and become null and void if construction authorized is not r conunenced within 180 days ofthe date of issuance,or iCconstruction is suspended for a period ot�I 80 days at any time after work has commenced. "I�he applicant is responsible for assuring all required inspections are requcstcd in confomiance with the State Building Code.This permit may be revoke any time for due cause. � � � � � ��U / � / �� Applicant Permi Signature Date Iss e y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. = - City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.j Mailrng Address: Permit number: aU �U —UO� /g,O,�.O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: �� p ,� ;� �, Street Address: Received by: '�',F, 4 �'� �ti 2750 Kelley Parkway Plan review fee: l.�k�Hog,� Orono, MN 55356 -- Total Fee: p�`��, (� Main: 952-249-4600 Fax: 952-249-4616 v,nn�w ci orono mr 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: �f f�5p C��,��r� "�rzul Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [�,No If yes,a specia/event permit is required with Police Department and City Council approva/60 days prior to the evenk Shutt/e bus service wiU be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/ PPLICANT INFORMATION: Name: ,rc�, c�v�c,.z ,-n � -�. �.�-� State License# Zv� �� Expiration Date: �3� u, l Phone: � t � � � �- � office cell Mailing Address: l(,,�sv �c.{.�(}-� c�{- N , City: ' Y'1� ZIP: � , �`",L��- Contact Person: _,�� Applicant is: � c o / Homeowner (Circle One) Email and/or Fax: �n{'c, Ty'��,�y�c�.. � C'_ � illt�' PROPERTY OWNER INFORMATION: Name: �, � � � Phone(day): �'1�` Z �"� '3 `Z � Address: '—� SG L�'.-�k�� '��rc., 1 ��ty� D rTrnc . �fJ�Z1P:.5�.?iS�� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8�permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Re-roof ❑ Fire Damage www minnehahacreek.crq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ jrj F�p 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 public 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 to su 1 the information,the a lication ma not be issued. ApplicanYs Signature: , Date: , �J . 01�? Last Updated: 05-04-2009 � - 1 C, ,�� P�- . � ATE �� TIME CITY OF ORONO ALLED IN INSPECTION NOTICE /'J Q . scHE�u�Eo �� PERMIT NO. 1 I (.%��/ .COMPLETED ADDRESS " � � ��i� OWNER .a TELEPHONE NO. � ��V��' CONTRACTOR �� U� � `� >': DESCRIPTION " `" "� � � lL ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS � O ❑ 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 INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z w � w � � GW ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� Owner/Contractor on site• Inspector. L'� �� White Copyllnspector's File Canary CopylSite Notice �Q�,•� 7 V! // ' V` � .r��i � p�Tc TIME V CITY OF ORONO CALLED IN � INSPECTION NOTICE b], SCHEDULED -� _/� _�� PERMIT NO. o10/D—DOOiJ�COMPLETED ADDRESS ��SO � �r OWNER TELEPHONE NO.��a S�D �09�� CONTRACTOR �DU/��Q�Q , �� DESCRIPTION �� `�' ' � 11� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ 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: � W a � J O � � O � W � Q � Z W � W � � GW �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W{LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspectiQn 24 hours in advance. �952� 249-46�0 Owner/Contractor on sit . Inspector. / l�� v White Copyllnspector's File Canary CopylSite Notice