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Home My WebLink About2010-01079 - roofing • CITY OF ORONO PERMIT NO.: 2010-01079 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuED: 1UO3/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 744 DICKEY LAKE DR P1N : 27-118-23-33-0007 LEGAL DESC : RINGERSWOOD : LOT 004 BLOCK 001 VERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 15,000.00 NOTE: TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 265.50 COMPAN[ON CONSTRUCTION STATE SURCHARGE(VALUATION) 7.50 3305 HARBORLANE N PLYMOUTH, MN 55447- TOTAL 273.00 (952)836-4806 Minnesota State License#: 20638527 OWNER PETTIS, GERALD& ALICE 744 DICKEY LAKE DR LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT Thc work for�chich 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 goveming this type of wark 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 I 80 days at an}�time after work has commenced. "I�he applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at a time for due cau . �"-, � _ � �� ,...�` /� Applicant Pcrmitee Signature Date �� % Issu 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: � � �� O�,�,�. PO Box 66 Permit number: �L� /D�� Q Crystal Bay, MN 55323-0066 Date received: / � � l �1 �,,,�� `-�� - � Received b � a,� � ,, Street Address: y� �'�,n A�, G~ 2750 Kelley Parkway Plan review fee: �9XESH04'� Orono, MN 55356 � Total Fee: � ��j� (�C� 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: �' • � �� ,:� ��' Will this be a Parade of Homes, emode ers howc se Home or ot er Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Department an 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 6e allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �on� n I �c;,-.� ��'or�, �'��-< <� �_- �/_ l� % � State License# ''o `�>�=�- h Expiration Date: Phone: �S Z- ;��' - �-,/ v� (office) 7�'3-- �� 7- �.�6d�S (cell) Mailing Address: S 3�S � J .,' 7-//� Cit : � �;�fh ZIP: �S �� Contact Person: ��, � ;�,' Applicant is: ntra / Homeowner �c�r�ie o�e� Email and/or Fax: PROPERTY OWNER INFORMATION: Name: � C'r � � �'r' 1T Il�� Phone (day): � �f--��,� - �,J �j Address: �5�`�/ /��",� �� ., /�` o,� .� � CitY�� L-4��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 e-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ /.��n � C� 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 information,the a lication ma not be issued. ApplicanYs Signature: Date: ��`.S �,� �j/ � Last Updated: 05-04-2009 �0 V V ATE TIME ( � CITY OF ORONO LLED IN d� � �� `� INSPECTION NOTICE SCHEDULED �� D __� PERMIT NO.a°�°--��`� COMPL�ETED ADDRESS � � OWNER TELEP O E NO.�-S�-�3� �� CONTRACTOR �L >; DESCRIPTION � � ll� ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS ti Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O �. � O � W � Q � Z W � w � � � 4�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-46�� OwnerlContractor on site:. Inspector. �- ;...� �-~ j�=3�5 White Copyllnspector's File Canary CopylSite Notice