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Home My WebLink About2011-00510 - roofing � CITY OF ORONO P�arn1T No.: 2oii-oosio 2750 KELLEY PARKWAY ! ORONO, MN 55356- �ATE Iss[1En: 06/23/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 970 FOREST ARMS LA PIN : 07-117-23-11-0004 LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN : LOT 005 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING -LJNDEFINED VALUAT[ON : $ 6,800.00 APPLICANT PERMIT FEE SCHEDULE 147.50 JENSEN CONSTRUCTION SERVICES LLC STATE SURCHARGE(VALUATION) 3.40 2620 GRANGER LN TOTAL 150.90 MOUND, MN 55364- (952)472-7223 PAID WITH CC# 3589 Minnesota State License#: 20639601 OWNER TRUSTEES, C& R LANGE 970 FOREST ARMS LA MOUND, MN 55364 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 addi[ional or related work which requires separate permits. All provisions of laws and ordinances governing this type oY 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 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 ali required inspections are requested in conYormance with the State Building Code.This permit may be revoked at any time for due cause. .�/��- �} ��-'�-=''—. � i �3 i -// i i Applicant Permitee ignature Date Issued By,'i nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . , City of Orono Building Permit Application for Internal Work " (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: /�v�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: � �@ Received b ��;�-�_%� a Street Address: Y� �'�n �� ti�' 2750 Kelley Parkway Plan review fee: ��ESH044' 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: Job Site Address: �� 7(,� ��°�`"C�S--�- �v`�`1't` �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No !f yes, a special event permit is required with Police Department and City Counci!approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficienf on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �C�-��)5�.yl (��✓'}`.�-�►�,�-ivr� �p�-v r��S L L. C State License# �C,��.j�� ;v l Expiration Date: ;3 3 j � Lead Certification Number: Expiration Date: (for work on homes that were consfrucfed prior to 1978 Phone: �(��;L-�,(�" - �J J�-}Ct (office) q� �- �"�� - -7-a�-3 (cell) Mailing Address: �� r-�,.,,� �, • City: �� ZIP: � S�3 �'� Contact Person: �QS,s Applicant is: �/ Homeowner (CircleOne) Email and/or Fax: �,� j �--' en,F,� GS � �L , L�;�,� PROPERTY OWNER INFORMATION: Name: i �'v` i�N� Phone (day): �S�. Address: l City: }h1c�w�1 � 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 �Re-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ � 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 I the information, the a lication ma not be issued. Applicant's Signature: ~ � Date: (�Q ' �3 ' I ( Last Updated: 03-01-2011 6`D�T� TIME V CITY OF ORONO CALLED IN G INSPECTION NOTICE /�S /�SCHEDULED " _�f __��J PERMIT NO.��L I!l/��C�COMPLETED ADDRESS g7p ��rest �'�S �� OWNER TELEPHONE NO.��a -��d— g7�. CONTRACTOR e�E�-L-�"yr��-� >; DESCRIPTION T�a'� � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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. ❑ FO�LOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � 1 � d W��RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN �NSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on sit� Inspector. �� White Copyllnspector's File Canary CopylSite Notice DATE TIME ✓ CITY OF ORONO CALL IN �p�, , INSPECTION NOTICE SCHEDULED �1�[L � PERMIT NO.o2��—�� `v COMPLETED ADDRESS �7D _�'�� /�'�S L� OWNER TELEPHONENO., �� u�`�� CONTRACTOR �C�� C�C • �; DESCRIPTION _ �" `�-L /`-T/� � Ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h 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 v ❑ 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 � COMMENTS: � W a � � � � ��t"✓�� h��'`,--, 0 � � 0 � W � Q � Z w � W � j GW ❑WORK SATISFACTORY:PROCEED Lt ROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑ C�RRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on sit : inspector. � White Copyllnspector's File Canary Copy/Site Notice