HomeMy WebLinkAbout2006-P10189 - re-roof ' PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P10189
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
8/8/2006
SITE ADDRESS: 340o Fox St Unit#
Long Lake,MN 55356
P��� OS-117-23-43-0005
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Typc:
Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 195.25 Valuation: $ 10,684.00
State Surcharge Fee: $ 5.35
TOTAL FEE: $ 200.60
APPLICANT: Kaufman S/M&Roofing OWNER: Mr. &Mrs.McNerney
2521 -24th Avenue SW 3400 Fox St
Minneapolis,MN 55406 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL 1MPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPL .ANT P RMITEE S[GNA'I'URE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reparts, I-Assessing,(If Septic, 1-Septic) Page 1
Aua'AUG:_ 7.2006m 11?,18AMTy OFKAUFMAN ROOFINGNI�`T�U V +95Z2494616 T-6�yp,829J1/UU�,2�qf f
Tot�1 Fee: $; � �� � Y3ate Received: ��
� Entered By: Permit#:
� � CITY' OF ORONO -B����P��T APPL�CATYON
�'��u ' d ' ull before lan review w►il16e started.
�'�'� All informa�inn q�ust be subm�tte m f p
(pleasepririr all infornaation)
__..__
THE APPLICANT Y5: �circle one) O�TNEIt OR CONTR�iCTOR
J'OB STTE ADDRESS: _,,,6 `1�C� D �C ��� _ZIP:
yVill this be a Paxade of Ho�es,ltemodelers S6owcase Hotae or otl�.er D3ispIay I�o�ue�
❑ Yes [�_ No rfyes, a special�venr permit �S required wirh Police Depamnent and Ciry
Council appYava160 days prior so rhe event. Non nerrnitted evenrs wzll noa
be a1low�d
NAME OF OWNER: PHONE: (home)
[ 1 (work)
MaII.,]NG aDD�SS: �J�1C� T'D X �J�' � CYT'�: (�Y'�n�la zIP:
. -
CONTRACTOR: �1�� � ��►� PHONE: �p ��-1 a�r D�(�S
COI�TTACT P�RSON; ��ll,�'i�, 2- MUB�LE!$AGER;
MATI.IN�G ADD�ESS: 5�.� a_��'^ CITY: ,�y� l(L S�ZYP: ,<���
5TATE L�CENSE: # �'o�.`� _
ARCBITECT/ENGIlV��R: PHONE:
MAYX.ING ADDIZESS: _ ,�C�TY: ZYP:
NA�,,� REGrISTRATION#
TYPE OF'WORYi: New Accessory Structure
Additiot� 1YiaYe
RemudeUAlt�ration Land AJteratioa
PRO��P OSEb WORK(desc�ib@ in derai�; _ ��l��l.�� ,(le�1 � �N 1�� � '�.
� `l�Sca.Y[� �t�
S74RIES: SQ. FE +"T OF EAC��'LUUR_
NO. OF BEDROOMS: GA'R,A,GE STALLS: ATT. DET-
cc� '
ESTIMATED CONSTRUCTION VALUA'TT0�1 (excludiug land): $ ��, �g�. —
I he�eby apply for abuildi��pernnit aad T ackrtowledge th.at thc infozmauon abovc is complete and aceutate;that rhe
wark vi►iu be in corifo�aace wiih the ordi�ances and eodes ef d1e G�ty and wi� ihe Srate Buildmg Code; tha�I
undcrst�nd this is uot s persnis�nd.+verk is aot te st�t wi�out�persrsiY;and t�as the work vri11 be in aceardazsce with
the approved plan. � ,,n
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APPLICANT'S SIGNATI�E: DAT�:
Aup-AU����7.20a6m 11,�.18RMTY OFKAUFMAN ROOFING +95ZZ494616 T^6�yp,8297ZI4o�,3,4f r
Sc�13.A4 R]GH7S DF 5V8JF.CTB�F DATA
3v6d.1. �pe oL d��a. Tae riah�c ot Indlvidu�l oo whom�h�dsrs i�uored or w be s�orod shaR be a�rxctorW in chis sectPoa.
