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Home My WebLink About2010-00845 - roofing r . . � �� CITY OF ORONO PERMIT NO.: 2010-00845 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 09/16/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 785 FERNDALE RD N PIN : 36-118-23-11-0012 LEGAL DESC : REG. LAND SURVEY NO. 1031 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -CEDAR ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 29,000.00 NO"I�E: TEAR OFF REROOF-PART CEDAR-PART ASPHAL"C APPLICANT PERMIT FEE SCHEDULE 456.00 TIMBERLINE ROOFING & SIDING STATE SURCHARGE(VALUATION) 14.50 5051 HIGHWAY SEVEN SUITE 270 M[SC FEE 0.00 MINNEAPOLIS, MN 55416- TOTAL 470.50 (612)363-6158 OWNER CULLUM JR, MICHELLE& THOMAS 785 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AIVD 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[3uilding Code. This permit is for only the work described and does not erant permission for additional or related work which requires separate permits. All provisions of laws o inances governing this type of work shall be compied with whet or n specitied herein.This permit will expire and become null d void struction authorized is not commenced within 1 s o� he te of issuance,or if construction is suspended for iod of I da at any time after work has commenced. Thc appii nt' respoi assuring all required inspections are reques d i o nce th State Building Code.This permit may be revoke • y t� e ue caus / � / �� / / /4�/ �V App ' ant Permitee Signature Date �s By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. / , ;�j,�!.?�� .�� , o� �i �,i�; �^ v! � � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) — Mailing Address: �p�p_�g� ,/ � � PO Box 66 Permit number: ' � �� Crystal Bay, MN 55323-0066 Date received: �/5/� � � ��0 .� O I �'�'1:�' �� Received by: � a '��t��;:� �.�; StreetAddress: �'s',�, , � Gti``' ' 2750 Kelley Parkway Plan review fee: L�kESHo4'� Orono, MN 55356 ��__'_� ��.�7� 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: -� �� -- (�G� 11 ^ / Job Site Address: ��<�°'� ��- / 1/ 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 Po/ice Department and City Counci/approval 60 days prior to the event. Shuttle bus service will be required unless app/icant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICA�T INFQRMATI . Name: � /� ��'�� G�� ' State License# � �2 Expiration Date: - ;3/ - � Phone: 9�Z— 9Z — l�l/v (office) ( Z �('�3 L�/.S:S' (cell) Mailing Address: o'-/ �i u• � S✓;lc Z70 Ci : /'�P�-�' ZIP: �/t/ Contact Person: � a„F�.-, r�. Applicant is: nt act / Homeowner (Circle One) Email and/or Fax: �SL ; 9 LG ' ,� � PROPERTY OWNER INFORMATION: Name: �� /v� Phone (day): �L - �l7(, - �" �o Address: �.-�� ,/�/ Cit :C.Uf�1so l� 71,�'�IP: ��9� 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 ❑Siding ❑ Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 e-roof ❑ Fire Damage www.minnehahacreek.orc� Overall Project Description: 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 rovide on this application is classified by State law as either private or confidential. Private data is information which er ly cannot be given to the public but can be given to the subject of the data. Confidential data is information whic en II cannot be given to either the public or the subject of the data. Our purpose and intended use of this inform �� o a ally update our records and records of other governmental agencies re uired b law. If ou refuse to su e ira#Orm � n,the a lication ma not be issued. �— ApplicanYs Signature: Date: � y < `� � ��' /i`'� Last Updated: 05-04-2009 ✓ Se;� 1,5. 10 01:29p TIMBERLINE ROOFING & SIDI 952-926-1368 p.1 City of Orono Building Permit Application fo� Internal Work (windows, doors, siding, re-roof, etc.) Marling Address: Permit nurnber: o24/D— (•10�� PO Box 66 �� O:\� Crystal Bay,MN 55323-0066 Date received: 9- �S- /D ,�„� �� •-� ,,�l Street Address: Received by: "�� '�� Planreviewfee: `•'��, , � Gti� 2750 Kelley Parkway �l � Orono, MN 55356 �xO4 Total Fee: �7D '"j0 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: c,i -- p / � .lob Site Address: 1 �d�G�G'G2 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No liyes, a specia!event permit is required with PoJice Departmer,t and City Council approval 60 days pnor to the event. Shu7/e bus service wil�be r�quired unJess applicant demonstrates sufficient on-site parking is available. Non-pe�mitfed events will not be allowed. CONTRACTOR I APPLICA T INF RMATI . ' Name: —%�`+ i�w_ f ,s��•^ � State License# Z('� Z Expiration Date: - - Phone: — 9Z — 9 office ( �(n cell Mailing Address_ o "/ G, .f`✓r Z7d Ci : MALS ZlP: ' Contact Person: � � �y. Applicant is: nt act / Homeowner (Cirnle One) Email and/or Fax: �/Sy � "LG � � _ PROPERTY OWNER INFORMATION: Name: i� r��v� PF�one(day): �S�L - `�?(. • "7 O ��9 Address: �y�� Ci :C�I'�uo f� �CZ1P_ � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑Doo�(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑wndow(s) ❑ Repair ❑Storm Damage 18202 Minnetanka Blvd Deephaven, MN 55391 ❑Siding ❑ Restoration ❑01her: (specity) Phone: 952-471-059Q � Fax; 952�71-0682 e-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Descri�tion: Estimated Constrvction Vatuatian of Project(excluding land) $ ` li�. APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Departmenl; • Certifies that ths information supplied is true and correct to the best of his/her knowledge. The applicant recogniz�s thai they are solely responsible for submitiing a complete application being aware that upon failure to do so, the staff has no alternative but to reject it untii it is complete; • Some or all of the information that you are asked to r�vide on this application is classified by State law as either private or confident�al. Private data is information whieh er ly cannot be given to the public but can be given lo the subject of the data. Confidentia( data is information whic en II cannot be,given to either the public or the subject of the data. Our purpose and intended use o(this inform ' i o a ally update our records and records of other governmental agencies re uired b law. If ou refuse to su e i rm n,1he a lication ma notbe issued. . � _ i / ApplicanYs Signature: � Date: r r '�! �O � Last Upda[ed: 05-04-2009 ✓