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Home My WebLink About2011-01100 - roofing CITY OF ORONO PERMIT NO.: 2011-01100 � ' � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE IssuEn: 10/04/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 565 LEAF ST PIN : OS-117-23-41-0028 LEGAL DESC : FOX HOLLOW : LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-CEDAR ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 40,000.00 NOTE: VALUATION OF PERMIT:$40000.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 5'74.25 AC CONSTRUCTION&RESTORATION SERV STATE SURCHARGE(VALUATION) 20.00 12510 FLETCHER LANE SUITE L TOTAL 594.25 ROGERS,MN 55374 (763)682-0770 Minnesota State License#:20634132 OWNER FOX,KOSIERAZKl& 565 LEAF ST 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 dces 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 conswc[ion 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 rev at any ' e for due cause. - � � /o i �- i �/ Applicant ermit e Signature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Sep. 22. 2011 3: 22PM AC Construction & Restoration � ` R�� No. 5433 P. 1 � �` Cit of Orono "�'�� ` �i �� y � � � � Bu�ld ng Permit Appl�cat�on for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address; Permit number: Q O�r D,�jO PO Box 66 � Crystal Bay, MN 55323-0066 Date reoeived; a �, StreetAddress� Received by: �. �� 2750 Kelle�Parkway Plan review fee; '�g��o� Orono, MN 55356 � Total Fee: ��9�/, �� Main; 952-249-4B00 Pax: 952-249-4616 www.ci.orono.mn.us "7-� This application form must be campleted in full and all required information must be submitted. Incomplete applications will be returned, ase print) GENERAL INFORMATION; �� Job Site Address: �_�_ �� Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes ❑ No If yes,a speclal event pennif ls required with Pollce Depertment and City Council approval B�days prloi to the event Shuttle Bus serviae will be rsquired un/ess applicant demonstrates su�cienr orr-site park/ng is avallable, Non PermKted events will not 6e allowed. CONTRACTOR/APP�ICANT INFORMATION: Name: C �C,oN3�a�c,l-;� d-� Q��3'a�rutT;aN State�icense# �.p(0 3� ( 3a Expiration Date: 3 3 ��'13 Lead Certification Number: �I Ar°� - (��{� c(- ( � � Expirakion Date: f!I a6t (for work on homes thet were constructed prior to 1978 Phone: �1(0 3' `t 1$` S a� � (office) C�(a'3 Is(o'�b�5�cell) MailingAddress: ��.5 I O �le'rc��, �N� S�n�� c�ty: �a s ZIp: fyC ,s',�'j Y Contact Person: �y� Applicant is: ontracto Homeowner �c�►�e o�a� Email and/or Fax: RGC tZ�lt�c1 v c�.;c�N � C� w�!}_�, . C o1� PR�PERTY OWNER INFORMATION• Name: Vv��tz.\� �C o s;�e rz.A-�2 1�i Phone(day): (q(a- -�a 3 - 3'1 S'S � - Address: SG S l.�f►F S'� . City: �(1.�n�o ZIP: �s 3 5^a Email and/or Fax " PROJECT INFORMATION: Type of Project: A�y earth movement may requPre ❑Door(s) ❑Remodel ❑ Fire Damage MCWD revlew 8 permits: Minnehahs Creek Watershed Distnct(MCWD) ❑Re-roof,asphalt ❑Repair ❑Storm Damage 18202 Minnetonka Blvd -roof, cedar ❑Restoration ❑Water�amage Deephaven,MN 55391 Phone: 952-471-059Q ❑Re-roof,other(specify� ❑Siding ❑Other� (specify) Fax: 852-471-0682 ❑Window(s) www.minnehahacreek.om Overall ProJect Descriptlon: Estimated Construction Valuation of Project(excluding landj $ o Oc�V APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building DepaRment; • Certifies that the information supplied is true and corred to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete applicetion being aware that upon failure to do so, the staff has no altemative but to reject it until it is complete; • Some or all of the inforr�ation that you ara asked to provide on this application is classified by State law as either private or confidential. Private deta is inFormation which generally cannot be given to ths public but can bs given to the subjact of the data. Confidentiel data is inform ' 'ch generally cannot be given to either the public or the subject of the data. Ou� purpose and intended use of t ' informatio ' to annually update our records and records of other governmental agencies re uired b law. If ou refus o su I the infor tion the a lication ma not be issued. Applicank's Signature: Date: 7 �� ( "/'1 Ldsl Updated: 08-09-2011 G DA E TIME `� CITY OF ORONO CALLED IN /O // INSPECTION NOTICE SCHEDULED /� � -��j� PERMIT NO.�/� Dl/D D COMPLETED � ADDRESS J��PS i2-l�7� OWNER TELEPHONE NO.�G�3'�� CONTRACTOR � � � � ��_ ��,a/�o =T`O_ �: DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL � MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 J ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a c � U !� �� f_� 0 a � 0 � W � Q � Z W � W � � GW �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWiTHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. ( � �> �� White Copyllnspector's File Canary CopylSite Notice D 9T,E TIME � CITY OF ORONO ALLED IN ��`� INSPECTION NOTI E SCHEDULED -/D 2 —// � PERMIT NO.��—O�/DO COMPLETED ADDRESS S�S �Q� �� OWNER TELEPHONENO. 71D3 r7��P 7��Z CONTRACTOR /7 G C� , �; DESCRIPTION �200� - �l�.� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE W ❑CORRECT WORK 8�PROCEED UE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWiTHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-Q6QQ Owner/Contractor on site: - Inspector. ` � `� � � White Copyllnspector's File Canary CopylSite Notice