HomeMy WebLinkAbout2010-00967 - roofing - cedar CITY OF ORONO PERMIT NO.: 2010-00967
2750 KELLEY PARKWAY
.
ORONO, MN 55356- �ATE lssuEn: 10/08/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 750 DICKEY LAKE DR
PIN : 27-1 18-23-33-0008
LEGAL DESC : RINGERSWOOD
: LOT 005 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -CEDAR
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 32,600.00
APPLICANT PERM[T FEE SCHEDULE 499.00
ALL SEASON REMODELING & EXTERIORS STATE SURCHARGE(VALUATION) 16.30
17344 PUMA ST. NW
RAMSEY, MN 55303 MISC FEE 0.00
(612)221-3318 TOTAL 515.30
Minnesota State License#:2038831 1
OWNER
PETERSON, GARY& DIANA
750 DICKEY LAKE DR
LONG LAKE, MN 55356
AGREEMENT AND SWORIV STATEMENT
The work for which this permit is fssued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Quilding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
pennits. All provisions of laws and ordinances governing this type of work
shall be compied�vith whelher 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� any time alter work has commenced.
'1'he applicant is res onsible for ring all required inspections are
requested i onfo nance th e State Building Code.This permit may be
revoked ny ' c fo ue� se.
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A licant ermitec Signature Date Issued S gnature Date
SEPARATE PERMITS REQU[RED FOR WORK OTH THAN DESCRIBED AB VE.
City of Orono
. Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
�,0,�. PO Box 66
O � O Crystal Bay, MN 55323-0066 Date received:
�'��" Received b
,a ���'��;e'�� s. Street Address: y�
�'�c,�` ` °A" ����' 2750 Kelley Parkway Plan review fee:
`�kEsxoti`' 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: � � �;�,�c � ,� ��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes, a special event permit is repuired with Po/ice Department and City Council approva/60 days prior to the event. Shutt/e bus service will be
required unless applicant demonstrates sufiicient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APP/�ICANT INFORMATION: 1
Name: _ I'y'�� �G��.� mv�,�«.�_�K�e�,3 �<L
State License# �-t,,���jr/ Expiration Date: 3- �r
Phone: i� 9q �j office) cell
Mailing Address: � 7;,3�i�/ ���a St .vw City: A.�,�-y ZIP: � 3�3
Contact Person: �,�,�,� 5������,r Applicant is� rac / Homeowner (Circle One)
Email and/or Fax: � � i�,ld4��s�s�>h �Jc�,�,cu sf.ti•�T
PROPERTY OWNER INFORMATION:
Name: `r<,��7 !'�'e �;3��,
Phone (day): ys� y ��d�,�
Address: 5,�� City: ZI P:
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.or
Overall Project Description: r ;Zc�G ,5 S" �,:�f- /c, -� ���
Estimated Construction Valuation of Project(excluding lan �� ,Sv�
,
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 th nformation e a lication ma not be issued.
ApplicanYs Signature: Date: !D '-��U
Last Updated: 05-04-2009
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CITY OF ORONO CALLED IN �0^��
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PERMIT NO. D D�/ IY� COMPLETED
ADDRESS /�� D�C��� �� Id"�-/
OWNER C�TE,L,E,PHONE NO. ��Z �� lla`
CONTRACTOR 4 l�CC '�U 1''�
>; DESCRIPTION ���lL�'t ���
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Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ' ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMB�NG RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CAII INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
� ' ` ��AT TIME ✓
CITY OF ORONO CALLED IN �
INSPECTION NOTICE Q SCHEDULED �0 ID _��
PERMITNO.a�O/Dr'DOT�� COMPLETED
ADDRESS ��O .I.�/C�-�N � �Yl./
OWNER TELEPHONE NO.IO�Z"ZZ � — 33�O
CONTRACTOR ��� SC�4.S4Y� �]'�"
>; DESCRIPTION �a� � � ��"`''-` S�Q�Q�
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� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y
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
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0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (J52� 249-4600
OwnerfContractor on site:
Inspector. ��Gl���
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White Copyllnspector's File Canary CopylSite Notice