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Home My WebLink About2016-00312 - roofing �' - � � CITY OF ORONO * Z 0 1 6 - 0 0 3 1 2 * � 2750 KELLEY PARKWAY DATE ISSUED: 03/3ll2016 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS 50 KELLEY PKWY PIN : 33-118-23-12-0007 LEGAL DESC : CITY OF ORONO ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE : ROOFING-ASPHALT ACTNITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,691.00 NOTE: ASPHALT REROOF OF THE SALT SHED APPLICANT PERMIT FEE SCHEDULE 0.00 G C BUILDERS TOTAL 0.00 7170 UNION AVE MAYER,MN 55360- (952)657-2284 Minnesota State License#: BUIL-20626549 � OWNER City of Orono ORONO,CITY OF 2750 KELLEY PARKWAY P.O.BOX 66 CRYSTAL BAY, MN 55323- 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 separate 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 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 revoked at any time for due cause. / / Applicant Permitee Signature Date Issued By Signature Date , City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EX�ANSION) �O�O MailingAddress: Permit number. �� (�' ';�/ PO Box 66 Crystal Bay, MN 55323-0066 Date received: �� -� � —� (o ,� Street Address: Received by: -� ti�, G� 2750 Kelley Parkway Plan review fee: t Orono, MN 55356 �XESHO�� . Total Fee: �f ,�. 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•1 Job Site Address: ��j7-�� T'6�G�� 7Ei� ��°j� Dj�'�C�.-t,�r�y Will this be a Parade of Homes, Remodelers Showcase Home or other isplay Home? ❑ Yes � No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e bus seivice will be required unless applicant demonstrates su�cient on-site parking is availa6/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �"��Uj�'��' State License# ��. ��;�' q ` Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) 9g�- yS7�-$3E%�� (office) c��- �/5'�— �3�,�� MailingAddress: -7/�U j,h,'v�� . City: � �,� ZIP: 5'S3 "2� Contact Person: �d�d� Applicant is: ontract / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: �'s �Y �'�, ��D , Phone (day): ��a��c�.-c��p� Address: �7�U x'�//�� D �y c�ty:�o��e ziP: ��5,6 Email and/or Fax: PROJECT INFORMATION: Overall pro�ect description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: f�Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project(excluding land) $ , oc°� 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 required by law. If ou refuse to su I the inform tion,the a lication ma not be issued. ApplicanYs Signature: � Date: �"�r ��1 Owner's Signature: � �r„��/,� Date: 7'�� Last Updated:January 2015 ✓ DATE TIME CITY OF ORONO CALLED IN �_ INSPECTION NOTICE SCHEDULED � PERMIT NO. � � L c PLETED ADDRESS OD � / � OWNER • ELEPHONE NO. CONTRACTORG•� �i � DESCRIPTION ��/ / ! � 4i ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q �FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP � ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 ONfNERICONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: � W C � 0 - �-- �/'� 3� �. � Q O � [ W � Q z -JC( �� :ee�p�ea�'s ��► rJ��e,f� W ^� � W � J d W� ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE W �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Catl for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContra on site: Inspector. White Copyllnspector's File Canary CopylSite Notice