HomeMy WebLinkAbout2010-00610 - roofing �` CITY OF ORONO PERMIT NO.: 2010-00610
• 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuED: 07/22/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 940 DAKOTA AVE
PIN : 26-118-23-33-0016
LEGAL DESC : JOHNSTONS RGT ALBEES LONG LAKE
: LOT 001 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 11,930.00
APPLICANT pERMIT FEE SCHEDULE 221.25
SELA ROOFING& REMODELING, INC. STATE SURCHARGE(VALUATION) 5.97
4100 EXCESIOR BLVD
ST. LOUIS PARK, MN 55416- MISC FEE 0.00
(952)915-7227 TOTAL 227.22
Minnesota State License#: 0001050
OWNER
ARNE, GERALD& KARLA
940 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 specifications,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 governing this 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 da s of the date of issuance,or if construction is
suspended for a p 180 days at any time afrer work has commenced.
The applicant i �`sp ible r as ing all required inspections are
requested in c fdr a ce it e State Building Code.This permit may be
revok t a tim f r e se. �7
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A pl er � e Signature Date Issued By ' nature D
SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABOV .
,. City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
4v�,� PO Box 66
Crystal Bay, MN 55323-0066 Date received:
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a � e�;�. �, Street Address: Received by:
�'�,n ' '9� �� 2750 Kelley Parkway Plan review fee:
�`�kEsxo4`� 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. (P/ease print)
GENERAL INFORMATION: �
Job Site Address: C��� ��C����� �'��
Will this be a Parade of Homes, Remodelers Showcase 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 will be
required unless appficant demonstrates sufficient on-site parking is available. Non-permitted events will not be alfowed.
CONTRACTOR/APPLICA�I T INFORMATION: ,�
Name: '
State License# Expiration Date:
Phone: � office cell
Mailing Address: U C' U�'t- (./f� Cit : ZIP: `i �
Contact Person: � t� Applicant is: ontractor Homeowner (Circle One)
Email and/or Fax: -
PROPERTY OWNER INFORMATION: �
Name: yZ�' /�/� '
Phone (day): /� f (
Address: � Cit : ��',�J ZIP: �,3,�'0
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.orq
Overall Project Description:
_ Estimated Construction Valuation of Project(excluding land) $ � �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 s e information, the a lication ma not be issued.
Applicant's Signature: Date: � �� �
Last Updated: 05-04-2009
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CITY OF ORONO CALLED IN L�
INSPECTION NOTICE SCHEDULED / v
PERMIT NO. MPLETED
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OWNER TELEPHONE NO. o ' .�7Z -3
CONTRACTOR —
�: DESCRIPTION
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y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W� ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
Inspector. ��-� ` ��� �
White Copyllnspector's File Canary CopylSite Notice
� ' ��� TE� TIME �/
CITY OF ORONO CALLED IN 7 �//D "��
INSPECTION NOTICE SCHEDULED ����(l�
PERMIT NO�/D���� COMPLET
ADDRESS %�� � � �2�
OWNER TELEP NE NO. 5� `��� �'�
CONTRACTOR
�: DESCRIPTION
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ,-7 CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46�0
OwnerlContractor o
Inspector.
ite Copyllnspector's File Canary Copy/Site Notice