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Home My WebLink About2009-00342 - roofing-asphalt � • CITY OF ORONO PERMIT NO.: 2009-00342 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/22/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 744 DICKEY LAKE DR PIN : 27-118-23-33-0007 LEGAL DESC : RINGERSWOOD : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 15,800.00 NOTE: TEAR OFF/REROOF-ASPHALT APPLICANT pERMIT FEE SCHEDULE 280.25 HOME VALUE IMPROVEMENTS STATE SURCHARGE(VALUATION) 7.90 18330 GLADSTONE BLVD MAPLE GROVE, MN 55311- TOTAL 288.15 (763)425-9500 Minnesota State License#: 20464927 OWNER PETTIS, GERALD&ALICE 744 DICKEY 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 additionai 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 wi[hin 180 days of the date of issuance,or if construction is suspended ior a period o1'180 days at any time after work has commenced. 'I'he applicant is resp s� le for assuring all required inspections are requ conform ce ith the State Building Code.This permit may be r o d t any ti�' or e cause. � � � � Z � D�j � ,6 / O .� p icant Pe mi ee Signature Date Is ed 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: Permit number. 'Qv�.� PO Box 66 �Q Q�� Crystal Bay, MN 55323-0066 Date received: ��. �?�-� 1iI � ��.`, s, � Street Address: Received by: �� .,� � ��,, ��% 2750 Kelley Parkway Plan review fee: ��9��¢,� � Orono MN 55356 kESH�� 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: ��}� �d� �� 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 approva!60 days prior to the event. Shutfle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APP ICANT INFORMATION: Name: 1�`Pr.�� Tnn[Y��?t Wntl�.�s State License# �a y�,�{q�,� Expiration Date: � — �� _ 7��p Phone: .. _ office) _ — �j 3 cell Mailing Address: ( `� Cit : ZIP:$$ 3/ / Contact Person: ; ,�• Applicant is: Contractor Homeowner (Circle One) Email and/or Fax: .� '� � , � PROPERTY OWNER INFORMATION: ►vame: C'-��Q.�S..� -tr (��e ��-i 5 Phone (day): Address: "j c}a,� �� L,q. �Q City��nS (�,[�,t ZIP� � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel MCWD review&permits ❑Water Damage ❑Window(s) ❑ Re air Minnehaha Creek Watershed District(MCWD) p ❑ 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 orct Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ �� g� 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 informatio. ' to annually update our records and records of other governmental agencies re uired b law. If ou refuse to u I the ihfor a � n, the a lication ma not be issued. i � ApplicanYs Signature: �,(/l Date: ��Z Z -�C� Las±Updatec' 05-0�-200� � �� J --------- ' v��// _DAT� TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED �-aa o� � PERMIT NO.�DfJq-P�D.3�faL COMPLETED ADDR�SS� D r OWNER CONTR.�,� ��CJ�C.! �fvL1�1?1V, TELEPHONE NO. ��— 7/�-� Ua-D.� �' SP . .— � DESCRIPTION __ T�PC?h. �� G� �la �fj2�' � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILUNG Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL � J�� Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION � _ ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS �''t � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � � Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O �. � O � W � Q � Z W � W � � � d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contractor on site• � Inspector. ��,� / � � •� � ��c �� White Copyllnspector's File Canary Copy/Site Notice