HomeMy WebLinkAbout2011-00365 - roofing CITY OF ORONO PERMIT NO.: 2011-00365
+� - t 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: OS/19/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 1743 FAGERNESS POINT RD
PIN : 17-117-23-22-0037
LEGAL DESC : MAPLEGATE INLET
: LOT 006 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING - UNDEFINED
VALUATION : $ 12,000.00
NOTE: TEAR OPF REROO�-ASPHALT
APPLICANT PERMIT FEE SCHEDULE 221.25
ALLSTAR CONSTRUCTION
5145 INDUSTRIAL ST STATE SURCHARGE(VALUATION) 6.00
SUITE 103 TOTAL 227.25
MAPLE PLAIN, MN 55359
(763)479-8700
Minnesota State License#: 20631575
OWNER
TAUBENBERGER, MR. &MRS.
1743 FAGERNESS PT RD
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The�vork(br�vhich this permit is issued shall be performed accordina to
the approvcd plans and specifications,applicable City approvals,and the
State[3uilding Codc. This permit is for only the work described and does
not grant permission for additional or related ti�ork which requires sc�arate
permits. All provisions of laws and ordinances�overning this type of�cork
shall bc compied�vith whether or not specitied hcrein.This permit�vill
eapire and become null and void if construction authorized is not
commenced within I 80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time atter work has conunenced.
l�he applicant is responsible for assuring all required inspections are
requested in confor it the State Building Code.This pennit may be
revoked ime for e ause.
-�% :��� �,7 �,/� ,
'cant Permitee Signat Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
� �� Building Permit Appiication for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: °w�� �� 3 Cp
Og,�,j�.O PO Box 66
Crystal Bay, MN 55323-0066 Date received: S ( //
�� '�' Received by:
I a, �. -�-�.� s, Street Address:
�',F, ' '%'� Gti� 2750 Kelley Parkway Plan review fee:
L�kESH�4'� Orono, MN 55356
�� �
�— Total Fee: ����• �5
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 Hom s, Remo elers Sho case Home or ther Display Home? ❑ Yes ❑ No
If yes,a special event permit is required with Police Department and 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-pe�mitfed events will not be allowed.
CONTRACTOR I APPLI T NFORMATION:
Name: 5� ��, �-
State License# ���/�j y Expiration Date: ��
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
� Phone: T"�S , �-�'_ �' � � (office) �, ' c (cell)
Mailing Address: fj S �- � � �- . ZIP:
Contact Person: ' � Applicant is: Contra / Homeowner (Circle One)
Email and/or Fax: � -- � - - _ �n
PROPERTY OWNER FORMATION:
Name: �`
��l l c,�-�-c��c�cnc��
Phone (day):
Address: ��-(-zj � ; r�� �f- ��_ City: 2)�'�, ,�; C^, ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits:
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391
Phone: 952-471-0590
�R�e-roof ❑ Fire Damage Fax: 952-471-0682
www.minnehahacreek.orq
Overall Project Description: �V�v c..,��_^
Estimated Construction Valuation of Project excluding land) $ j� �,-2� 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 'nfor ation,the lication ma not be issued.
Applicant's Signature: Date: l
Last Updated: 03-01-2011
� � D E TIME �
CITY OF ORONO `/����� CALLED IN �
INSPECTION NOTICE SCHEDULED
PERMIT NO���' �d3�� COMPLETED
ADDRESS I��� ����—�/�� _ �� �
OWNER TELEPHONE NO.
CONTRACTOR���h�
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>; DESCRIPTION
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t� ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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O ❑ 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (952� 249-4600
Owner/Contractor on site:
Inspector. �( -f7 ��
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�� I '�A3Er�� TIME , /
CITY OF ORONO CALLED IN _ 47� "
INSPECTION N ICE 2 SCHEDULED (
PERMIT NOc�D� — DO J�S COMPLETED �� �
ADDRESS �
OWNER ELEPHONE NO.I �Z ��
CONTRACTOR
� DESCRIPTION ` l�� ��/
� ❑ FOOTING ❑ PLUMBING FINA� ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
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W��GVORK SATISFACTORY:PROCEED �PROJECT COMP�ETE
W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46�0
Owner/ContractprQ sit -
Inspector. �T
White Copylinspector's File Canary CopylSite Notice