HomeMy WebLinkAbout2016-01295 - roofing CITY OF ORONO * Z 0 1 6 - 0 1 2 9 5 *
2750 KELLEY PARKWAY DATE ISSUED: 10/12/2016
� ORONO, MN 55356-
� (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2683 CASCO POINT RD
PIN : 20-117-23-23-0001
LEGAL DESC : AUDITOR'S SUBD.NO. 265
: LOT 001 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-LJNDEFINED
VALUATION : $ 20,200.00
NOTE: VALUATION OF PERMIT:$20,200.00
ROOFING PERMITS ISSUGD WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECT[ONS. (WE REQUIRE 24-48 NOTICE,PR[OR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BGING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOV�D.
APPLICANT PERMIT FEE SCHEDULE 371.71
STATE SURCHARGE(VALUATION) 10.10
ALL STAR CONSTRUCTION TOTAL 381.81
5145 INDUSTRIAL ST Payment(s)
#103 CREDIT CARD 8119 381.81
MAPLE PLAIN, MN 55359-
(952)913-2196
Minnesota State License#: BUIL-BC690352
OWIYER
ERICKSON,GERALD& SANDRA
2683 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfornied according to
the approved plans and specifications,applicable City approvals,and the
State E3uilding Code. This permit is for only the work described and docs
not grant permission for additional or rclated�tiork which requires separate
permits. All provisions of laws and ordinances goveming 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 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 Building Code.This permit may be �
revoked at any time�ee�,cause. �
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Applic nt Permitee �gnature Date ' Issued By Signatur Date
City of Orono
Buildin� Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number: ) � — '� ���
PO Box 66
Crystal Bay, MN 55323-0066 Date received:
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Street Address: Received by:
ti�, � 2750 Kelley Parkway Plan review fee: ��""�
t � Orono, MN 55356
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Total Fee: � Q C>/
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us c> ��
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
JobSiteAddress: Z(!�� �GtSLp �"'�• �OGt� ��✓�2�fyi � N 553q (
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 su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: f}(11'tar �on�+rv�t;� �;�/�nfi�l L�C
State License# (�� (��d 3 5 2 Expiration Date: 3-3 � - ze i�
Lead Certification Number: ;�yfi7-_ � �r� � 4�� _� Expiration Date: y-3 _ZoZ�
(for woik on homes fhat were constructed prior to 1 78
Phone: (cell) 5�)�j (�_a I�� (office) �� ��
Mailing Address: 514�j u +�n'al S+ ID City: /t �19i� ZIP: SS S
Contact Person: G,,� Applicant is: Contracto / Homeowner (Circle One)
Email and/or Fax: �c,1c.�� y!/,f.t���-�q�, .�oM
PROPERTY OWNER INFORMATION:
Name: � �G�S
Phone (day): _3
Address: _ Z t��3 � Cq S�o �oi�t �c� City: Mlc�La}�G� ZIP: 55 3 q �
Email and/or Fax:
PROJECT INFORMATION: Overall project description: �� � ��G�'
Type of Project: Any earth move nt may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8 permits:
Minnehaha Creek Watershed District(MCWD)
Re-roof,asphalt ❑ Repair ❑ Storm Damage 15320 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ Zo, 20�
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 required by law. If
ou refuse to su I the information,the a lication ma not be issued.
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ApplicanYs Signature: � Date: �
Owner's Signature: Date:
Last Updated:January 2016
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� DATE TIME
CITY OF ORONO CALLED IN _���7�10 i7"�"""—
INSPECTION NOTICE SCHEDULED F_
PERMR NO.�1_��f�! l� COMPLETED
ADDRESS c� 0 /� � � C�-� �► (�;
OWNER TELEPHO E NO. C�� , ��-�q�
CONTRACTOR
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑ pHOTO TAKEN
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❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-48��
OwnerlContractor on site:
Inspector: (��� � '
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CITY OF ORONO cnLLED IN
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PERMIT NO. � �`�� COMPLETED
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OWNER TELEPHONE NO. �G�`�' � � 3 �"��
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ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
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Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BUHNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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� ❑COHRECT WORK,CALL FOR REINSPECTION TEAAPORARY
V BEFORECONERINO PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
CsN for the next inspection 24 hours in advanoe. (952) 249-480�
Owr�Contra�on�sf e:
Inspector: �, ' �
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