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Home My WebLink About2009-00463 - roofing CITY OF ORONO PERMIT NO.: 2009-00463 � 2750 KELLEY PARKWAY � ORONO, MN 55356- �ATE�SSUEn: 08/06/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 140 GOLDEN VIEW DR PIN : 33-118-23-43-0023 LEGAL DESC : HALLSON ESTATES 2ND ADDN : LOT 002 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 20,000.00 APPLICANT PERMIT FEE SCHEDULE 339.25 TIMBERLINE EXTERIORS, [NC. STATE SURCHARGE(VALUATION) 10.00 200 FLORANCE AVE S ANNANDALE, MN 55302- TOTAL 34925 (651)329-6916 Minnesota State License#: 20633887 OWNER HICKOK, CHRIS& ELIZABETH 140 GOLDEN VIEW DR LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicabie 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 construc[ion authorized is not commenced within I 80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. �he applicant is responsible for assuring all required inspections are � reque�d.in.�Qnformance tat ilding Code.This permit may be �(� �_ � ��., rev ed at any time foc due caus ��'�� --� - " / � / �� ,,��_-C C�� Applicant Permitee Si re Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , City of Orono ' Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �0\ PO Box 66 � Crystal Bay, MN 55323-0066 Date received: � O ::il\ O\� � Received by: a �'�'�z-�;� a ,i Street Address: �'�n��'�;"�, ��! 2750 Kelley Parkway Plan review fee: �kESHO� Orono, MN 55356 - Total Fee: 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: ; 1 Job Site Address: �;11 � C��G1�'✓1 V;tw �� w^c� L� �� ,/�/1N 5 � � 5� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �c No lf yes, a special event permit is required with Police Department and City Council approva!60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is avaifable. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 7,.��1,� �x1-��.�- -, i�.c State License# 2oG 7 3 �� 7 Expiration Date: /3 I Z o � � Phone: �5 r� 3 2 `t —�a�� (office) �GSI � 3s3 �- 88y Z (cell) Mailing Address: z�c� ��-,c , � S Cit : r��a�d�.� Mn� ZIP: 5 5 �� Contact Person: o,.,,'� :� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: �Z D �-2�'`� — ?t 5 � ��.�� PROPERTY OWNER INFORMATION: i� Name: �l�w� 5 l `7 c �v�G Phone (day): �52� 4�73 — 25yZ Address: �ct n.�� City: ZI P: Email and/or Fax Iu/,� PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) �Repair [�Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ 2�3, Od c� 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. �'�__ � �' �/�/� I Applicant's Signature: Date: Last Updated: 05-04-2009 �i� � DAT TIME � /� /, CITY OF ORONO CALLED IN C/ INSPECTION NOTICE SCHEDULED � PERMIT NO. '� �COMPLETED • ADDRESS D ��%U� � OWNER __CONTR. TELEPHONENO. /CiC��'; ��—" �o ��I� � DESCRIPTION � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION iFINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � __ - _ _._ W . a � - - _ _ _ _ __ J -- __ __ O � � _ _ _ _ O _ � W - - - � Q � __ _ � _ _ _ . Z W _ _ ... . .. - � _ __ _.. W -- � - . _.__ � - - _ . ._ . d � ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED I SUE CERTIFICATE OF OCGUPAMCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR -�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANC,E ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: Inspector. _,�o(.r`-. � White Copyllnspector's File Canary Copy/Site Notice V- �-' " DA E TIME CITY OF ORONO CALLED IN �"� '�7 INSPECTION NQ�T�IC�./E� �� SCHEDULED ��y � PERMIT NO. �U�/ COMPLETED ADDRESS "7'� � ' __---- OWN ER CONTR. TELEPHONE NO. � � � � a�'— ��D � DESCRIPTION �� a� � ' � ❑ FOOTING � MECHANICAL RI ❑ CAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BUANER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTAIL. ❑ FOILOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � J O a � O � W � Q � Z W � W � � d W,�GVORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ �SSUE CERTIFfCATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-46�0 OwnedContractor on site: '" inspector. �.,� i � � White CopyllnspectoPs File Canary CopylSite Notice