HomeMy WebLinkAbout2011-01218 - roofing CITY OF ORONO PERMIT NO.: 2011-01218
" 2750 KELLEY PARKWAY
� ORONO, MN 55356- �AT�1SSU�D: 10/10/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 4030 ELM ST
PIN : 06-117-23-41-0072
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 000 BLOCK 008
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOF[NG-ASPHALT
ACTIVITY : O/S BUILD[NC -UNDEFINED
VALUATION : $ 12,200.00
NOTE: VALUATION OF PERMI7': $12,200.00
ROOFING PERMII'S ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR"IO
WORK[�EING S"CARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVF RTISING SIGNS MAY ONLY BE ON THE YROPERTY DURING THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPI,E'CED TFfE SIGNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 236.00
WEATHER-TITE EXTERIORS STATE SURCHARGE(VALUATION) 6.10
1984 QUINBALEE RD
DEPERE, WI 541IS- TOTAL 242.10
(704)577-5901 PAID WITH CC# 5779
Minnesota State License#: 20638654
OWNER
ROSCOE, MR& MRS GEORGE
4030 ELM ST
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
"I he work for which this permit is issued shall be performed according to
the approved plans and specitications,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 governin;ihis type of work
shall be compied with whether or not speeified herein.This pennit will
expire and become nuli and void if construction authorized is no[
commenced within]80 days of the date of issuance,or if construction is
suspended lor a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State I3uilding Code.This permit may be
rcvoked at any time�for ue cause. ��.�
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Applican e mrtee� nature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�
, City of Orono
Building Permit Application for Maintenance ! Renovation
(windows, doors, siding, re-roof, etc.)
,�_--__�, MailingAddress: %r,�,' , � �
���,�� PO Bax 66 Permit number. -" i -��;ri�
!%�O �� O ,` Crystal Bay, MN 55323-0066 Date received_
I�� , ��"�;�. ��i Received by:
9��� Street Rddress
'�\� ` � �"� Y Y Plan review fee:
,�,� `��, �ti 2750 Kelle Parkwa '
�?�Es�o$�/ Orono, MN 55356 ;, „
�=__=� Totat Fee: .�:�� �� ;.-� , ���,
Main: 952-249-4600 Fax: 952-24911616 v,rvvw.ci.arono.mn.us
This application form must be completed in full and all required information must be submitted.
Incamplete applications will be returned. (Please print)
GENERAL[NFORMATION:
Job Site Address: �L�J-�� ���-� � � � ������c�, �,�P�`
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes ❑ No
If yes,a specia!event permit is required with Po%ce Departmenf and Ci'ry Counci!approval 60 days prror fo the event. Shuttle bus servrce will be
reguired unless applicant demonstrates s�cient on-site parldng is available. Non-permitted events wil!not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: .�J�-'�i�-�r�- �"r i� ��-=i=�,.�`�"_.5
Shate License# �'; `�� ',j Expiration Date: `y -j�'% - ` �.�%„�
; �
� Lead Certificativn Number: ,�'f �,�,g. Expiraiion Date:
(for work on homes thaf were constru�or to 9978
Phone: �;x„� /-- �'�-�`,�y (office� �' ,� .� ���`c j_ '7�'„s':' {cell)
Mailing Address: r�j� �y T v,n �,¢. ,c� ,� Cify: .-�j�'r,,.-..� ZIP: �'
Contact Person: � ,,�� Applicant is: Contractor / Homeowner (CtrGe One)
Email and/or Fax: ��-�" -��fj.r ,� ,? �y- "? �
PROPERTY OWNER 1NFORMATION:
Name: � �;`_�;e-�`.�. �'�';:,� c�c�-�
Phone{day):
Address: , �-�,-,�-�_ City: ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require ;
❑ Door(s) ❑ Remode( ❑ Fire Damage MCWD review S�permits:
Mi�nehaha Creek Watershed District(MCWD)
e-roof,asphalt ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd
❑Re-roof, cedar ❑ Restoration ❑Water Damage �eephaven, MN 55391 ,
Phone: 952�71-0590 i
❑Re-roof, other�specify) ❑Siding ❑Other. (sp2afy) Fax: 952-471-0682 �
www.rninnehahacreel<.ora i
❑Window(s) r
Overal! Project Description: � °+� �=A.�"= - v,�W
Estimated Construction Valuation of Project(excluding land) $ �' �� �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and carrect to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for subrnitting 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 provid2 on this application is classified by State law as either private or
confidential. Private data is irtformation 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 rec�rds of othpr governmPntal a�enr..ies
re uired b law. If ou refuse to thejc� rma ,the a {ication ma not be issued.
�,_,,,,�. µ .,�._._.---„_._,_..._..... _ .
Applicant's Signature: -'�„�,�.�`1 °•��— Date: ��� / � ����
,�
Last Updated: 08-09-2011
�t�� � , r� -�`I F �'�� ✓
/ DATE TIME
CITY OF ORONO CALLED IN !L
INSPECTION NOTICE SCHEDULED .�-C/i�J ��fZ'f:
PERMIT NO�L�1 � ��� `�'�� connP�E1E�
ADDRESS � ��� '-�C�� � � �� � �
OWNER TELEPHONE NOc���' �-�"�� 7�'l'�
CONTRACTOR � �- �� �'�C'�'�n '�/7��
>'; DESCRIPTION ����E������ ��
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� O FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ 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
Z OWNERICONTRACTOR TO MEEf YOU:_YES_��NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE
W ❑ RECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ;� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
C INSPECTIOtJ REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DAT TIME �/
CITY OF ORONO CALLED IN ��— _
INSPECTION NO ICE��.2�� SCHEDULED //- �/
PERMIT NOa� P COMPLETED
ADDRESS 7��0 C_�--y,�11 Sf
OWNER TELEPHONE NO.iSZ J�6� 763�
CONTRACTOR L��a-"ry� �LL��
>; DESCRIPTION r/�-1✓O T �� �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
❑ 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-46��
Owner/Contractor on site:
Inspector. .
White Copyllnspector's File Canary CopylSite Notice