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Home My WebLink About2009-00181-old PID# - roofing CITY OF ORONO PERMIT NO.: 2009-00181 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 04/27/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2697 ETHEL AVE ., PIN : 20-117-23-24-0045 LEGA�I)ESC : REG.LAND SURVEY NO.0115 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,000.00 APPLICANT pERMIT FEE SCHEDULE 118.00 AMUNDSON,C.GORDON STATE SURCHARGE(VALUATION) 2.50 2697 ETHEL AVE TOTAL 120.50 WAYZATA,MN 55391- (952)471-7700 OWNER AMUNDSON,C.GORDON 2697 ETHEL AVE WAYZATA,MN 55391- AGREEMENT 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 Buiiding Code. This permit is for oniy the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shal(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 f issuance,or if construction is suspended for a period f 180 days at time after work has commenced. The applicant is resp sible r as � all required insp ions are requested in confo ance �th ta Building Code. is permit may be revoked a y ti for e ca � � /� CJ/�V� `��a�"� 7��. Appli ant Perm�ee ig ture Date Issued By Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application ��--� Mailing Address: Permit number: � PO Box 66 �/� �Q�;� Crystal Bay, MN 55323-0066 Date received: / ��, � ��. � ��'R'�;� i; Received by: �,� t �� ,�._,. �, Street Address: �'�, ,� � 9w�j,� ��,! 2750 Kelley Parkway Plan review fee: '��vk�� % Orono, MN 55356 \_ESHD/ �=— 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�� -7 --- Z� / /� V� 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 Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: , Name: �..:;E-J � -�` ��F �� E=� K (� State License# Expiration Date: Phone: (office) (cell) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: C. - C--�Cr�c�l c,v'� �-��'l� l l U1 C�<<:C�b�"� Phone (day): q 5 Z -- L( � i — '1 —1 C7C� Address: �,��-�,��.- � c �(n��,M1.� City: ZIP: 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: Estimated Construction Valuation of Project(excluding land) $ �j� �r��. , �G 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 an ally update our records and records of other governmental agencies required by law. If you refuse to supply the ' formati , the application may not be issued. �,. � ApplicanYs Signature: Date: �� l � ,/�p� � �J�� `�L� i � �//`� L p�,/b� TIME CITY OF ORONO � CALLED IN � INSPECTION NOTICE rl SCHEDULED ��1 --�- L��'�`" PERMIT NO. ��'�X I COMPLETED ADDRESS -�� C�% � � �� Z'`� OWNER�Il�y,Lln CONTR. TELEPHONE NO. �� D S - �'f� �/�� DESCRIPTION � L//!11 � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/ ING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ OEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP Q _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL �( ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES 11 NO d ' � COMMENTS: � W a � .—�/ � p �. � •�� i/� � �Q i /� 1 l��L v�1 `TC� � __ � � f� �� C� � � � -�C� � � �4� � c.-.J�A-�-�s'� %�n � � �' A�-P W Q `l� r �i itJ 1Q � � 2 W � W � � O W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUiRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. � � �� White Copylinspector's File Canary CopylSite Notice