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Home My WebLink About2010-00296 - roofing . CITY OF ORONO PERMIT NO.: 2010-00296 � 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: OS/03/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 145 MANOR CIR PIN : 04-117-23-11-0024 LEGAL DESC : COUNTRYSIDE MANOR 3RD ADDITION : LOT 1 BLOCK 1 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 11,500.00 NOTE: TEAR OFF AND REROOF APPLICANT pERMIT FEE SCHEDULE 221.25 W.F. SMITH CONSTRUCTION STATE SURCHARGE(VALUATION) 5.75 6585 SO SAUNDERS LAKE DRIVE TOTAL 227.00 MINNETRISTA,MN 55364 (612)867-3117 PAID WITH CC# 9675 Minnesota State License#: 5309 OWNER NAFSTAD,ADAM&KRISTIN 145 MANOR CIR 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 sepazate 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 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 all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any t� e fo due cause. �� e � , v App icant Permitee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , �" - "�^�„�� €� k-ar =�� N.�. _ �^v� dr . � �'�t++�,� S' ey '=�� 7' :� t'. : i_ . .. ,�`y 4 _ ,� _ ,. �5.ry 4 ) su�,. � 1�� ,f �` � S�-� � x: N� t! ,,.2�.��C�'A,A..r��f' S� :`� � . City of Orono � � }�. Building Permit Application for Internal Work � r � (windows, doors, siding, re-roof, etc.) R Mailing Address: , _ �. �' � g,0,� PO Box 66 Permit number: .�C'/� L�'. > k �,�! 0 ^1 Crystal Bay, MN 55323-0066 Date received: � -�� /C� � I \ � $� ,�i� I' �t�' Received by: �a � ��a�a� �. Street Address: � �'.�, ' � �" Gti 2750 Kelley Parkway Plan review fee: � ' '�� g� Orono, MN 55356 �:� kEsxo J Total Fee: � :� � �O � 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. � ` fi Incomplete applications will be returned. (Please print) GENERAL INFORMATION: � / Job Site Address: `7 � �� 2- �-1 �� ' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No �"�` /f yes, a special event permit is required with Po/ice Department and City Council approval 60 days prior to the event Shuttle bus service wi/l be ;�� required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. i; CONTRACTOR/APPLICANT INFORMA�rION: Name: � F, `1 /l� � T'� �--�I�� .;; State License# �� Expiration Date: 1 d�-� zQ 1 � � ; Phone: office cell �' j Mailing Address: ��-g -- 5:, �h� ,�, � �..-f�- � � tr . � Cit : d�, ' ,� ZIP:rf � � , (' Contact Person: �3�� Applicant is: Contractor / Homeowner (Circle O � � ; Email and/or Fax: �.;n ►�.,rz..C,-�.��S';.�r�i'i•,� r�, � �� G-> ,,v� � { PROPERTY OWNE INFORMATION: Name: - �'J �l 01- l� S �`�i.�- � �'\ �;;:j Phone (day): *`�� Address: ) � � Q�Z�,� C�,�c.L-e__ City: ZIP: "�`j Email and/or Fax k' rti:I ;$3 � � `:; i PROJECT INFORMATION: r; j Type of Project: Any earth movement may require IMCWD review&permits � ❑ Door(s) ❑ Remodel ❑Water Damage y Minnehaha Creek Watershed District(MCWD) �, �,-"� ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd 1:.�� Deephaven, MN 55391 Y ��' ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 � f Fax: 952-471-0682 `;� �s� ❑ Fire Damage www.minnehahacreek.orq r. ,� Re-roof � r�� '' Overall Project Description: J �� Estimated Construction Valuation of Project(excluding land) $ � �� S.� 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 � re uired b law. If ou refuse o su t information,the a lication ma not be issued. �� ;�' ��; Applicant's Signature: Date: �� 2`' I � Last Updated: 05-04-2009 s i^ .�� ,. ; ' } � �,�� .�� , � � � .e . _ x .. � �„�.., .. _._. � �.<„__f�' � ._� .��7�.�:��r_„�a��f,?,a;:.z�„_,�, �� TIME V CITY OF ORONO + CALLED IN � � �`' INSPECTION NOTI E (`�� /�SCHEDULED � _� PERMIT NO. � 0`�— �'�cOMPLETED ADDRESS / �� C/"' ( '� - OWNER 1 TELEPHONE NO. � �� =��7 CONTRACTOR � " '�( '� � >; DESCRIPTION ��U` � ' � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADI ILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y � FRAMING ❑ MECHANICAL FINAL Q ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL�'/ ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES�,�NO r� � � COMMENTS: � W 0. � � O �. � O � W � Q � Z W � W � j ��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W�❑�RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED � INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on sit • Inspector. White Copyllnspector's File Canary CopylSite Notice