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Home My WebLink About2010-00577 - roofing CITY OF ORONO PERMIT NO.: 20�o-oos�� 2750 KELLEY PARKWAY � � ORONO, MN 55356- DA7'E iSsuEn: 07/13/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 775 FERNDALE RD N PIN : 36-118-23-1 1-0016 LEGAL DESC : REG. LAND SURVEY NO. 1031 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 8,500.00 APPLICANT pERM[T FEE SCHEDULE 177.00 J. BENSON CONSTRUCT[ON STATE SURCHARGE(VALUATION) 5.00 7020 WALKER STREET ST. LOUIS PARK, MN 55426 MISC FEE 0.00 (952)920-0717 TOTAL 182.00 Minnesota State License#:4740 PAID WITH CC# 9655 OWNER ERICKSON, BRADLEY& KAREN 775 FERNDALE RD N WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed 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 governing 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 (80 day f the date of issuance,or if construction is suspended for a peri of 0 days at any time after work has commenced. The app nt is res onsi e Yor as required inspections are request confor nc the State Building Code.This permit may be revoke t any tim cause. / / / / ppl ant Pe e Signature Date Issued By ature SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV . City of Orono � � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number. �j ��,�.�\ PO Box 66 Q �N O\ Crystal Bay, MN 55323-0066 Date received: ' �`a'"''�, 1� Received by: I,� "�� F,�� , Street Address: �'�,nL � q'' ��' 2750 Kelley Parkway Plan review fee: `�gESHog� 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: / D / �I f Job Site Address: 77,s ��NC1,�C �� /Cc�, �a,�.,T`'� Will this be a Parade of Homes, Remodelers Showcase Home or other 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 sutficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �, ,(3.Q/U�c�� e,c�ti S /�CJ'c !V� State License# �/?�,E t� Expiration Date: 03 3 ao/7. Phone: 5a- a�'?.- �JG office �' S�- 9�a- ��7 cell Mailing Address: 3!L'ya cvt .�4�-r j�t/�t Cit : c�i �� ZIP:S � Contact Person: L�c S �i v�• Applicant is: �ontractor / Homeowner (Circle One) Email and/or Fax: L,S� �4o c� m .�-t � �-�• Ca � PROPERTY OWNE INFORMAT ON: / Name: �R/�d �R i'C F-- � u.� Phone (day): 52 - �f�2 - 3� (,,;7 Address: 77$ I�.c��cG4 �i c�, �, City:��/�,�SL�i� ZIP:Jrs 39� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) ❑ Remodel ❑Water Damage � Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ S� ing ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ 50(� ��U 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 a li ation ma not be issued. ApplicanYs Signature: � Date: �7 13 � � �U Last Updated: 05-04-2009 TE TIME v `��`� � �J o CITY OF ORONO CALLED IN // � INSPECTION NOTICE ,s..�1 `�HEDULED � _..,`��?�1L� PERMIT NO.C�d/D 'vv��COMPLETED ADDRESS �� -��•��- �G� ` �' OWNER TEL a� ONE .�5��!�' '��lD�/ CONTRACTOR t- L�/��i� - � �: DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ 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 � OWNERICONTRACTO TO MEEf YOU:_YES_NO � COMMENTS: �� G�� Gf/l � C � J O �. � O � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED � ROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED G I UE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��CITATION ISSUED ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: r � � Inspector. � White Copyllnspector's File Canary CopylSite Notice