HomeMy WebLinkAbout2017-00507 (roof) CITY OF ORONO * z 0 1 7 - 0 0 5 0 7 *
2750 KELLEY PARKWAY DATE ISSUED: OS/15/2017
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3243 CASCO CIR
PIN : 20-117-23-43-0010
LEGAL DESC : SPRING PARK
: LOT O15 BLOCK 000
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : ROOFING -ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 35,428.00
NOTE: VALUATION OF PERMIT:$35,428.00 (WORK FOR ROOF AND SIDING ON HOUSE&GARAGE)
ROOF[NG PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO
WORK BE[NG STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECT[ON MAY NOT BE tSSUED.
S[GNS-ADVERTIS[NG SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME TF-IE ROOF IS BEING DONE.
ONCE WORK[S COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 557.86
STATE SURCHARGE(VALUAT[ON) 17.71
MINNESOTA EXTERIORS INC. MAIL-IN FEE 2.00
8600 JEFFERSON HIGHWAY
OSSEO,MN 55369 TOTAL 577.57
(763)391-5508 Payment(s)
Minnesota State License#: BUIL-BC002877 CHECK 206777 577.57
OWNER
MILEUSNK,GEORGE& MARILYN
21 l0 SUGARWOOD DR
ORONO, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according ro
the approved plans and specifications,applicable Ciry 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 separate
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 l80 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 in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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� Applicant Permitee Signature Date Issued By Signature Date
- City of Orono
� Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number: G�� 7 "D(,��i
PO Box 66
� Crystal Bay, MN 55323-0066 Date received: ��1 S�/ �
i
StreefAddress: Received by: ��
5�, � 2750 Kelley Parkway Plan review fee: /"l
t � Orono, MN 55356
�k£s���� _7� s�
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: l /
Job Site Address: � � � "" O �7'L� ��G' zt�� 7
Will this be a Parade o omes, Remodelers Showcase Home o other Display Home. ❑ Yes ❑ No
If yes,a special event permit is required with Police Department and City Coun il approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-srte parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
�
Name: 1�1I11. �K' ���� �� L-YX..�_ ,
State License# � l Ex iration Date: �
,,������ 7� p� /t
Lead Certification Number:,��T�c, ��_� Expiration Date: 5-.�U
(for work on homes that were constructed prior to 1978
Phone: (cell) (office) �. � .1/��'�D�
Mailing Address: ���np�, „���� %,��.� City�SS�� ZIP: ��,��
Contact Person: �1�,��� ��,,y-�E,�--� Applicant is: c__n rac o?�Homeowner �c���ie'Gne)
Email and/or Fax: jL'G'2r'/So72� InrJ�v��c�*.� 7��• fz'S.�� c�'�.�0
PROPERTY OWNE INFORMATION:
Name: }�c�-s`�;c� /»t �C u S� `�C
Phone (day):
Address: ��� L/� �Sf'� _ «�c; (C" City��1��� •�w f�z ZIP: S S.�'��
Email and/or Fax:
PROJECT INFORMATION: Overall project descriptio � � (,,Ce �C`� �.��n c�,r )c'.�s� G �-�< '
Type of Project: Any earth ovement may also r re
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
�roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ Re-roof, other(specify) iding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orp
Estimated Construction Valuation of Project(excluding land) $ ' � '
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 required by law. If
ou refuse to su I .the informatQn, the a lication ma not be issued.
Applicant's Signatur . y-° . -r�./�7�I Date: S ���� �,�
v/
Owner's Signature: Date:
Last Updated:January 2016
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pq�E„ ,� TIME
CITY OF ORONO CALLED IN a�LY`/
INSPECTION OTICE SCHEDULED �
PERMIT NO �� � OMPLETED
ADDRESS �� � �
OWNER ELEPMONE NO� — ��
CONTRACTOR � S �
� DESCRIPTION
� q� •
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTI INAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v �FMFAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SUHVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
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W� ❑WORK SA ACTORY:PFiOCEED ECT COMPLETE
W ❑OORRECT WORK�PROCEED ❑I E CERTIFICATE OF OCCURANCY
0 ❑OORRECT WOFiK CALL FOR REINSPECTION TEMPOFiARY
V BEFORE CdVERINO PERIiAANENT
❑CORRECT UN3AFE CON01710N WITHIN FIOURS• ❑pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑pTATION ISSUED
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
CaN tor the next inspection 241aurs in advance. (952) 249-4600
on site:
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