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Home My WebLink About2010-01015 - roofing � i CITY OF ORONO PERMIT NO.: 2010-01015 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUE�: 1U12/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 345 FERNDALE RD N PIN : 36-118-23-41-0028 LEGAL DESC : HILL O'WAY MANOR : LOT 023 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 7,000.00 NO"fE: "I'EAR Oi�F PRONT OF HOUSE ONLY-REROOF APPLICANT PERMIT FEE SCHEDULE 147.50 DIVERSIFIED ROOFIN CO. STATE SURCHARGE(VALUATION) 5.00 23525 VARIOL[TE ST NW ELK RIVER, MN 55330- MAIL-IN FEE 2.00 (612)490-6498 TOTAL 154.50 Minnesota State License#:20230092 OWNER WILLIAMS, JAMES &JUDITH 345 FERNDALE RD N WAYZATA, MN 55391 AGREEMEIYT AND SWORN STATEMENT The work for�chich this permit is issucd sl�all be performed according to the approved plans and specitications,applicable City approvals,and the State[3uilding Code. "Chis pennit is for only the work described and does not arant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whcther 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 at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State L3uilding Code."I�his permit may be revoked at any time for due cause. /H`t�c.! �l, � � ��'�1 i i Applicant Permitee Signature Date Issued Bv, gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRBE BOVE. �� r � City of Orono _ � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O.¢,�,j�.O PO Box 66 � Crystat Bay, MN 55323-0066 Date received: �''� '- Received by: ,� � `�� .� � �, Street Address: 's',F, �� '%'� �� 2750 Kelley Parkway Plan review fee: L�kESH04� Orono, MN 55356 h' -__— Total Fee:'.:�l1'�(,' �1� 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. (P/ease print) GENERAL INFORMATION: - _ _. Job Site Address: ��-r J �'U. /--��rt��Q �c�. � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [�� 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: n � },s State License# �C� 3c�O y�. Expiration Date: i.�- Phone: �j1�i.��,yy�' (office) � (cell) Mailing Address: .��' �=�„� �,-�., f f • City�.�l��'L,1� ZIP:/�,� . 3��) Contact Person: � ,� Applicant is: �ontractor �/ Homeowner (Circle One) Email and/or Fax: ' ^� � -,nr PROPERTY OWNER INFORMATION: Name: I� �'►� (,�,ll��vvLS Phone (day): Address: ,j��`' f-�'rc%if' /1�I CitY: �,�}nU ZIP: � ,� .3�'/ � 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 e-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: ' , t- �, I�c.-�si; ,�( f k� Estimated Construction Valuation of Project(excluding land) $ �Q(�( .� " 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 application ma not be issued. � �U� � /v ApplicanYs Signature: Date: � / Last Updated: 05-04-2009 i �I� i --?,-';- - ,�; ;;, , - ------ --- �rade I '� ---- � -- —---- �� ---- -------- --- _ - -- ___ C ' 0 2Xcavaf�on ; �S'► l�•�idt� — - -- — --,1— -- ----- � __----- � Z �� P_ rt W � ----- — —c---- --5 f __ � � '�___- - �, e ;. ' f-- - -- --sk'� �s�cu a�s� �.�A�hM�, - � ------ _.--- --- _e - � — -- _ -- ---- ___ c..o,.c�t�c 12" X � 8 `� �n�-�'�b¢ --- --- -- - - _ _ -- --- ---- �iY� �C�� i0�'!n S �_Draw�n . ------ - - _ _----9----- 9 --- h�n�� : �,�z-��`/-3S��_---- — ___ --- ----- - ----- ---- S i-7�c �; ��Z - �7 3 �- .��1�----- — _:_.:—�Q -- - � �2--6`�v._ s �� - � , �_ ��5� �t/��, �� . , � r= r��.�L = �� , ti �� `�� - �, � ,� �— � �� << 3 �� s � �