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Home My WebLink About2011-00423 - roofing; t i ) :� CITY OF ORONO rExMiT No.: 2011-00423 ' � 2750 KELLEY PARKWAY ,, � � ' ORONO,MN 55356- DATE ISSUED: 06/06/2011 ` 952 249-4600 FAX: 952 249-4616 ADDRESS : 250 HOLLANDER RD PIN : 25-118-23-44-0014 . LEGAL DESC : HOLLY ACRES 3RD ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL � COPISTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 14,000.00 APPLICANT pERMIT FEE SCHEDULE 250J5 'MIDWEST ROOFING STATE SURCHARGE(VALUATION) 7.00 6541 SYCAMORE CT N MAPLE GROVE,MN 55369- MISC FEE 0.00 (763)427-9696 TOTAL 257.75 Minnesota State License#:20637010 OWNER BRADLEY,R JEPPSON&L 250 HOLLANDER RD WAYZATA,MN 55391 AGREEMENT AND SWORPi 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 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 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 aze requested in conformance with the State Building Code.This permit may be revoked a 'me for due cause. � / � / �� / / Appl' ant Permitee Signature Date Issued By Si ture ate SEPARATE PERMITS REQUIRED FOR WORK OTHER N DESCRIBED AB E. City of Orono � • Building Permit Application for Internal Work � (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O�,L,�,�0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: ,� � ;. s, Streef Address: Received by: �'� ' '� Gti�' 2750 Kelley Parkway Plan review fee: L�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: ( � / '? �� Job Site Address: ,�j .�� tG �(CVI� � c=C � ��tl Z�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes,a specral event permit is required with Police Department and City Council approval 60 days prior to the event. Shuftle bus service wil!be required unless appficant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: +��1;��.Sf��oF�� 1,�� i✓ ,��,�s State License# ��,�,r� ;; ?� Expiration Date: �3- ��_ j� Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 9978 Phone: �(� � ��<� 7 �'�f�� (office) (cell) Mailing Address: �( � � �u.,,-�e� G�, City: �ra„e ZIP: _S'5.1�s' Contact Person: ��,�,�y �-�CSr-, Applicant is: o ractor Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: ��i ,SC'�'r��,''` Phone (day): Address: �.,r�`-, jF��,�.,��G,— ��_ City: (,✓C{yZ�� ZIP: Email andlor 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 , ] Re-roof Phone: 952-471-0590 ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: 7�y;��-�� __� - 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 t I the information, the a lication ma not be issued. ApplicanYs Signature: ��-- Date: (t! �Ki� Last Updated: 03-01-2011 DA TIME " CITY OF ORONO CALLED IN �O INSPECTION N TICE ,/ SCHEDULED PERMIT NO. � (�Y��UCOMPLETED � H ADDRESS O�S� � �l Q vl�f� /( D�.� _ OWNER TEL HONE NO/��-3aY CONTRACTOR � DESCRIPTION ��J`� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POUREO 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 p PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOA TO MEET YOU:_YES_NO � COMMENTS: � W a � � � O � � O � W � Q � Z W � W � � d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITiONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR W4LL RETIJRN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 24J-460� Owner/Contract si J Inspector. ��- White Copylinspector's File Canary CopylSite Notice DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.�o� �-a� a3COMPLETED - (-� ADDRESS �S� 4-�� l ��'� OWNER TELEPHONE NO. CONTRACT�R /n�'� _ ��S� �C2p�i rt S � n � DESCRIPTION �� /�� t C C� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS 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 J ❑ 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 c�., COMMENTS: � W a � � O �. � O � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED /�ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR W{LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail forthe next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice