HomeMy WebLinkAbout2009-00525 - roofing CITY OF ORONO PERMIT NO.: 2009-00525
2750 KELLEY PARKWAY
~ ORONO, MN 55356- DATE IssUEn: 08/3U2009
�_� (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 80 LEAF ST
PIN : 04-117-23-22-0004
LEGAL DESC : REG. LAND SURVEY NO. 0744
: LOT 000 BLOCK 000
PERMIT TYPE : M[NOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTNITY : O/S BUILDING -UNDEFINED
VALUATION : $ 1,600.00
NOTE: REPAIR ROOF STORM DAMAGE
APPLICANT PERMIT FEE SCHEDULE 60.75
NEW LIFE CONTRACTING STATE SURCHARGE(VALUATION) 0.80
8030 OLD CEDAR AVE#119 TOTAL 61.55
BLOOMINGTON, MN 55431-
(65l)224-3442 PAID WITH CC# 0073
Minnesota State License#: 20249486
OWNER
HALL,JEROME
80 LEAF ST
LONG LAKE, MN 55356
AGREEMENT AND SWORN STATEME1vT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
Sta[e 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 specitied 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 i nformance with the State Building Code.This permit may be _�
revoked t y ti e for due cause. � �-.��''��
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Applicant Permitee Signature Date � �
Issued By Signature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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�� City of Orono ��
. f'' Building permit Applic$tiQn for int�rnal Work
� (windows, doars siding, re-raof, etc.
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Th13 applicat'i0n�fdrm must b�oompleted It1 full and all reqUired'infom�t�on must oe subM ttod.
h�r.o�pletb appllcatlons wfil be�eturned. jPlease prlr,y
GENERAL INFORAAATION:�
Jo6 Slto AddnCss: b� _..�,
Wfll th(s be a Parade omes, Remoa�b�a g►�r,agg Nome or other Display Home? �� Yee o
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roqidrod uroltlt app�a�nrananaMa sNliciom o�s/fs p�urkJn�Is a�eAeble. No,n•p�am�dlor!auamF w�1M�t hQ allbwo4'
CON7'FIAC'nOR/APPi.IC'AMTINFCRYATIOW:
Name: �
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Phone: �•- - office r-0I
Mailing Address: ' � ; �
Con�M�e�son: a ' App iccnt iet
Email andlor�ar. / eowner tc�o onn
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PRDPER7Y OWNER INFORMI�TI Nt � � � O
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eatlme�ed Constructlon Valustlon of ect excludi an S �
APPLICANT ACKNO'WL.ED L=IiAENT: �
. 11p�eeB tp provide ail� ormation required or reques�ed by the 8ulldinp DepartmeM;
. Ce�'ies�Aa1 fie i�faRmatlai suppf�d ia t�ue and cvr�eet to the best of hlslhar knowladge, Thu applicent Re4qnl=ee the!thoy
ere solely reeponofbb�or�uDmidf�g a comp►ete application being eware that upon laiiure w do so, �Ao q�M hAs�o altemative
bu�to ro�Oa�un�l le ia campleee:
� Sama ar a0 0/IFw Inle�oen ehal y�u era se(aoq to ptqVlq@ On SA�epp�catlon (S �d Dy StsCe law ne elftk�prwaC�er
co�fidenad. Privab�dAta�ia iMormatlon whloh pa+tiorally cannot be given 10 ths p�boc ba can De glvon to�e �ubJoCt o�the
d�. Corlfidetitie! daSa i� IMo►madon w�dch gonorally conn� oo given tu �iltrer lho public or U1� t�DJ�af the daSa. Our
pufpoa� +1nA IrnAndAd u�i al�hl: :�torm�on �to annuelly updds w�r recc�rqs enf�l I�bOb(d0 vf o{�e��overnmpn�l ep9nok,
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V DATE TIME ` /
CITY OF ORONO CALLED IN �'- ���� ��
INSPECTION NOTICE ���SCHEDULED -
PERMIT NO. - LETED
ADDRESS � �
OWNER CONTR. �I-Q11� �i t e.
TELEPHONE N0. ,L�J � - �Z-� � ���Y Z
� DESCRIPTION �C�`�" �( 1'�a I
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ 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-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:,(�YES_NO
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOPORDER POSTED.CALLINSPECTOR
❑ INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46�0
OwnerlContractor on site:
Inspector. �,,�o
White Copyllnspector's File Canary Copy/Site Notice