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Home My WebLink About2008-P12036 - re-roof . PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p12o36 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/7/2008 SITE ADDRESS: 1525 Long Lake Blvd Unit# Long Lake,MN 55356 P�� 35-118-23-22-0002 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 88•50 Valuation: $ 2,200.00 State Surcharge Fee: $ 1.10 TOTAL FEE: $ 89.60 APPLICANT: Hometown Restoration Minnesota Inc OWNER: Marie Wendt Trustee 7308 Aspen Ln N Suite 110 . 1525 Long Lake Blvd Brooklyn Park,MN 55428 Long Lake MN 55356 • THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. C�-� � � ' L - ,� 1�:��°,� APPLICANT PERMITEE SIGNATURE ISSiJED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 Total Fee: $ Date Received: -��7 O f Entered By: Permit#• ,(� CITY OF ORONO - BUILDING PERMIT APPLICATION All informatiom m�st be submitted in full before plan review will be started. (please print a11 infornration) THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOBSITEADDRESS: /5'� �onq �a.�'c.,,g/� ZIP: 5S3S(� Will this be a Parade of Homes,Remodelers 5howcase 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 su„�icient on-site parking is available. Non permitted events will not be allowecl NAME OF OWNER: , �lll'lPa �e�"KxT PHONE: (home) �- 57/- y�/y� MAILING ADDRESS: /SaS L.�Y.�a�c ,(�lK� CITY: o (W ZIP: 5S3S6�a4-� CONTRACTOR: _ �ome�uw��a� /fl'in�resm�w PHONE: 763--��f�69S CONTACTPERSON: Td�/j1u.lt�elv// MOBILE/PAGER: ��o�j/p9 MAILING ADDRESS: 73��,lr� t1.,4�t(a, CITY:6rao�,��ryv� ZIP: $'S 3�' STATE LICENSE: #�QP 3aS3 y EXPIRATION DATE: �l3/�9 ARCHITECT/ENGINEER: PHONE: MAII.ING ADDRESS: CTTy; �p: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home RemodeUAlteration(ie: Siding, Windows) Any earth movement may require MCWD review and p�ts! PROPOSED WORK(describe in detain: /�.� ��t ��(/�� 6.eG,�a�/��0 STORIES: SQ.FEET OF EACH FLOOR: NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIlVIATED CONSTRUCTION VALUATION(eacluding land): $ ��QO � I hereby apply for a building permit and I acknowledge that the information above is complete and accura.te; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code;that I understand this is not a perrnit and work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: J�"fl 7"r�� 31 Sec.13.04 RIGHTS OF SUBJECI'S OF DATA Subd.1. Type of data The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.'fhis requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav nlace the notice required under this subdivision in the individual income tax or prooertv tax refund instructions instead of on those forms. Subd.3.Access to data by individual.Upon request to a responsible audiority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without a►iy charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pu�uant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. T'he responsible authoriry may reqti►e the requesting person to pay the actual costs of making,certifymg,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediabe compliance is not possible.Ifhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4.Procedure when data is not accurate or complete.M individual may co�test tlie accwac,y or completecess of public or private data conceming ttimself.To�ercise this righ�an individual shall notify in writing the responsible authority describ'vig the natu►e ofthe disagrcement.'fhe responsible authority shall within 30 days either: (a)correct d�e data found to be inaccurate or incomplebe and atbempt to notify past recipients of inaccurate or incomplete data,induding recipients named by the individual;or(b)notify the individual that he bel ieves the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disag�ement is included with the disclosed data. The detemvnation ofthe responsible authority may be appealed pursuant to the provisions ofthe administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departrnents may require you to furnish certain private or confidential information. You are notified that: L The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve,some information may become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First Middk Lx4t Address Cily Stste Zip Phone I understand my rights as sta above. �---�7--�-�' signato.e Reset Fcum 32 MINNESOTA DEPT.OF LABOR b iNDUSTRY Construction Codes and Licensing Divesion - 443 Lahyette Road N. St Paui,MN 55155 HOMETOWN RESTORATION MINNESOTA INC HOMETOWN RESTORATION 7308 ASPEN LN N SUITE 110 BROOKLYN PARK,MN b5428 _ _ ._ y,3�.' � ;: ::•:is i -�. ��A�inn�ota ' Go�+.c�r��dde��.