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Home My WebLink About2011-01349 - roofing , CITY OF ORONO PERMIT NO.: 2011-01349 2750 KELLEY PARKWAY l ORONO, MN 55356- DATE ISSUED: 10/28/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3640 JACOBS MILL RD PIN : 32-118-23-24-0010 LEGAL DESC : JACOBS MILL : LOT 004 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 28,116.80 NOTE: VALUATION OF PERMIT:$28116.80 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUS'F BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 456.00 CVA DESIGNS CONSTRUCTION STATE SURCHARGE(VALUATION) 14.06 15832 VENTURE LANE EDEN PRAIRIE,MN 55344 MISC FEE 0.00 (612)216-5513 TOTAL 470.06 Minnesota State License#:20634594 OWNER HOFFMAN,KEITH&MARY 3640 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 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 are requested in conformance with the State Building Code.This permit may be revok y ti e for due cause. � �� — / / plicant Permitee Signature Date Issued By ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. City of Orono Building Permit Application for Maintenance / Renovafion ` (windows, doors, siding, re-roof, etc.) Mailing Address: '�,L+0.� PO Box 66 Permit number: �� Q Crystal Bay, MN 55323-0066 Date received: �n �a �3''�'�:;; �,� Streef Address: Received by: �'�,n "�t' ',,;v;�_ �ti 2750 Kelley Parkway Plan review fee: L�'kESH�4� 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�� `� �1� �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a specia/event permit rs required with Police Department and City Counci/approva/60 days prior to the event. Shutt/e bus service will be required unless applicant demonstrates sufficienf on-site parking is available. Non-permitted events wif/not be al/owed. CONTRACTOR/APPLICANT INFORMATION: Name: �-�l�/�1 ��v�'� Lc�;1�i-r�c-�<i � State License # � �� Gl�( Ex iration Date: �.3i_ � c�.--_`I p� L�3 Lead Certification Number: Expiration Date: (for work on homes that were constructed prior fo 1978 Phone: (office) (cell) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: , Name: t'��...:��T�C� t-��>�� cx �v, Phone (day): � �` - -(� Address: � y l' � City: ��-�,��j - ZIP: �� Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review &permits: Minnehaha Creek Watershed District(MCWD) �Re-roof, asphalt ❑ Repair [�Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restorafion ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Sidin Phone: 952-471-0590 g ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description: Estimated Construction Vafuation of Project(excluding land) $ � � 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 pub(ic 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 vou refuse to su I the information, the a licafion ma not be issued. A IicanYs Si nature: �� PP 9 (G�1� �� _ ��w�� Date: /G% � �� 'ast Updated: 08-09-2011 -pAT TIME ✓ CITY OF ORONO CALL D IN �a � INSPECTION NOTI E p SCHEDULED � "� - PERMIT NOaD��3�/ COMPLETED ADDRESS �6�� (��i'�'��'� �—�- OWNER TELEPHONE NO. ��a d ��"l CONTRACTOR Gv� �� "�_ >; DESCRIPTION �```-� I�'"' �/ � L� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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. ❑ FO�LOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O � b,�' .1�� '` . � i?y�('� 0 _ � W � Q � Z W � W � � GW ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector.�� 'l '1 White Copylinspector's File Canary CopylSite Notice