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Home My WebLink About2011-00486 - roofing CITY OF ORONO PERMIT NO.: 2011-00486 2750 KELLEY PARKWAY ` ORONO, MN 55356- DATE ISSUEn: 06/17/2011 ' 952 249-4600 FAX: 952 249-4616 ADDRESS : ]065 NORTH ARM DR PIN : 07-117-23-14-0058 LEGAL DESC : REG. LAND SURVEY NO. 0244 : LOT 000 BLOCK 000 PERMIT TYPE : M[NOR ALTERATIONS PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING -LJNDEFINED VALUATION : $ 8,500.00 APPLICANT pERMIT FEE SCHEDULE 177.00 W.F. SMITH CONSTRUCTION STATE SURCHARGE(VALUATION) 4.25 6585 SO. SAUNDERS LAKE DR. TOTAL 181.25 MINNETRISTA,MN 55364- (952)472-6539 Minnesota State License#: 5309 OWNER ILLIES, ROGER 1065 NORTH ARM DR MOUND, MN 55364 AGREEMEIVT 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. 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 l80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in con ance th the State Building Code.This permit may be � re ked a[ ny im or du use. � � � � , �6 � l �� c ��c �r� , C� ;/ � /� Ap � ant Per itee S�gnature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. C i ty of O ro n o �'�� `� Building Permit Application for Internal Work � (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O�v O,�O PO Box 66 Crystal Bay, MN 55323-0066 Date received: ,� �`� �� ,. Street Address: Received by: �'��A�c �vti� 2750 Kelle Parkwa � Y Y Plan review fee: �kEsH�4' Orono, MN 55356 Total Fee: /�l, .� � � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us f This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: ' ��p � ��it-l� , %Z�l'1 �� 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 Polrce Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: �}- Name: '� , �. � Y�n ,..�"��- � /�, � I State License# S-�� r Expiration Date: +-� _ � '�- Lead Certification Numb re Expiration Date: (for work on homes that were constructed prior to 1978 Phone: 5--� _ � � E S-3�. (office) G i ;�- � � � '7 - � < < — (cell) Mailing Address: ��- S--� : S/�v c %'', City: 1ntiw+^-e' .s �ZIP: S S-s'G � Contact Person: �,�� Applicant is: � Contractor Homeowner (Circle One) Email and/or Fax: ��,n��.�� ,.� ,i, �� ,;; ,-,� . PROPERTY OWNER INFORMATION: Name: �� Phone (day): Address: City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 �Re-roof Phone: 952-471-0590 ,,� ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project (excluding land) $ �' �� c� 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 to su the� formation, the a lication ma not be issued. ApplicanYs Signature: Date: (� � � ( �� Last Updated: 03-01-2011 / DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTiCE SCHEDULED PERMIT NO. a�I�� COMPLEfED _,,-� �• /5 ADDF�E$S ��5r ./ve-I"f�C }�r�+�l. ��t�e, OWNER TELEPHONE NO. CONTRACTOR �'1�•F- S j,�,•Z`�, C'Q,'�L' _ � DESCRIPTION �yQ' �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG Q ❑ POURED WALL ❑ MECHANICAL RI ❑ 11�KESHOREN11EfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION � ❑ RADON SLAB O WATER HOOK-UP ❑ PROGRESS � ❑ FINAL O SEWER HOOK-UP p COMPU4INT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTiC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUt�IDATION/REMOVAL � OWNERlCOMTRACTOR TO MEET YOU:_YES_MO v�, COMMENTS: a *OLD PERMIT - NO FINAL INSPECTION REQUESTED � � • O � l��K �ieDe��s �' w+.ol�� 0 ti � �Cr�►.� �i�t,f,�NQ � � Z W � W � J � ❑WORKSATISFACTORY:PROCEED � '�ROJECT COMPLETE W O CORRECT V1�RK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CdVERING PERMANENT ❑CORRECTUNSAFECONDITIONWRHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �INSPECTIOM REQUIRED.CALL TO ARRAiVGE ACCESS. Ca0 for ttae next i�es�Aon 2�h�u�un aslvan�. �952� 249�4600 Ownea�IContractor oe�si�e: lnspector. �Alh e Copyllnspec4or's File Canary CopylSite fdotice