The URL can be used to link to this page

Home My WebLink About2010-00371 - roofing `" CITY OF ORONO PERMIT NO.: 2010-00371 ' 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEn: OS/20/2010 952 249-4600 FAX: 952 249-4616 REPRINTED ON 5/20/2010 ADDRESS : 1545 LONG LAKE BLVD PIN : 26-118-23-33-0012 LEGAL DESC : ALBEES LONG LAKE ADDN : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 26,465.00 NOTE: TEAR OFF REROOF , APPLICANT PERMIT FEE SCHEDULE 434.50 BERWALD ROOFING STATE SURCHARGE(VALUATION) 13.23 2440 N.CHARLES ST. TOTAL 447.73 MN 55109- (651)777-741 1 Minnesota State C,icense#: 20015088 OWNER BIGHAM,JAMES&CYNTHIA 1545 LONG LAKE BLVD 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 does not grant permission for additional or related work which requires separate permits. AII provisions of laws and ordinances governing 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 construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring alI required inspec[ions are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � � � ` �`�"°`�� S�'`�d��° �-- �.S'l� l/v Applicant Permitee Si �ature Date IS By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. :�;,. ,,,. � : . /�� .. � City of Orono ��s�r: �. Building Permit Application for Internal Work ��'3+�� ` �, �:. �,,� (windows, doors, siding, re-roof, etc.) �� Mailing Address: � � �v 0� PO Box 66 Permit number: p�d Q-��7� � � ��k Q � Crystal Bay, MN 55323-0066 Date received: .> /!7 �� ': ,� ��' -��` a StreetAddress: Received by: �� F`� !4 ��%, �'.; �'� '`� q� Gti 2750 Kelley Parkway Plan review fee: L�kESH�g'� Orono, MN 55356 - �4`-� 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) s`�° �,' GENERAL INFORMATION: �> �_:� Job Site Address: %��''L�,� �,� ��,f , - �� _, � �"�: Will this be a Parade of Homes, Remodeler Showcase Home or other Display Home? ❑ Yes ❑ No � �y� 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 {?� re uired unless a licant demonstrates sufficient on-site arkin �s available. Non- ermitted events will not be allowed. �: 4 PP P 9 P � CONTRACTOR/APPLICANT INFORMATION: � �,�� ,��. � � Name: . � State License# �pp/�—p �� Expiration Date: s �^,�j-� // �;s:: � Phone: - (office cell � .,rp� Mailin Address: Cit : � ��; 9 �o-. . ZIP: �S"�o9 v6�.1' Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: ��-7�y-� /�7j � PROPERTY OWNER NFORMATION: � Name: _ �� q�� Phone da � ( Y)� </��-/—ove�� $ Address: ��„� �e� �o,�, City: ;.��,Ly�-�sr.�� ZIP: 5 5 ��5,6 `a = Email and/or Fax �, ; s, �% �� PROJECT INFORMATION: �� 'E Type of Project: Any earth movement may require �.. �; MCWD review&permits �, ❑ Door(s) ❑ Remodel ❑Water Damage «: Minnehaha Creek Watershed District(MCWD) �- ❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ' ,`;_; Deephaven, MN 55391 �' ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 �;i Fax: 952-471-0682 '°�' (�Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: _ Estimated Construction Valuation of Project(excluding land) $ ,�G' L�(,S .. -� APPLICANT ACKNOWLEDGEMENT: r� s�� • Agrees to provide all information required or requested by the Building Department; 3-:� ��: ,°'� • 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 �k �� but to reject it until it is complete; �n � ��. ` ' • Some or all of the information that you are asked to provide on this application is classified by State law as either private or �� `t 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 �' '` re uired b law. If ou refuse to su I the information, the a lication ma not be issued. d�? �,..; � � / � hV '��; ApplicanYs Signature: ,� � Date: � — 6� �—/�' �-'= ��' Last Updated: 05-04-2009 �,,� i� � * 1 ?k c '� � 5s�w � ._ . . _, , , .l�. _ .,#`�n�'i , b.eb�..,+�d.� r ) . ,.. '��c. 3 ei.L �___ �-•Ki .,. .r�,T t �, ,. . . ��:o ,