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Home My WebLink About2011-00533 - roofing CITY OF ORONO PERMIT NO.: 2011-00533 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISsuEn: 06/28/2011 � ` 952 249-4600 FAX: 952 249-4616 ADDRESS : 3680 JACOBS MILL RD PIN : 32-118-23-24-0009 LEGAL DESC : JACOBS MILLS � : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 13,420.00 APPLICANT pERMIT FEE SCHEDULE 250.75 DAN LILLESTOL ABLE RESTORATION STATE SURCHARGE(VALUATION) 6.71 17316 KENYON AVE#103 TOTAL 25'7.46 LAKEVILLE,MN 55044 (612)280-4807 OWNER COLLINS, STEVEN&BARBARA 3680 JACOBS MILL RD 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,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 sepazate pertnits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not speci5ed 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 � J � 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 at any time for due cause. i l �i��'i /� Applicant Permitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Cit of Orono � �c��'v Y , ' Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) (/- D`� �� Mailing Address: Permit number: O�v�,� PO Box 66 ,`�y ' � Crystal Bay, MN 55323-0066 Date received: V �� g/�� a� �� ;q �, Street Address: Received by: x' ' v�' �,ti�' 2750 Kelley Parkway Plan review fee: �t`�kESHo�`v 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 INFORMATIO ' I 1 4�� YD C� ) ," l rv Job Site Address: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes If yes, a specra!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 sufficrent on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/A,�PLICANT INFORMATION: Name: .,U�,��; � l,rs+� I � b 1� �sfora:.�� State License# a(��-��,�� Expiration Date: Lead Certification Number: Expiration Date: (for work on homes hat were construcfed prior to 1978 Phone: � � Q��'"(� � (office) �<:� - � �� ' v U (cell) Mailing Address: J "7" � -p City: �j ZIP: �;�(� � Contact Person: Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: C�',1�� . �S . ' �� , PROPERTY OWNER INFORMATION: �9 Name: :�"C i�`�`' G�1'lU �r�"Y�. �� 1 �S Phone (day): Address: � � �j a�b�S (�/� I � I � � City: D j�'p n� ZIP: 5�` �� 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 e-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: `.� o, a Estimated Construction Valuation of Project(excluding land) $ S h � 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 annuafty update our records and records of other governmental agencies re uired b law. If ou refuse to su I the infor tion,the a lication ma not be issued. ApplicanYs Signature: ( ��jr� � ,I�� Date: � " �7'` � Last Updated: 03-01-2011 D E TIME � CITY OF ORONO ca��N �� INSPECTION NOTICE SCHEDULED —ZZ'� � PERMIT NOa�I�'DD S33 COMPLETED ADDRESS J�IOo� IVL� i�2� �° OWNER P�T�LEPHONE NO.fQ�Z"Z�D- �O� CONTRACTOR A�/l P ��Jy� a DESCRIPTION �l`� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALI ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB � ❑ WATER HOOK-UP ❑ PROGRESS � � FINAL ❑ SEVYER HOOK-UP O COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING Rl ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO • � COMMENTS: Dl D7! � W a j �, �` � � s�� ° ,�� r 0 � W � Q � 2 W � W � � � ❑WORKSATISFACTORY:PROGEED �PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFOREC�IERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHiN HOURS. p pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPEC710NREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on site: � Inspector. � White Copyllnspector's File Canary CopylSite Notice