HomeMy WebLinkAbout2009-00383 - roofing CITY OF ORONO PERMIT NO.: 2009-00383
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 07/07/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 735 DICKEY LAKE DR
PIN : 34-118-23-22-0007
LEGAL DESC : RINGERSWOOD
: LOT 003 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT D�� ��,Q�
VALUATION : $ 22,677.00
APPLICANT PERMIT FEE SCHEDULE 383.50
HOME VALUE [MPROVEMENTS STATE SURCHARGE(VALUATION) 11.34
13756 REIMER DR TOTAL 394.84
MAPLE GROVE, MN 55311-
(763)425-9500
Minnesota State License#:20464927
OWNER
SKOOG, PAUL& SHERRY
735 D[CKEY LAKE DR
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 d s of the date of issuance,or if construction is
suspended f�a period f 0 d a[any time after work has commenced.
The applic2�nt is responsi e r assuring all required inspections are
re u conforma ce rth the State Building Code.This permit may be
r voked any ti or c}tie use.
� � r7 � 8�
1 �� i i
i ant Per itee Signature Date Issued By i nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED AB .
City of Orono
• Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
���,_ Mailrng Address:
PO Box 66 Permit number:
' � ��� Crystal Bay, MN 55323-0066 Date received: `�
� � 0' 2
��a �'���-�`�; a�� Street Address: Received by:
`�'� � � �� ' 2750 Kelley Parkway Plan review fee:
L`�.%ESH�/ 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. (Please print)
GENERAL INFORMATION:
Job Site Address: �S �1 " �`� e �Q�r �j rj 35 `
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
/f yes, a special event permit is required with Police Deparfinent and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/AP`�PLICANT INFORMATION:
Name: �C7VY�� t�0.-� �W�LYtO c�� yY1�v`�S
State License# 2oiFlr49 �.'1 Expiration Date: �-3 1 - 201d
Phone: (03- 3 I - 4 (office -i-!2,5 -4�5� cell)
Mailing Address: �� Ci ZIP: � 1�
Contact Person: ; Applicant i . Contra tor / Homeowner (Circle One)
Email and/or Fax: .�(��� e � �p
PROPERTY OWN 1NFORMA N:
Name: � t ��C'� S�a�
Phone (day):
Address: ��j35 �C � x Q City: �,�(�t ZIP�SS�jrj (o
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
verall Project Description:
Estimated Construction Valuation of Project(excluding land) $ � n`j '1
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 thi information � annually update our records and records of other governmental agencies
re uired b law. If ou ref u I the i orma on, e a lication ma not be issued.
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ApplicanYs Signature: (�f/� Date: 7� ���
Last Updated: 05-04-2009