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Home My WebLink About2010-01044 - roofing CITY OF ORONO PERMIT NO.: 2010-01044 / ' 2750 KELLEY PARKWAY ORONO, MN 55356- DATE issuE�: 10/22/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 50 HACKBERRY HILL PIN : 33-118-23-44-0025 LEGAL DESC : DANIELS LONG LAKE HEIGHTS : LOT 006 BLOCK 003 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 9,960.00 NO"I'E: RL'ROOF-TGAR OPF APPLICANT pERMIT FEE SCHEDULE 191.75 EXECUTIVE EXTERIORS& REMODELING STATE SURCHARGE(VALUATION) 5.00 4205 LANCASTER LANE PLYMOUTH, MN 55447- TOTAL 196.75 (763)432-4677 PA[D WITH CC# 5383 Minnesota State License#: 20592356 OWNER AUTRY, MARY 50 HACKBERRY HILL LONG LAKE, MN �5356 AGREEMENT AND SWORN STATEMENT I�he work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building Code. This pcnnit is tbr only the work described and does not grant permission for additional or related work which requires separate pennits. All provisions of laws and ordinances�oveming this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commcnced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter 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. �e�z�C��'�r�✓1, i� �Z2 �l� /D, o�a; /�} Applicant Pcrmitee Signature Date Issu 3y Signature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCR[BED ABOVE. ` City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) —� Mailing Address: p /O l,G 0 PO Box 66 Permit number: pZ0/�--� / Q� �\ Crystal Bay, MN 55323-0066 Date received: ��a-- /a � £,. ll a '9� t �, Street Address: Received by: ��-- � �',�, Gti``' 2750 Kelley Parkway Plan review fee: l� �� w Orono, MN 55356 9kEsxo� �—= Total Fee: / g/�,�� 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. (P/ease print) GENERAL INFORMATION: Job Site Address: �jG I-Ic��k ��rr��v Will this be a Parade of Homes, Remodelers Sh case Home or other Display Home? ❑ Yes No If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service wi/l be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: .��(�CUf"iV�' � t2(�vr5 �rVl� ��,/lu► State License# zc� qZ'3�G Expir ion Date: ; I �2C)I� Phone: 7�3-y.3,z- �i�,7] (office) (cell) Mailing Address: �' � Cit : � ZIP: � Contact Person: ,�• � Applicant is: on ractor / Homeowner (CircleOne) Email and/or Fax: a e � ; — X� ,�'�� PROPERTY OWNER INFORM TION: Name: Phone (day): _ Q ' Address: �'Lj` f�uckb�rrv N City: ZIP: � ,3j� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) ❑ Remodel ❑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: �- {" a�c� �. U . � � Estimated Construction Valuation of Project(ezcluding land) $ q�(� 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 app�ication 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 sup I the information,the a lication ma not be issued. ApplicanYs Signature: / � Date: �U � '.�� Last Updated: 05-04-2009 � � ��- ,�� TE TIME CITY OF ORONO CALLED IN �D `� INSPECTION NOTICE SCHEDULED � _�G�' �( PERMIT NO.�D/O—OIC��7�COMPLETED ADDRESS ��'�� l/ OWNER TE,LEP�NE NO./�/�J'��7� CONTRACTOR _�� l/L�J � � >; DESCRIPTION /�� ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � a W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952) 249-46QQ Owner/Contractor on site: Inspector_ White Copyllnspector's File Canary CopylSite Notice DATE TIME " �O�TY OF OROPV� CALLED IN EIVS�E��O�IOI rV �� SCFiEDULED -��r�1�� _t�� WIIT NOe � � �O C PLETED � ��RE� � �w�� . � �o. co��G�� ' � -- � ��sc�i�°ria� -- � � ❑ FOOTING ❑ PLUM8IMG FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURfJER/FIREPLACE ❑ SITE INSPECTION �`�O�I SLAB ❑ WATER HOOK-UP ❑ PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT O EMO-SITE � SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FIIVAL ❑ SEPTIC INSTALL ❑ HARD COVER REP/IOVAI_ � 0 PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OMIfdERICOMYRAC'fOR TO AAEET YOU:_YES_NO O ��: � � '�OLD PERMIT — NO FINAL INSPECTION REQUESTED � J O �. � O � � � � � � W � � � j d ' �sd ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEI�E � ❑ CORRECT WORK�PRQCEED ❑ SUE CERTIFICATE OF OCCUPANC`( W o ❑CORRECT WORK,CALI FOR REiNSPECTIOM TEP/PORARY V BEFORECOVERING PER9VIANENT ❑CORRECTUNSAFECONDITIONWITHIfV HOURS. ❑ PHOTOTAtCEPJ INSPECTORIMLLRETURN ❑CITATION ISSUED ❑STOP ORDEfl POSTED.CALL IPISPECTOR O INSPECTION REQUIRED.CALL TO ARRAMGE ACCESS. ��I��CDP�P(E�6��7��9R1S�D�$��P��w&�t''�OP9��lV�69�� , ��-�d�� ' O�sne�iCe�retr�cfl��°��s6t�: �eas��a� --- �AJhi4e Copylinspec4or's File Canary CopylSi4e V�oBice