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Home My WebLink About2011-00520 - roofing � � CITY OF ORONO PERMIT NO.: 2011-00520 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE �SSUED: 06/27/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3420 HIGH LA PIN : OS-117-23-12-0026 LEGAL DESC : N/A : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BU[LDING-UNDEFINED VALUATION : $ 6,500.00 NOTE: TF,AR OFF REROOF HOUSE AND GARAGE APPLICANT PERMIT FEE SCHEDULE 147.50 MIDWEST ROOFING STATE SURCHARGE(VALUATION) 325 6541 SYCAMORE CT N TOTAL 150.75 MAPLE GROVE, MN 55369- (763)427-9696 Minnesota State License#: 20637010 OWNER WOLVERTON, WESLEY& ELIZABETH 3420 HIGH LA LONG LAKE, MN 55356- ACREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State E3uilding Code. This permit is for only the work described and does not grant permission for additional or rela[ed 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 no[ commcnced 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. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked t rry t� e fo due cause. � �� a�� i �i ! Applicant Permitee Signature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK O HER THAN DESCRIBED ABOVE. � j City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �/l� DU�� O4v�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: // �\�� Received b � '. ��°;� a, StreetAddress: y� �' '� 6� G'.F 2750 Kelley Parkway Plan review fee: ��'�Esxo4`'� 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: � /,�D �1�� /n . Job Site Address: 7 C� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No /f yes,a specia/event permit is required with Po/ice Department and City Council approval 60 days prror to the event. Shuttle bus service wi//be required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR/APPLICAN INFORMATION: Name: /'�'t.�G✓�151 State License# ��(p�) Expiration Date: p�-3/-/� Lead Certification Number: Expiration Date: (for work on homes that were construcfed rior to 1978 Phone: ,(p � , f� � (office) (cell) Mailing Address: S/ $y�,.._,�� , City: q�.e (,�/pvG ZIP: $'�'��9 Contact Person: �,.� Applicant is: n ractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: f n/.(� �/O�(/��7�'� Phone (day): a-Gl7 — /�6 Address: 31��d ;�� (�, City:��eZ,� ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 �Re-roof ❑ Fire Damage Fax: 952-471-0682 www.mi nnehahacreek.orq Overall Project Description: .Cl�/ Q(� .. ,e�,� !/SC Estimated Construction Valuation of Project(excluding land) $ �p� 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 I the i formation, the a lication ma not be issued. ApplicanYs Signature: Date: �Q "p� �✓ � Last Updated: 03-01-2011 � � TIME ✓ CITY OF ORONO CALLED IN � INSPECTION OTICE �5a0 SCHEDULED ___�7��' ._.��L PERMIT NO.� co PLET.�D ADDRESS � OWNER EPHONE NO. 7Y3 -��D�� CONTRACTOR '>; DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � � O � � O � W � Q � Z W � W � � d � ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED � I SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CQRRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETIJRN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: Inspector. /j�� White Copylinspector's File Canary CopylSite Notice � � TIME CITY OF ORONO CALLED IN �� `� INSPECTION NOTICE SCHEDULED PERMIT NO. �� 'S� COMP ETED � ADDRESS � � �'�— OWNER HONE NO. CONTRACTOR �� —' >; 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 � ❑ DEMO-SITE ❑ SEPT�C MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � GW �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL 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� 249-4600 OwnerlContractor on site: Inspector. � `' � � White Copyllnspector's File Canary CopylSite Notice