HomeMy WebLinkAbout2009-P00101 - roofing � �
CITY OF ORONO PERMIT 1�10.: 2009-00101
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSIJED: 03/10/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2705 ETHEL AVE
PIN : 20-117-23-24-0014
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITv : o/sG�. �3u+ Id+,�� _- LLr�c1�C���-�
VALUATION : $ 3,278.00
NOTE:
REROOF TEAR OFF
APPLICANT pERMIT FEE SCHEDULE 103.25
PILLAR, LAWRENCE STATE SURCHARGE(VALUATION) 1.64
2705 ETHEL AVE TOTAL 104.89
WAYZATA, MN 55391
OWNER
P[LLAR, LAWRENCE
2705 ETHEL AVE
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perYormed 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 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 days of the da[e of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applican[is responsible for uring all required inspections are
requeste$in conformanF�e with t �State Building Code.This permit may be
revoked aY any time Yor�u e.
_'.�� , , ;�, � �� o`� � /� �
Applicant Permitee Signature Date � C / / D
Issu d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO�'E.
_ � �
City of Orono
Building Permit Application
�--_�,� Mailing Address: Permit number: D� • D�/��
/ �j,�,�.\ PO Box 66 /
/Q O�, Crystal Bay, MN 55323-0066 Date received: ���� �
�.
� �" �'� Received by:
�1,� t�`�r •�- ,, i Street Address: , /
\�'.�,L ' "' �ti i 2750 Kelley Parkway Plan review fee: /v��
9kESH�/ Orono, MN 55356
Total Fee: /D �/ � �
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: v`-��'S �-7 �C'c ���ci�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o
If yes, a special event permit is required with Police Department and City Council approva160 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/APPLICANT INFORMATION:
Name:
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATIO,I)i
Name: {q�� �;� ���/L
Phone (day): - � - �i
Address: !���-�- a27i�r�� C'�iF J�+v�` City: `1�i' M�-F7r;�r ZIP: �S 36 '�
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.orq
verall Project Description: r � p
Estimated Construction Valuation of Project(excluding land) $ � �"7'7. S"��—
APPLICANT & OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department,
• Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and owner recognize
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.
. The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property by
City Staff, consultants or agents, for purposes of investigation of this request.
• 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 informati which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use of this i formation is t nn update our records and records of other governmental agencies
re uired b law. If ou refuse to s l the infor ti n, lication ma not be issued.
Applicant's Signature: Date: a'�l�'/- ('��'
Owner's Signature: Date:
—"` �_ f�l�TE TIME ✓
CITY OF ORONO CALLED IN ��,��`—�,,�
INSPECTION NO ICE SCHEDULED �ZJ�L
PERMIT N '�ld COMPLETED --1�
ADDRESS ��0..� �=��
OWNER�f/Jj?ij�CG �/.L�Q��" CONTR.
TELEPHONE NO.
� DESCRIPTION �e� �
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
� ❑ PLUMBING RI O SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W � WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE
� ❑ RRECT WORK&PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL flETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �952� 249-46�0
OwnerlContractor on ite: '
Inspector. � `
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