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Home My WebLink About2011-00480 - roofing � ,� CITY OF ORONO PERMIT NO.: 2011-00480 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/16/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4455 FOREST LAKE LANDING PIN : 07-117-23-24-0037 LEGAL DESC : REG. LAND SURVEY NO. ]019 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING - UNDEFINED VALUATION : $ 5,000.00 NOTE: TEAR OFF REROOF HOUSE APPLICANT PERM[T FEE SCHEDULE 118.00 MIDWEST ROOFING STATE SURCHARGE(VALUATION) 2.50 6541 SYCAMORE CT N TOTAL 120.50 MAPLE GROVE, MN 55369- (763)427-9696 Minnesota State License#: 20637010 OWNER ERICKSON, SANFORD& MARGARET 4455 FOREST LAKE LANDING MOUND, MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this pennit is issued shall be perfonned according to the approved plans and specitications,applicablc 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 180 days of the date of issuance,or if construction is suspended for a period of I 80 days at any timc after work has commenced. The applicant is responsible for assuring all required inspections are reques[ed in conformance with the State Building Code.This permit may be revokefl�Cany tim r due cause. - � (1� �� (p� l (�� /� Applicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono �� 5 � ' Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) MailingAddress: Permitnumber: Q//- 6� O�,L,�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: �`� a� � .-� �. Street Address: Received by: �' ' ''� �titi 2750 Kelley Parkway Plan review fee: ��kESHo�`'� Orono, MN 55356 Total Fee: ��Q,� 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: J Job Site Address: � `'� �5 �j�� f- �/��- �s/jGr� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No !f yes, a specral event permit is required with Po/ice Department and City Counci/approval 60 days prior to the event. Shuttle bus service wi//be required unless appficant demonstrates su�cient on-site parking is available. Non-permitted events wil!not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �"2 i iC�(�F`'S� State License# , �,�,(c; 7 Expiration Date: ��s'- �—/3 Lead Certification Number: Expiration Date: (for work on homes that were construcfed prior fo 1978 Phone: ��' �. _ �� (office) (cell) Mailing Address: 5/ C"C<<ti�� - City:r�7l� l( c�E�t� ZIP: �j'�G Contact Person: ��>�-Z� Applicant is: rac / Homeowner �Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: -- Name: 5�ti;��:-t:;(? E.-��'�C�.��'' Phone (day): Address: � �,j o��P �t �c-rl� ��,�2y City: (��'`�U 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: � �t��- � f--F ,�- ��G{ � Estimated Construction Valuation of Project (excluding land) $ _�� 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 u I the information, the a lication ma not be issued. ApplicanYs Signature: Date: �'�� r Last Updated: 03-01-2011 �� ✓ � DATE TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE �i SCHEDULED _t�� PERMIT NO. D —DV MPLETED ADDRESS -S� � � OWNER T HO NO� �7- CONTRACTO �' �; DESCRIPTION �Q� � � ❑ FOOTING ❑ PLUMBING NA ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � d ��.Id'WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP OFDER POSTED.CALL INSPECTOR n CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: Inspector. J White Copyllnspector's File Canary CopylSite Notice � �� D TE TIME v CITY OF ORONO CALLED IN � /� INSPECTION NOTICE �) SCHEDULED 7 �O PERMIT NO.a� �" COMPLETED ADDRESS ��SS e� LQ'� �-�'I OWNER � �� TE� PHONE NO. � CONTRACTOR � � �; DESCRIPTION Qv� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ 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: ��u-� �L SCV�� C� Q �/VL G�ooV � W � � J O � � O � W � Q � Z W � W � � � GW ❑WORK SATISFACTORY:PROCEED �OJECT COMPLETE � ❑CORRECT WORK R PROCEED �:, ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL{NSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on si�: Inspector. White Copyllnspector's File Canary CopylSite Notice