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Home My WebLink About2009-00550 - roofing � � ' CITY OF ORONO PERMIT NO.: 2009-00550 2750 KELLEY PARKWAY ORONO, MN 55356- oATE Iss[7ED: 09/04/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 135 CRYSTAL CREEK RD PIN : 33-118-23-33-0004 LEGAL DESC : CRYSTAL CREEK : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S `'�"'�� VALUATIOIY : $ 12,400.00 NOTE: TEAR OFF REROOF APPLICANT PERM[T FEE SCHEDULE 236.00 NEW LIFE CONTRACTING STATE SURCHARGE(VALUATION) 6.20 8030 OLD CEDAR AVE#119 BLOOMINGTON, MN 55431- TOTAL 242.20 (651)224-3442 PAID WITH CC# 0000 Minnesota State License#: 20249486 OWNER GOODWALD,JERRY& LORAINNE 135 CRYSTAL CREEK RD LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permi[is issued shall be performed according to 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[permission for additionai or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied wi[h 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 180 days at any time after work has commenced. The applicant is resp sible for assuring all required inspections are requested in confor nce with the State Building Code.This permit may be revok d at any[im r d cause. ,,,.._ °r , Y , Z�os , b Appl cant Permitee Signature Date Issu d By 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.) Mailing Address: pQ q—QQ��O ��,�.� PO Box 66 Permit number: �� ,,, �� Crystal Bay, MN 55323-0066 Date received: g� p `��r. �� ,a ��,;� �, ' Street Address: Received by: �'.�n � '� '" G� 2750 Kelley Parkway Plan review fee: L`�kE`sxo4`'� Orono, MN 55356 - Total Fee: a !�( p� .�d 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: � � � ��'�- ST r�-�C� C�2_�i�l�-- Will this be a Parade of Homes, Remodelers howcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ill be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATI �I: Name: �� ' �� J�`� r �( ��L-G� S l�`�� State License# '� Expiration Date: '�' Phone: �'�( office (�- cell Mailing Address: -,� �Uvv� Cit : ZIP: �� — Contact Person: � - " Applicant is: ontra r / Homeowner �c�r�ie o�e� Email and/or Fax: - �y=-l�v�j PROPERTY OWNER I�EORMATIOI� Name: �, (9(}�^(,J✓-�L Phone (day): - � -r'� Address �� Cit :��l� ZIP: � � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&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.orq Overall Project Description: ,�,`�p��`�� C)r,`7 Estimated Construction Valuation of Project(excluding land) $ � 6�j � 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 I the informat� n,the a lication ma not be issued. , A licant's Si nature: ��--�- � Date: � ��J�� PP 9 7 Last Updated: 05-04-2009 DATE TIME �/ CITY OF ORONO CALLED IN INSPECTION OTICE c— SCHEDULED PERMIT NO. -C�SJ�OMPLETED �v�� ADDRESS I 3 � C �`f �t� � Cje� lC OWNER CONTR. N�� -'� TELEPHONE NO. � DESCRIPTION ��L L F � '~`� � � � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. O �_� �"(> l Z S L�S f�'� � J�.i� � �� •� �� 0 � w � Q � z W � W � � d W� ❑�WORKSATISFACTORY:PROCEED ��iOJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: / Inspector. White Copyllnspector's File Canary CopylSite Notice