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Home My WebLink About2011-01195 - roofing � � CITY OF ORONO PERMIT NO.: 2oii-oli9s 2750 KELLEY PARKWAY ORONO, MN 55356- nATE tSSUEn: 10/OS/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1140 GARDEN CT PIN : 07-117-23-23-0033 LEGAL DESC : W[LDHURST WOODS/5 : LOT 005 BLOCK 001 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT VALUATION : $ 29,000.00 NOTE: VALUATION OF PERMIT:$ ROOFING PERMI7'S ISSUED WITHOUT GNOUGII NO"I'ICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PI20VIDE COMPLETE SET OF PICTUKES OR A FINAL INSPECT[ON MAY NOT BE ISSUED. SIGNS-ADVERTIS[NG SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS I3EING DONE. ONC1;WORK IS COMPLETGD THE S[GNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 456.00 EVERLASTING HOMES INC P O BOX 914 STATE SURCHARGE(VALUATION) 14.50 BURNSVILLE, MN 55337- MISC FEE 0.00 (952)435-2148 TOTAL 470.50 Minnesota State License#: 3024 PAID WITH CC# 2143 OWNER MEHTA, SHIRISH & DEEPTI 1 140 GARDEN CT MOLJND, MN 55364- AGREEMENT AIYD SWORN STATEMEI�T Thc work for which this permit is issued shall be performed according to the approved plans and specifications,applicablc City approvals,and [he 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 goveming this type of work shall be compied with whether or no[specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of Ihe date of issuance,or if construction is suspended Yor a period of l80 days at any time after work has commenced. The applican[is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoke at any time for due cause. ,� �— 6 � -�� '6�� -r P- ' � �o� 5' � % Appl cant ermitee Signature Date [ssu d By ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � , City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) _�� Mailing Address: Permit number: �'D//- �// �.5� ��v�,�� PO Box 66 � � O\, Crystal Bay, MN 55323-0066 Date received: !U - S � i� �'��,.. ,� '� � �? �, ; StreetAddress: Received by: a'-�-- ��c, �'��'�� Gti%� 2750 Kelley Parkway Plan review fee: \kEs��'� Orono, MN 55356 —�� Total Fee: J� ?�, J�U 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: ` ' U („� �r _� L r � �.:< < 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 Counci/approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: � Name: L (� z-� 1�. �r� / � L � State License # �� `.� � Expiration Date: � � �U/� Lead Certification Number: �� !� Expiration Date: (for work on homes that were constructed prior to 1978 Phone: �} S��- y�s—_ � � c� � (office) (cell) Mailing Address: �� /`j� X � City: � r-�� ZIP: 5--�-�� Contact Person: ,� � �L �p< < � Applicant is: ontractor '/ Homeowner (Circle One) Email and/or Fax: �', S-,�. - ��"S- -- �L 4 y PROPERTY OWNER INFORMATION: Name: �� ,�. �L � ��'-e-•�7�t �� e.� f� Phone (day): ��y _ � c, 3 _ � �� Address: l� �� G'�:.�� c� r� � City: p :�,� O ZIP: - �,�' G � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) B�roof, asphalt ❑ Repair Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ � � p Uv 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. ApplicanYs Signature: J� �,,��C�----- Date: �CS�Y /1a l/ Last Updated: 08-09-2011