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Home My WebLink About2009-00786 - roofing CITY OF ORONO PERMIT NO.: 2009-oo�s6 � 2750 KELLEY PARKWAY � ORONO,MN 55356- DATE IssuEn: 1 U04/2009 � 952 249-4600 FAX: 952 249-4616 ADDRESS : 2750 KELLY AVE PIN : 21-117-23-23-0038 LEGAL DESC : VERN-MAR MANOR : LOT 013 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,500.00 NOTE: TEAR OFF REROOF APPLICANT pERMIT FEE SCHEDULE 147.50 KURT THOMAS CONSTRUCTION STATE SURCHARGE(VALUATION) 3.25 1811 EASTLAND CIRCLE NE TOTAL 150.75 BUFFALO,MN 55313- (763)807-2489 PAID WITH CC# 4812 Minnesota State License#:20633527 OWNER ETAL,JOHN KOZAR 2750 KELLY AVE EXCELSIOR,MN 55331 AGREEMENT AND SWORN STATEMENT 1'he 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 aze requested in conformance with the State Building Code.This permit may be revoked at any tjm or due cau e. ! ' -� // �/ / a / / A plicant Permitee Signature Date Issued By Si ture Date 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: a�� O �v 0,� PO Box 66 Q ,\ Q Crystal Bay, MN 55323-0066 Date received: / p 1 `��_��, � � � �? ��, Street Address: Received b y ��.,;` �,�I Y� �, '� ''" �� 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: �� ,�� - �k e n c f3;�� .� / Will this be a Parade of Homes, Remodelers Showca e Home or other Display Home? ❑ Yes � No lf yes, a special 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 sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT.�I F�MATIO�: � Name: `� '• � o.� •�s � o.� � �sc�c. �a-�� State License# a,�� Z 7 Expiration Date: Phone: 7l� �a 7 ,�c��C'y (office) (cell) Mailing Address: �/ �� , . � �j/F Cit : ' �,�<<,�z ZIP: �.'��3 ' Contact Person: /' ,,i- ,� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: Phone (day): Address: Cit : 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 ee Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ Cf" pp . 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. ' ApplicanYs Signature: � Date: �� ` C� Last Updated: 05-04-2009 / DA TIME � CITY OF ORONO CA �E� l INSPECTION�JO�TI�,E��7�y�SCHEDULED ! - -4 PERMIT NO. oi. D`� O COMPLETE ADDRESS o? 7SD OWNER CONTR. �C_U�" �LOYnQ/.1.J TELEPHONE N0. ��P�J -' �O� � Z�{�� DESCRIPTION 1 C�-D� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/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 Q ❑ DEMO-FfNAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W C � J O � � O � W � Q � Z W � W � � d W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED !�' ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN u CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALITOARRANGEACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4600 Owner/Contractor on site: ' Inspector. � ( � White Copyllnspector's File Canary CopylSite Notice �-lo ✓ ATE TIME CITY OF ORONO CALLED IN / INSPECTION NOTICE SCHEDULED 9 PERMIT NO�, -'��S��COMPLETED ADDRESS l�c �Jr� �C"��j��f�. OWNER CONTR,�LG/,�� .��/1I TELEPHONE N0. �.wc-! ' 7�J'` S�7-'O�� G��,, ` � DESCRIPTION � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION r �'FIFTAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i � PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO v�, COMMENTS: � W a � J O a � O � W � Q � 2 W � W � � � ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETt}RN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-460� OwnerlContractor on site: Inspector. White Copyll�spector's File Canary CopylSite Notice