Subd.2.lntormaCton requircdro be given Tndtvl�uul.sn individual askc�to supply prlvs�e or con'�dendsl d�s coa�ernina 6fmdel{aha11 be
(ntormsd ut: (�[hs purpose pad incqnded uae o[nc�requrlcQd d�cs withfn�h�wl(eRiqfi snsc ageoq�,polictcdl subdivisioa,or s�at�wlde systcm;(b)
whe[1►erbe may�(ure or ii leg�llY I'oqufrai to supply�ha roque►t►d data;(c)�ny lo�owp consequ�llCe aflsln�G'om hIS 7upplying or rcdusiag LO sWpph'
prl�acoor cnnfiden[ial dsrs;and(d)rhe Idm�iry of ac6�rper9on3 0�entrtics au[hori2od by scata4r[eder�l law m rcn,ve the daRa.Tbis roqult^emencsh�u
noi apgly When an iadiv�aaul is osked m suppty 7nre�tfL'ativu dain,parcuan�on s.ecooa 13.52,�uba�v�eton 5,co a faW anfol'CsmOnt oiGcer.
The eammission4[o�rlw�nae muv vinS � n�rieo requf►es1 an �r�his subdiri ion in tht Indiv_i fAI� ��Me'tzY��� ouoesv ess rctund
at inst�ud 8t m � •
Subd.3. �►c�wi so dass 6y►ndiridual. Upan rcquec��o a respons�plQ putdo�9q,an iadividnal slf�ll be In(orn►ed wha�har Op i�tLe eubject oi
rtor�d dats ao fndl�idual�,and wheshe�(�ia elaQ�iCud a9 publ�t,pNvau or confid�nclzl. Upan b�s futd�¢r reqtte►�ap indiv�du�l wl�u ig LUe subJ�c�of
swrod pntiuc or publfc da�a on indiridual�shafJ be shown ihe dreu v+ithouc any cAer=e w him Qod,it he desiree,shalL be jniermQd oi cb�mnme«and
meanine oi ihat dsra• wtter an indi�idvsl has baea slw+vn zhe priv�w dasa and]niormed of i[s maain�,chQ d�ra aood aos bQ a�rtnsed w hIM Por s�
mnnsh�iheruuher enlest a dlepurrt or aaioo p¢nuan<<o�dis saetioo i,pondlhg or addidonal dow on cbe indyiduol bps ban eolloerad oe crrued. Tbe
respon91b1e�ut6ontyshsllproviCeqopleso[l'hopriv��eorpubllcd�uuponraqucYebythelndiytduaJPubJec�of�h�dsn. Ther.zponsiDlcsuchonqm��
requOro�he rcqueRtin�petson so pay t�e actual a5�o[n�kiar,ceni�in�,and mmpilios ihe mplei.
The ru�oaubJc author3cy shall eomplyienmediu�ely,if possiblo,wl�a nay reques[mad�pul�su�pt w th{s aubdlvlslnn,nrwithin Gv¢d�y�ot[Ac
daw of�he r��queac,rYcludln�S��71�y�,Sueday9 an d Ie�a1 hnlidpyq f�Immedi��e a+mplinner i�oot pos6bin tt hecannoi complr wirh eLs rtqueawhb�.a
�hvrCmA 1lespall w InCoRs��ho individus�l,aad may havc un addi[tonal 6v�dsyrwi�in whieh�o comply wi�h=he nqaa�,oxcluding Sawlday�Snndv�3
and Ie�tl hofidays. ,
Subd.4. Procodure when d�ia it not ieeatste or complew.A,n indiridu�J m�,Y�n«s�ib��ccuraey orsomplt�eness oCpubfie or prfvute dop
�rscer,�in�hlmsrlL To e:ersisethit riQl[t,an Indl�dva!chall�orYy in W�I�ing tbe respon�lbls ouShurity d�serl�ln�[hC aA'[ure ofths dlsa�ntm�n�Tbe
respos�sibla uucknn4�shall w1[Aln$0 dq�citber: (s)corr�a stio desa found�o be loaccur�se or(ocomplKt sed se�amps m uetify pasC roolplenrs of
Snaccu�o�a cr Inoomp1aor drra,9oalud�ng r�clpleots named by[Ile ledlv{dual;or(ta)nor1�the iu�livFdual tlw�he 6eli�es t1�e da�f w be coRocG bpta in
di�pu�e�h7t11 be distlos�d only If sho iadiviaunl�Y swamenc ot df��rocmeat is Encludad wi�h sqe disNocad d�n,
The daurm�nut7on olihe responSibla auihoriq�uiay be appeafaa puriuuat[o the provisioas of Wfe AdmlAfstTa�ive nroadur¢ac�pota�ne�o
contcs{l�cAQE6.
