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Home My WebLink About2009-00582 - roofing � CITY OF ORONO PERMIT NO.: 20o9-ooss2 � 2750 KELLEY PARKWAY � ORONO,MN 55356- DATE IssuEn: 09/1U2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3745 JACOBS MILL RD PIN : 32-118-23-24-0011 LEGAL DESC : JACOBS MILL : LOT 001 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 15,000.00 APPLICANT pERMIT FEE SCHEDULE 265.50 CVA DESIGNS CONSTRUCTION STATE SURCHARGE(VALUATION) 7.50 9637 ANDERSON LAKES PARKWAY EDEN PRAIRIE,MN 55344 MISC FEE 0.00 (612)216-5513 TOTAL 273.00 Minnesota State License#:20634594 OWNER ADAMS,BRADLEY&LYNN 3745 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. 1'his 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 governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if conswction authorized is not commenced within 180 days of the date of issuance,or if conswction 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 tirpe for due cause. �� , i i i i Applicant Permitee Signature Date Issued By nature Da SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . '' City of Orono � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �.,0,� PO Box 66 �Q ,,l 0 ,\ Crystal Bay, MN 55323-0066 Date received: � Received b `� �'✓��'�;, �, � Street Address: y� �'�n � r� Gti� 2750 Kelley Parkway Plan review fee: r�kE3H � 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: '�-7 y�_ J�c�� 1�� ( I c� Will this be a Parade of Homes, Remodelers Showcase Home or ot er Display Home? ❑ Yes No /f yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �Vi� 7�T �<� C..:��ti�-��-'��,) State License# =�L�c�.�� Expiration Date: Phone: � _ office cell Mailing Address: � � �,, Cit : ' :��;.� ZIP: � ' Contact Person: � " A licant is: ontractor / Homeowner � p (Circle One) Email and/or Fax: PROPERTY OWNER FORMATION: Name: �res- � �� i/��-S Phone (day): Q5� -�7� _�-��r ;� Address: ��y� ��.c�a ��6�V1.�;�� l� L� City: �j'��. ZIP� ��j��j� 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) $js G�;�j 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 su I the information, the a lication ma not be issued. r", / t� ApplicanYs Signature: "� ,�,� Date: ( O ' i LastUpdated: 05-04-2009 DAy� TIME �(/ CITY OF ORONO CALLED IN ' /� INSPECTION NOTIC SCHEDULED -�� s�i�( PERMIT NO.a�D - 6S��OMPLETED �� ADDRESS �7�� O��-�� /'�� kL OWNER CONTR.C V�' aCJ�'�yh4 TELEPHONE NO. ��Z Z�� 5�� ' � DESCRIPTION �e� ��'� T � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a � � O � � O � W � Q � Z W � W � � WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Ca11 for the next inspection 2a hou in advance. (952) 249-4600 OwnerfContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice DATE TIME , / CITY OF ORONO CALLED IN �� INSPECTION I �DD��.�cHeDULED � �� r`> PERMIT NO. L�PLETED ADDRESS � OWNER CONTR. �� TELEPHONE NO. �� DESCRIPTION . — /`"'�'� � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ IAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO v�, COMMENTS: � W 0. � J O � � O � W . � Q � Z W � W � � � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE W ❑CORRECT WORK�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTIOM1I TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPEGTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 forthe next inspection 24 hours in advance. (g52) 249-46�� OwnerfContractor on sit : . Inspector. White CopyMspector's File Canary CopylSite Notice