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Home My WebLink About2015-01337 - roofing , CITY OF ORONO * z 0 1 5 - 0 1 3 3 7 * • 2750 KELLEY PARKWAY DATE ISSUED: 10/16/2015 ORONO, MN 55356- 952)249-4600 FAX: (952 249-4616 ADDRESS : 1030 LOMA LINDA AVE PIN : 07-117-23-14-0056 LEGAL DESC : LJNPLATTED 07 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : M[NOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CO1�iSTRUCTION TYPE : ROOFING-ASPHALT ACTNITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,900.00 NOTE: (RE-ROOF DETACHED GARAGE&WEST SIDE OF HOUSE-NOT FLAT ROOF) APPLICANT PERMIT FEE SCHEDULE 139.40 STATE SURCHARGE(VALUATION) 2.95 ERICK N KALLERUP CONSTRUCTION TOTAL 142.35 1602 ARCHWOOD ROAD Payment(s) MINNETONKA,MN 55305 CHECK 5130 142.35 (612)'701-9892 OWNER GARY W WOLLNER,LORI A HUINKER& 1030 LOMA LINDA AVE MOLJND,MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to 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 governing this type of work shall be compied with whether or not specified herein.This permit will expire and bewme 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 in conformance with the State Building Code.This permit may be revoked at any time for due cause. � 2� � �� .c�� '��#-s�; 1�� t� � �s Applicant Permitee ignature Date Issued y Signature Date City of Orono B�ilding Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O�O MailingAddress: Permit number: �b � S � � PO Box 66 Crystal Bay, MN 55323-0066 Date received: � � �' (�- ( S Received by: ��- � Street Address: � 9 G� 2750 Kelley Parkway Plan review fee: � t �, Orono, MN 55356 �kESHO� • 1 L�Z . 3 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: rf� � ,. � �f,,� Job Site Address: �L=` �� : L '�{�� .C�C �"�-- 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 will be required unless applicant demonstrates s�cient on-site parking is availab/e. Non permitted events will nof be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: _ (`� C N � l �h u Yl�'�• �, LL State License# �C d p ��G � Expiration Date: 6 3 3 i � � Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (office) Mailing Address: llQ�j"L rG W �0 • City: /v�-TK�- ZIP: G� �j3Gs"" Contact Person: Applicant is: Cont� r�aJ or / Homeowner (Clrcle One) Email and/or Fax: � — --=------ -_ _ __�_ _ c�.S� PROPERTY OWNER INFORMATION: - - --- ---__ Name: J L, L `� Phone (day): � C� O 1, y� ct� L..I n � vC ' Address: �Z � Z� � '7 1 � Z City: 4�0!l�C� ZIP: Email and/or Fax: PROJECT INFORMATION: Overall pro�ect descri tion: �� E�a�C,� �a C W.�� •�- �� Type of Project: Any earth mo ement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: � Re-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) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ O9 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 information, the a lication ma not be issued. ApplicanYs Signature: �'`�.� Date: 1 � 6s✓ Owner's Signature: Date: Last Updated:January 2015 - � V DATE TIME CITY OF ORO O CALLED IN I INSPECTION NO�E _/� cHe�u�E� �S PERMIT NO. s vl��OMPLEfED --`�� ADDRESS ��`�� G��-�-- ��- OWNER ��HONE NO.��Z-7D�–��/� CONTRACTOR r� G � DESCRIPTION �� W ❑ FOOTING ❑ DEMO- INAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT L ❑ WATER HOOK-UP ❑ FOLLOW-UP ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO c�.� COMMENTS: o� , a 0<<- 5 0� �� `F �rc L c �-�( r/crel-� j Ll i[�C___�2r1�` ��D�'�b�d " o �- � � Q tL 4G//�'� yt/QS t � ttiJ PS� S�c d-1� W � �6l�c o��y — /1d� �1�� a�L' Q z __ - ��r� �mf' �.� ,o�� _ W �a,�,•.C� ��ct.-� i'�...�el.L'P � � j d W� ❑WORK SATISFACTORY:PROCEED �jECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice