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Home My WebLink About2010-00623 - roofing . CITY OF ORONO PERMIT NO.: 2010-00623 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 07/26/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 900 DAKOTA AVE PIN : 26-118-23-33-0018 LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE : LOT 003 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 14,500.00 NOTE: TEAR OFF RF,ROOF APPLICANT PERMIT FEE SCHEDULE 265.50 ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUATION) 7.25 5145 INDUSTRIAL ST SUITE 103 TOTAL 272.75 MAPLE PLAIN,MN 55359 (763)479-8700 Minnesota State License#: 20631574 OWNER RUTTER, GREGG 900 DAKOTA AVE 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 specitications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additionai or related work which requires separate permits. All provisions of laws and ordinances governing[his type of work shall be compied with 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 atter work has commenced. The applicant is responsible for assuring all required inspections are requ ted in c nformance with the State Building Code.This permit may be rev d�n me f due ause. � 2� � i�� /U Applicant Per i e ature � Date Is u 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: �ylL�__ �J�� ,�,� PO Box 66 Permit number: Q Vil Q Crystal Bay, MN 55323-0066 Date received: / �-(p /a � � r�'�,��d;, �, I Street Address: Received by: A�, ��' 2750 Kelley Parkway Plan review fee: �t`�gEs�o�`'� Orono, MN 55356 � � Total Fee: a�7�p �5 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: �� ` � U �J1 • �.i� Will this be a Parade of Homes, Remodelers Showcase Home o other Display Home? ❑ Yes o If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus seivice will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wil!not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: (,or�S�.J�,t1 v� State License# D� 3 i S � Expiration Date: Phone: �'( � ?w office � cell Mailing Address: �,�y� ��.t��;,�.t, s;• City:`n v�Rw�,tii ZIP: 5 �5�9 Contact Person: �n��C,F ��(I�'� Applicant is: n rac Homeowner (Circle One Email and/or Fax: "�j('p 3.� y ��j� (,�o� PROPERTY OWNER�INFORMATION: Name: (�(�� " Phone (day): � Z ( �— J �y Address: _�( oo �64�K'.a� � � City:Qi2-�l`,c� 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: � Estimated Construction Valuation of Project(excluding land) $ � , S'U U� _i 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; s • 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 refu to s I the inform tion,the a lication ma not be issued. ApplicanYs Signature: ! Date: � ' Z �" �� Last Updated: 05-04-2009 `