HomeMy WebLinkAbout2010-00328 - roofing �
� CITY OF ORONO PERMIT NO.: 2010-00328
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: OS/1U2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1250 FRENCH CREEK DR
PIN : 10-117-23-32-0013
LEGAL DESC : FRENCH CREEK
: LOT 005 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : ROOFING-CEDAR
ACTIVITY : O/S BUILDING - UNDEFINED
VALUATION : $ 2,800.00
NO"CE: NEW CEDAR SHAKE ROOF ON GAZEBO
APPLICANT
PERMIT FEE SCHEDULE 88.50
KUHL DESIGN& BUILD, LLC STATE SURCHARGE(VALUATION) 1.40
1515 STH STREET SOUTH
HOPKINS, MN 55343- MAIL-IN FEE 2.00
(952)935-9469 TOTAL 91.90
Minnesota State License#: 20195769 PA[D W[TH CC# 1472
OWNER
DANIELSON, SCOTT&SHARI
1250 FRENCH CREEK DR
WAYZATA, MN 55391
AGREEME1vT AND SWORN STATEMENT
"I�he work for which this pennit is issucd shall be performcd according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. "I�his permit is for only the work described and does
not grant permission for additional or rclated 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 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 for due cause.
l lLG��1 �3/ �� l �� l /
Applic�itee Signature Date Issu y Signaturc �Date�� �
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
J � City o� Orono
Building Permit Application for Intern�l Work
(windows, doors, siding, re-roof, etc.)
�==0� MaiN�gAddres�� permitnumber� �/�� �6�
'� � PO Box 66 � ..
Q Q Crystal Bay, MN 55323-0066 Date received: ,5/
� ,�i: � StreetAddress� Received by: ` �
� � 2750 Kollay Parkway Plan review fae: �
y H�' Orono,MN 55356
Tocal Fee; �g� �v
Main: 952-249-4600 Fdx: 952-249-461fi wvyyv,ci.orono.mn.us
7his application form must be completed in full and all required information must be submitted,
Incomplete applications will be returned. (Plaase prrnfJ
GENERAL INFORMATION:
Job Site Address: 125� �r p„��� (' r��v ri �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes,�specia/event parm/r is requ;ied with Police Deparrmen[end Ciry Council approval 60 days prior fo tne avenG S�ut[I�bus sc�rvice will bo
rBqulrod unit�ss dppliCdllf dBmo�SffetBs SllffiCiErtt uri-site pdrkinq is eVB11861e, Nop�OMliltdd evdnts will no!be allnwed.
CONTRACTOR/AI'PLICANT INFORMATION:
Name: k��lnl ��cf'���(�1�,���
State License# 2 U_ 9 r,i�u� rY Expiration Dato: �j�,���;� f,I
Phone; ����S _��y��� (office) TT (cell)
Mailing Address: — —.r, - Cit �� .,��L _ _ ZIP: y��.�c{3
Contact Person: ���,, ��,i„ � Applicant is: Contract �;( Homeowner �c�rau o�o�
Email and/or Fax� �.�.�.r�� � �<<,�� ��,c �_•��„��,��+��Li nn-,
PROPERTY OWNEFt INFORMATION:
Name: 5c �� �. S .,��' �qn �'clsur�
Phone(daY)' (y i Z • 3l�o - �3'�? ._ .._ ,._
Address� 1 • 1c Ci : O � - ZIP: `� .�3�
Email and/or Fax ��„��;��[a n i�l$u n -/ Ma r C ��n-�
PROJECT IN�ORMATION:
7ype of Project: Any earth movement may I'AqUll'e
MCWD revlew 8 permits
❑Door(s) ❑Remodel ❑Water Damage
Minnehaha Cresk Watr3rshed District(MCWD)
❑Window(s) ❑Repair ❑Storm Damagb 19202 Minnetonka Blvd
Deephaven, MN 55391
❑Siding ❑Resioretion ❑Other; (Specify) Phone: 952-471-U58U
Fax: 952-471-06ff2
Re-roof ❑Fire Damage www innehah�,r.rHak.oro
Overall Project Description: G�bl�R S'F�AIC�_��c� e G.�ZJ�C-.�o __,
Estimated Construction Valuation of Project(excludin�land) $Z�pp,00 _
APPLICANT ACKNOWLEDGEMENT:
• Agroes to provide all informa[lon requl�ed or requested by the Building DepBrCrrient;
• CertifleS that the information supplied is true and correct to the best of his/her knOWledge. The applicant recogni2es that they
are solely responsible for suGmitting a complete application being aware Ch&l upon failure to do so, the staff h8s no alternative
but�o reject it until it is complele;
• Some or all pf the information that you are asked to provide on this application is classifiEd by State law as aither private or
Confidential. Private data is infOrmapon which generally cannol be given to the public but ean be givon io the subject of fhe
data. Confidential data is informatipn 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 flovernmental agencies
re uired by law. If you refuse to sup ly the information,the application may not be issued. ___._,M
Applicant's Signatute� , Date: � I �•
Last Updated; 05-04-2009
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