D P AC AD'VZSORY
In aecardance w�h M.S.13.0�4,Subd.2,"Rlghts uf subjects of da�a",�we wouid lfke�o iuform you thaC yoar requesc
for a permfc nr liceast from cbe City oi Orono or any of its depar�men�s taay�equ9re you to fur�ish certain prlvate or
coaiSdepcial infarma�ioa.
lrou ur¢no�fied tlu�
1. Tbe iniormauon you tl�rnish wfill he�ad to determine�our qualigcaflen for t]ie pet�mit or licen�e ra�uesced.
2. You amiay�e[tfse co supply data,but refusal may require r,lu�t the City den�rbe pelmit or license.
3. The iniot�atien re�y be shared wfth other locsl,state or fe�leral agencies to the exteut peee9;ary[o�roeess
ttie permit or license.
4. I�yoar req�ested perm�t er Iieepse requirts Couacil action to approve, some iaforntac�on[qay becorae
publia
5. You have certain ri$hts ut►der M.S,1�.o4(availAble upon request)t�re'�+iew privau data on yourself.
6. Your fvll�na�e is required to p�ocess�hfs�pplicatiou or permiti
�be��' k' -/�a. .v�
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Y uaderstaa my ri�hu as ster.cd ahove.
Stgnaw�c
UG 7.2006 11�18AM KAUFMAN ROOFING N0.8z9. . P.4i4
f�ri•`5���''°'�-R State of Minnesata Construction Cades and LiG�n;��������s�on
"� �''°. Depar�ment of Labor and Industry T�leplione:(651) 284-5065
��=�•�`�='����:�� 443 Lafayetta Road;N. E-mail address:,dli.contr�ctorCa�state.mn.us
�� St. Paul,MN 55155�344 Wehsite address: www.doli.state.mn,lis
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es'��,�'���T,' � � �
Reside�ntial Roo�er License �
Legal�Vame: KAUFMAN SHEE�M�?AL ROO�ING�NC . Bus�ness Structure: �
DBA: CORPORATION ,
Address: 252� 24TH AVE S - � ,
� MPLS, MN 55d06 -,
License Identificatian Number: 932q Qualifying Person: TH�RESE H�RRERA
License Expiration Date: 3/31/2007 Continuing Education:7 hours due by 3/31/2007
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AU6. 7.2006 11� 18AM KAUFMAN ROOFING N0.829 P. 1i4
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� ,,. bate• —1 ,� Time:
,i � , ,. J .
� d �� Number of pages including cover sheet:�
4��DA�'�l�
q�' A�. Ka.ufman Roofing, Inc.
� 2521-24`h Avenue South
'� Minneapolis, MN 55406
G J �L�' (612) 722-0965
'ljTY•S�`�� Fax (612) 722-1021
'�O: � D FROM: �JY I�� ��i l��'--
�T; AT: �aufman Roo�ng, Tnc. _ _
p�p��: PI-�ONE#�: (612) 722-09G5 �
FAX#: "l��' � 4� -��' � F�#: (612) 722-1021
M�MO: ���U�� c��� w �� o�� �� � ��s�
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r�'ll�►'t�S,
C�F�V�S��
� CJ'rgent � For your review � Reply�SAP � Please comment
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