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Home My WebLink About2010-00646 - roofing CITY OF ORONO PERMIT NO.: 2010-00646 . 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 08/02/2010 . 952 249-4600 FAX: 952 249-4616 ADDRESS : 2625 KELLY AVE PIN : 20-117-23-14-0026 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 000 BLOCK 005 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 17,052.00 NOTE: ASPHALT ONLY-PER CONTRACTOR APPLICANT PERMIT FEE SCHEDULE 309.75 LAKEWOODS REMODELING INC. STATE SURCHARGE(VALUATION) 8.53 9001 E. BLOOMINGTON FREEWAY ST TOTAL 318.28 BLOOMINGTON, MN 55420- (952)888-5550 Minnesota State License#: 20443066 OWNER NEJEZCHLEBA,CURT&CHRISTA 2625 KELLY AVE EXCELSIOR,MN 55331 AGREEMENT AIYD 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 additionai or related work which requires separate permits. AII 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 requesfed in conformance wi the Stat ilding Cod This per �-ttfay be revoked at any time for du cause. /� .--� i i �c C C��YI�IC�'d`'1�� L� �""/�� ' �� i i ,Applicant Perrrli ee Signa r Date Issued By Signature Date / SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � s . City of Orono , Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Og,�,j�.O PO Box 66 Crystal Bay, MN 55323-0066 Date received': a ��' �, Street Address: Received by: '�}, � GtiF 2750 Kelley Parkway Rlan review fee: r9,kE$xo4,� 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. (P/ease print) GENERAL INFORMATION: Job Site Address: v� a�5 i! Will this be a Parade of Homes, Remodelers Sh wcasef ome or other Display Home? ❑ Yes - ❑ No /f yes,a special event permit is required with Po/ice Departmenf and City Counci/approval 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: ►vame: l�Ke.�o��-�e� �hc �,�� State License# �(�3p�,� Expiration Date: ?,—�� - �� Phone: —s v office - — cell MailingAddress: � F' �� Ci : ,,,.�, " � ZIP: Contact Person: Applicant is: ontractor / omeowner (Clrcle One) Email and/or Fax: �• ��-� ��`�� PROPERTY OWNER INFORMATION: Name: r Phone(day): a.- — Address: �-i.,�'�-- 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 verall Project Description: Estimated Construction Valuation of Project(excluding land) $ ��S�bG 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 s I the inform ' n,the a lication ma not be issued. : � ApplicanYs Signature: � Date: � Last Updated: 05-04-2009 r MINI�SOTA DEPT.OF LABOR�INDUSTRY � Construction Codes and Licensing Division P.O. Box 64217 ` S�t. Paul, MN 55164-0217 , LAKEWOODS REMODELING INC 9001 E BLOOMINGTON STE 144 BLOOMINGTON, MN 55420 ,, . ,, <. °r ' St��t�f M��tnesota ;' �ort�tru��ion �oc��rnd Licensing Division �:;N ':�J�partrr�ent of Labor and lndustry 'Te[�ph�rte. (651)2��-5034 ; P.O. Bax�4217 � mail �ddress. dlt:l3cense@state.mn.us ' - St. Paul, MN 55164 Q217 „:.: Website address: www.dli.mn,, ov , ,� •• 9 � .. ; :. : , > , , ; , . > ,;: _ ; R��L��N"�"�AL BI��LDING`CONTRACTOR Lf�E�� ega1 Na�►e #.AKEVV�q#7S REMODELING iNC 8us��es��tructure: :: :17BA :: <., ; :`< ; CORP�F�ATION Address: 9001 E BLOOMlI�GTON > STE 144 ,;' > , , : ; ; ,, ; ; BLOO�VIINC.�sT+�7N,MI� �54�0 , ';; ' , << .; ;. ;. ;: ,;.;<. License Identification Number. 20443066 Qualify'rng Person: SCOTT H RISE " . ; ; : : �.�c��se��p�ration C�at� �}3/31/2012 Coi��nwin'g Educa�t��n #:� h�urs d��y 03/31/2012 . _. ': � . ,- ,. _ .�,.,,,.,,�,�,,� __ ��f� ��/�"— � � e A TIME � CITY OF ORONO CALLED�N � O INSPECTION OTICE�/, (�/�, SCHEDULED �L�= �� -�� PERMIT NO.��6�!/��/'� COMPLETED ADDRESS �� e / OWNER T LEPHONE NO�✓�� '� � CONTRACTOR 40 � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � O W �ORK SATISFACTORY:PROCEED ❑ PROJECT COMP�ETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETItRN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-4600 Owner/Contractor on site: Inspector. �./ � �� White Copyllnspector's File Canary CopylSite Notice � DATE TIME v CITY OF ORONO CALLEo iN INSPECTION OTICE / SCHEDULED � � PERMIT NO.��D "ODrp Y�Q COMPLETED ADDRESS oI(a�.�S /��GP-�f�"T� OWNER TE EPHONE NO. ��Z 3�.p �5�.� CONTRACTOR � � � � DESCRIPTION /- ln� �`" � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y ❑ 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. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO v�, COMMENTS: � W a o , G --} �t-G �n-� �� 0 � W � Q � 2 W � W � � W ❑WORK SATISFACTORY:PROCEED iJ�ROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CQRRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cati for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on si e: Inspector. White Copyllnspector's File Canary CopylSite Notice