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Home My WebLink About2012-00949 - roofing i _ � , CITY OF ORONO * Z 0 1 2 - Q1 P1 9 4 9 * , � 2750 KELLEY PARKWAY DATE ISSUED: 09/24/2012 ORONO, MN 55356- • (952) 249-4600 FAX: (952) 249-4616 ��DDFtESS : 2160 KENWOOD WAY � ' IN : 17-117-23-41-0004 EG�:L DESC : RGT WALLACES ADDN-LOTS 42-43-5 : LOT 000 BLOCK 001 �ERD'[IT TYPE : MINOR ALTERATIONS �?ROFERTY TYPE : RESIDENTIAL �ON��TRUCTI01�1 TYPE : ROOFING-ASPHALT �CTI`JITY : O/S BUILDING-UNDEFINED �'ALi�ATION : $ 11,000.00 �:OTE: VALUATION OF PERMIT:$ll000.00 ; �OOFiNG PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO o'ORK:BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. �: x $fGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. f)NCF WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 206.50 �;��iAXI VIUM CONSTRUCTION STATE SURCHARGE(VALUATION) 5.50 =,�33 W sNTERBERRY �'001)BURY,MN 55125- TOTAL 212.00 �`;12)�90-3793 PAID WITH CASH 212.00 `�Iinne�,ota State License#:BC639363 r "v OWNER �-�'CARk'_USEN,PAUL 160I�ENWOOD WAY '�,/AY�.ATA,MN 55391- ;�: , ,�GREEMENT AND SWORN STATEMENT ';7►e wcrk for which this permit is issued shal(be performed according to ihe app`oved plans and specifications,applicable City approvals,and the F=tate Biiilding Code. This permit is for only the work described and does �:ot gra�t permission for additional or related work which requires separate � rmits All provisions of laws and ordinances governing this type of work liall be.compied with whether or not specified herein.This permit will zxpire�md become null and void if construction authorized is not �omme�iced within 180 days of the date of issuance,or if construction is ',uspenc�ed for a period of 180 days at any time after work has commenced. ;�:_�'he apX;licant is responsible for assuring all required inspections are �,��quest�-d in conformance with the State Building Code.This permit may be ;.' ��ivoke�'at any time for due cause. '� .�._. i�� l Z`f /Z�'�2 , 9 �.p ic.int Permitee Signature Date �« � �`� Issu By Signature Date `� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �-�.,� , �� f ��a�� , . � ��6�ir�g P'er�i� Ap�p��a�iQr� �or NEair��er�a��e / �enQva�io� (winaov�rs, ciov�-s, siding, r�-roaf, e�c.) Mailrng Adaress: i ��,� PO Box oo � Permit number. /a—� / (�\ Crystal Bay, MN 55323-0066 �� Date received: �- -Z ' � � �., � �� 4 �`�� I' Street Address: �Receivetl by�: � � � ' \'�� '� `"�'� F 2750 Kelley Parkway o o. .,t i .�� o �fan revi,.w fe,.. � `�,k�SHo�''� Orono, MN 55356 Tota1 Fee: � `� � �� Main: 952-249-4000 Fax: °52-249-4016 www.ci.orono.mn.us This appficaiion form must be completed in full and all required inrormation must be submitted. Incompiete appfica�ions wiil be returnec�. (Please print) GENERAL INFORMATIO�: Job Site Address: ZIb L� ��W�c�� (!`� Dr°�o ✓�l� 5�:3 � � Will this be a Parade of Homes, Remodeiers Showc se Home or other Display Home? ❑ Yes No !f yes, a specral event permit is required with Po(ice Deparimenf and City Council aporoval 60 days prior to the event. Shuttle bus service wil!be required unless app/icanf demonstrates sufircienf on-sire parking is available. Non-permitted evenfs will not be allowed. CONTRAC�'OR/APPUCANT INrORMATIONt: Name: �4�X f�Vl VI�C- State License # gGb ��C� 3 b 3 Expiration Date: 3 31 D ( 3 Lead Certificafion Number: (�/�j� �2,2'L I� -I Expiration Qate: 3 '� L n � 7 (for work on homes fhat were coRstrucfed prior to 1978 Phone: 6 I Z- 2 `I�- 3 7�i (ofrice) (cell} Maiiing Address � (��y�.F..Qr i- �,r� City:(�J ;� ZIP: s j Z ,S`� Contact Person: J3 o b �✓;�(,a-�,.s�rl App(icant is: Contracto� / omeowner (CircYe One) cmail and/or Fax: 6 5`/ - �f o�7._ �p L S� PROPERTY OWNER INFORMATIOt�: Name: h'G-�� li�.-��C s e-✓� Phone(day): �j 2 -6 y � ' �S�6 �� ° Address: Z l 60 /Gp,,,�,,,•oocQ L.�� City: ��e„i o ZIP: s $,3�� / Email and/or Fax PR�JcCT IN�ORMl��101�: Type of Project: ! Any eartn movement rrzay require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ,�Re-roof, asphaft ❑ Repair , $f Storm Darriage I� 1 E202 Minnetonka Blvd � � I I Deephaven, MN 55391 ❑ Re-roof, cecfar i ❑ Restoration ❑Vbfater Damage Phone: 952-471-Q590 ❑ Re-roof, other(specify) I ❑ Siding ❑ Other: (specify) Far,: 952-471-0682 ! www.minnenahacreek.orq � ❑Window(s) � Overall Project Descriptiort: %�. � S ,�o-.-� l-�-,-�, Estimated Consfruction Vafuation of Fr ect (exciucfing land) $ �/. 4c�G' � �`� APPLICAI�T ACKh10WLED�EM�P��': • Agrees to provide all information required or requested by the Building Depariment; • �ertifies trat the information suppfied is true and correct to the best of his/her knowledge. The applicant recognizes that fhey are soleiy responsible for submitting a compiete app(icaiion being aware that upon failure to do so, the siaff has no alternafive but to re}ect it unfil it is�omplete; • Some or alf of tne iniormation that you are 2sked to provide on tnis appfication is cfassified by S;a'te law as eitner priva'te or conrideniial. Private da;a is information wnicn gene�aliy cannot be given to the pubiic but can be given to the subject of the ca,a. Confideniia! data is information wnich generalfy cannof be given io eitner the public or the subjecf o` tne da;a. Our purpose and intended use of this informafion is to annualfy update our records and records of other govemmen;al agencies reauired bv law If vou refus�to suppf�tne inTorrrzaiion tne anpfication mav not b�i�su�d I ApplicanYs Signature: � �-- pat�. �Z � Z J t 2 �ast Uodated: 0°�-09-2011 DA TIME ,V CITY OF ORONO ALLED IN _ Z � 2— INSPECTION NOTICE ,/� SCHEDULED � � �- PERMIT NO. �� Z"��`T� COMPLETED ADDRESS o?/�r D e vL,WO''D c� (� OWNER � TELE NE NO � � - g�37 g� CONTRACTOR � DESCRIPTION � ❑ FOOTING ❑ PLUMBING ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q 0 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 ❑ WARD COVER REMOVAL J ❑ PLUMBING RI O SEPTIC FINAL ❑ FOUNDATIOWREMOVAL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W 0. � J � � Q G:�� R o�1 (d � � �1 Q��Q��./' ° O� I�J� � �Sti r3 �� t2ofi' W � Q � z W � W � � � .�'�11�RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C�IERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED O INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. � . � White Copyllnspector's File Carrery CopylSite Notice