HomeMy WebLinkAbout2010-00988 - roofing , , CITY OF ORONO PERMIT NO.: 2o�aoo9gs
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 10/13/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1040 KNOLL MANOR RD
PIN : 26-118-23-31-0014
LEGAL DESC : KNOLL MANOR
: LOT 004 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 12,000.00
NOTE: TEAR OFF REROOF-ASPHALT SHINGLES
APPLICANT pERMIT FEE SCHEDULE 221.25
K.RANDALL&COMPANY STATE SURCHARGE(VALUATION) 6.00
3801 SUNSET DRIVE TOTAL 227.25
SPRING PARK,MN 55384
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Minnesota State License#: 20637998
OWNER
CARGILL,W BIGLEY&K
1040 KNOLL MANOR 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. 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 applicac�t is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
rev ed at any time for due cause.
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App icant Permite ' nature Date Iss y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
- City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: /D-('O �
.¢,�,�. PO Box 66
Crystal Bay, MN 55323-0066 Date received:
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,� �``".,� �, � Street Address: Received by:
'�,�, '�%� Gti 2750 Kelley Parkway Plan review fee:
t.�����7� ¢,� Orono, MN 55356
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- Total Fee: d�7 ��
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: �C `/v ��7c // ���i�r,c 12��1 �(
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ill be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICAJ�T INFORMATION:
Name: 1�� c(� 1 � �m
State License# Z G��; 3 -� �; �� Expiration Date: 3 �3� ��2-.
Phone: (v 1 Z - Z 431 - ��o:�3 (office) �t �2 - �i 1 I -� �s �7 (cell)
Mailing Address: f�t� � � \ °,, Cit : S ' �c� ZIP:" E; ��
Contact Person: v � s Applicant is: ontr ctor Homeowner (Circle One)
Email and/or Fax: K � A,���� ��� c v C.� � : �cu ��
PROPERTY OWNER INFORMA�ION:
Name: � l lu �c.i 1 �
Phone (day): � �2 — 8 5`� - /�Z 3
Address: %c� �jo IL,�, �i ��,-„n 12�,:�l City: UsZ�.(/a ZI P: S 5 3Z3
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) $ �-2 , D6o. o��
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 generalfy 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: L_ �� � Date: I � -- �3-� � �%
Last Updated: 05-04-2009
_ � ✓
�` � D E �� TIME
CITY OF RONO CALLED IN �O �
INSPECTION NyOT,ICE Q�/SCHEDUIED /D
PERMIT NO.�/��—��' O COMPLETED
ADDRESS ��� /`l �2�� ��2�C�/�
OWNER TELEPHONE N�l�`��� �
CONTRACTOR � �
� DESCRIPTION �
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
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
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI � SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOH TO MEET YOU:_YES_NO
c�n COMMENTS:
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� �{lVVORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. .�-�`� �� ���
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