�°Licensing Divi.sion �.7:'�� ,.. :.>. �net�t'�Labor and Industry T�pl�.�e,,��)2&�065 ... ... ., . ; . .. �L�faye�Road N. ..;- E�.ad�: dh hc�se�state.mr�.a�s :;:�: SL Paul� MN 55155 Website address: www.doli.state.mn.us .. ,. :. > . :: '� ��.��U1��IG CONTRACTOR LiC ;.�15�: ; :, .: . `�'�i�. ;��T�FtA710N IAMINESOTA INC �.Strt�fure: :. : },..: . ' ' . ....:. , . .:: .;.: ' _ .. . . ' .c... ��. . 3�. ... .:..,. .:� � ,.:; Yk{� I�ETOWt��E3TORA110N �tPOR�k"I'ION Address: 7308 ASPEN lN N StJITE 1:1�.. , , ; , ,: BROOKLYN PA�,�11d.S�id28 . , : ,. ,: :.> , � ;::;. : , :: > : Licer�se Ider�titication Number. �2�'3053� �ualifying Person: TODD P MULVE�lItL. � k �ie�ense�x�rat��e ��/2009 Con�c�Edu�t �t��+c�e by a31;31/2009 , ,:::. .;.,:, _ . � . ACORD„ CERTIFICATE OF LIABILITY INSURANCE o3;20,� � 651-257-1042 651-257-5772 TH1S CERTIFICATE I.S ISSUED AS A MATTER OF iNFORWITION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Stein Agency Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 603 ALTER THE COVERA(iE AFFORDED BY THE POLICIES BELOW. 12800 Lake Blvd. Lindstrom, MN 55095 �Ng(��g AFFORDING COVERAGE NAIC�k � 630-675-8061 763-494-8695 INSURERA:Th2 Builders Grou Hometown Restoration Minnesota Inc iriSurt�te:State Auto Insurance 7308 Aspen Lane North #110 INSURERC: Brooklyn Park, MN 55428 INSURERD: INSURER E: COVERAGES THE POlIC1ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POIICY PERIOD INDICATED.N0TIMTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VIMICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRiBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONOITIONS OF SUCH POLICIES.AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PO�ICY N11� POIJCv EFFECIIVE POLICY ExPIRATiOq �� HoccuriRE►� S 1,OOO,OOO B X �1MERGuc�Er�EwLLune�urv PBP2481605 03/O1/2008 03/O1/2009 pREpuSEg Es,ccurance s 100,000 �� - MED EXP(Any ons peraon) S 5,0 0 0 �tsow+�BnDVIruuRY S 1,000,000 c�r�w,�a,cc;REGate s 2,000,000 GENL AGGREGATE UMIT APPUES PER: PRODUCTS-COMVIOP AGG t 2�O O O,O O O POLICY � LOC AU7�OMOBItE LIABMlTY COAABINED SINGLE LIMIT f (Ea acddeM) ANV AUTO ALL OVN�D AUTOS BODIIY INJI#2Y s SCHEDUlEO AUTOS ��D��) WREDAUT� BOqLYINJURY = NON-0WNED AUTOS (Px eockknt) PROPERTY DAMAGE S (Per aaJderk) �� AUTO ONLY-EA ACCIOENT S ANY AUTO OTHER THAN �'� s AUTO ONLY: A� _ �� Ei�CH OCCURRENCE S __ �� ❑��M� AGGREGATE i S DEOUCTIBLE s RETENfION s s WC STATU- OTH- WO��110N AIID • A ��W�� 011287 03/O1/2008 03/O1/2009 E.LEACHACCIDEHf S 500,000 ANY PROPR�TORIPAR7NER/EXECUTIVE � pFFIC6ZMBYtBER IXCLUDED7 E.L dSEASE-EA EMPLOYEE E 5 0 0,0 0 0 M •IAL�PRO SVl�iorseeww E.�.aSense-aoucvU�uT t 500,000 OTIIER DE1CRPl10N OF OPERATIOqS/LOCATIOMS I V&YCLES I EXCWQIONS ADDED BY BIDORS�AEMT I SVECIAL/R�510NS CERTIFICATE HOLDER CANCELLATION EXOULD ANY OF 1XE ABOVE OESf�POLICIEa BE CANCdJl�O BEFORE 1ME E7�iM10N Hometown Restoration Minnesota, Inc. Dn7E TMEREOF�'n1E�uNci iNs��A��1��►� �T� 7 308 Aspen La ke Nor th #110 Npnc�Tp t�CErt�wc��Na.oEn w►MEo ro 7��r.e�rr F�unE To 0o so sNa� Brooklyn Park, MN 55428 �E��q:u�e��y o��+r qNp wo�n�Ngunet,��s at REpRESE1/TA7WE8. pll7Npp�p REPNESOJTATIVE vVl .�F r�►. L.G ACORD 25(20M/08) m ACORD CORPORATION 1988 DATE TIME V CITY OF ORONO CALLED IN s _Q /,� INSPECTION N TI/�f�j? SCHEDULED PERMIT NO. �`—v`�� COMPLETED ADDRESS r`' o? �� L��!G L, .��n ��U L� OWNER CONTR. TELEPHONE N0. �� "=e �� o? ' .��S�� ' �.; �l Q�� l�r �� DESCRIPTION � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FR,4MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI • ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � � � J$WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W�O CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �95Z� 249-4600 OwnerlContractor on site: Inspector. L�c ��b'S �� White Copyllnspector's File Canary CopylSite Notice