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Home My WebLink About2014-01181 - re-roof (expired) CITY OF ORONO * z 0 1 4 - 0 1 1 s � ' 2750 KELLEY PARKWAY DATE ISSUED: 10/10/2014 , ORONO, MN 5_5356- ' (952) 249-4600 FAX: (952) 249-4616 ADDRESS . 3393 CRYSTAL BAY RD PIN : 17-1 17-23-44-0020 y� i fe,� �� "l LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B ��t� : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING - ASPHALT ACTIVITY : O/S BU[LDING - UNDEFINED VALUATION : $ 4,978.36 NOTE: VALUATION OF PERMIT: $4,978.36 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TGnR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE. PRIOR TO WORK BEING STARTED) MUST PROVIDG COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NO'T'BE [SSUED. SIGNS-ADVERTISING SIGNS MAY ONLY F3F_,ON THE PROPERTY DURING THE TIME THE ROOF IS BEfNG DONE. ONCE WORK[S COMPLETED THE SIGNS MUST BE REMOVGD. APPLICANT PERMI I FEE SCHEDULE 118.00 STATE SURCHARGE (VALUATION) 2.49 VIKING CATASTROPHE SERVICES TOTAL 120.49 307 GREENHILL LANE Payment(s) LONG LAKE, MN 55356- (952)681-9822 CHECK 2687 120.49 Minnesota State License#: BUIL-RR667769 OWNER JOHNSON, MATTHEW 3393 CRYSTAL BAY RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed accordine to the approved plans and specifications,applicable Cit�approvals,and the State Building Code. This permit is for only the work described and does not grant pennission for additional or related work�vhich requires separate permits. All provisions of laws and ordinances governing this type of worh shall be compied with whe[her 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 inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for du cause. f , � '(� � �/i � ( ( l 1� '�.,^ 1 , t i 1',. � � r�� < A li t ��i e. i n tu e ate � Pp g Issued B��Signature Date City of Orono �c��l Bui�ding Permit Application for Maintenance / Replacement / Renovation � ' (No structural expansion. Onfy windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: yF 1 � 2750 Kelley Parkway Plan review fee: �' Orono, MN 55356 `�'rESH�� 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. Incompiete appfications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: �� j � ��-y 5�� ✓�y�� /c�/�. Will this be a Parade of Homes, Remodelers Showcase Home or other Dispfay Home? ❑ Yes No !f yes, a special event permit is required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is availabfe. Non-permitted events will not be allowed. CONTRACTOR/APPL CANT INFORMATION: Name: /'' �, , ��,.�g G %��6� 3f7'"� �GcL �v"d� ('�'�� State License# �� ,-� :�2 7 i Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) �� 1; (office) Maifing Address: �f>% G�r�-��',�1 tfI� � �'� City: ��j,�jl�,��- ZIP: �3� - - Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: � 7_ ` , q..�a.4- � ,� f�;.x•: - ('�: /� _ f' �,�� PROPERTY OWNER INFORMATION: Name: �2�1 �tif f��' �t)L,�,v� �:?✓► Phone (day): � , y- �D 1 �7 5�D / Address: /`"(��Z � �r:�.,c ;��,-�- r�✓� City: �s.��/z,w•f2� ZIP: �j�17�� Email and/or Fax: PROJECT INFORMATION: Overall project description: i ype of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: �Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Vafuation of Project (excluding iand) $ �/ 5 �� . 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 applicant recognizes that they are solely responsible for submitting a compiete 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 infor ation which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this info mation is to annualfy update our records and records of other governmental agencies required by law. If ou refuse to su I th inf ' n, the a lication ma not be issued. i App(icant's Signature: y � Date: ' � Own�r's Signature: Date: Last Uoaatea 03/06/20^3