HomeMy WebLinkAbout2011-01099 - roofing CITY OF ORONO PERMIT NO.: 2011-01099
_ 2750 KELLEY PARKWAY
• ORONO,MN 55356- DATE ISSUEn: 09/22/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 1121 NORTH ARM DR
PIN : 07-117-23-14-0063
LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTTON TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 11,950.00
NOTE: VALUATION OF PERMIT:$11,950.00
ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 2448 NOTICE,PRIOR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT pERMIT FEE SCHEDULE 221.25
R DAVIS CONSTRUCTION STATE SURCHARGE(VALUATION) 5.98
710 N 4TH ST #306
MINNEAPOLIS,MN 55402- MAIL-IN FEE 2.00
(612)259-8363 TOTAL 229.23
Minnesota State License#:20635925 PAID WITH CC# 6631
OWNER
SOLIE,GLENN
1121 NORTH ARM DR
MOLTND,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 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
pertnits. All provisions of laws and ordinances goveming 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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for d�e cause. -
`7?�t�-� �- / / � / /
Applicant Permitee Signature Date Issued By ' ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
09/22/11 9:27 AM R DAvis � 61235350h0 P�ge 1
a-�� c
� City of Orono
Building Permit Application for Maintenance / Renovation
(windows, door�, sidin , re-roof, etc.
Mailinp Add��v: permit number: dD//- ��D
O.Q,,��.0 P�Box G6
Grys[al Bay, MN s53z3-ooee Date�ceivea: ��ZZ- 1/
a ��;, n, SheetAddress: Raceiv�ed by: � S
� , � 2750 Kelley ParKway Plan review f¢3e:
��i�aas� Orono,MN 55356 T�tal Fee: a�a?�, a 3 .,F a°%
M�in: g5�-�49-�1600 Fax: 952-2ag�616 wwvJ ci,orono.mn.us
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This appfication form must be compt�ted in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INF�RMATION: �J��
Job Site Address: .._.I.,I✓..,�.. Y�_Y�a.. �16��
Will this be a Paratle af Hcmes,Remodslers Showcase Home or other Disptay Home? ❑Yes No
1!yes,�aperys/eMenf permit is�quired with f�olicE Uop�rimenl and G'ily Cuuru:i!xppruvr�l B�deyA prior fp fh�ervrant Shutfle bus service will be
►epuirgd un/ess applic2nt demonstiaies suKi�qn!on-,aiie,oerl.%ng is available. Non-paanitAed events will not bo al/owed.
CONTRACTOR/APPLI NT INFORMA�ION: `
Name: ���V�� ��/�S�I''(Jc''`f1.��...
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State l.icsnee# �'�G���Sc�..�-5�� .... . .. �x�ir�ti���ete: � �/ =�
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Lead Ceft'rficativn Number: Expiration Dale:
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(ror worK on homes rher were consw�r prlor�o�a7a
Phone: � �� - �.��7•- j'1s :5 toffice) `�S.�'-�?S - c-�.` �;'� (ce�q
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Mailing AddresS: j,a � � .. City� ZIP: .�'"�C+' �
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Contact Person: (i , _ Applicant is: Contractor omeowner �circro v,w1
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Email and/or Fax: ,L.;Z•��",�"�,�.��.g�.-._._.��'l:�v �.J.�.t��r•V'�"s' Cf�i7Sfi�'l.��.i :•�.�".?1.�:lr..�l?.'+,��......,. .
PROPER7Y OWNER INPORMATION: ��
Name: -�l�t� '� '�� ..�.�E.�r......_... ........... . ....--- ----�--�--....... ......_....
Phone(day): �i/:.�-.�tic�'•• :a'`��' . ..
AC1Clr@SS: ���� /� �Yi�'a_��',�ir1!'_�'''-: ,_..._... . .. ...........---• Ci4Y: �l�'✓�"'7(� ZIP:
Email and/or Fax
PROJECT INFORMATION:
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Typs of Project: � Any earth mweme�t may require
�or(s) ❑Remodel ❑ Fire Damege MCWD ra�iew 8 pormits:
Mi�nehaha Creek Water3hed District(MCWD)
Re-roof,asphalt �]Repair ❑Storm 4amage 18202 MiMeLonlG3 BIVd
Deephaven,MN 55391
❑Re-roof,cedar ❑Restoration ❑Water Damagc� phonQ: 5,�52�71-05�J0
❑Re-rooF,ether(spoclryl rl Staing f�I Other. (speciry) Fax; 852-n7�-0862
, ❑Window(s)
www.mii�n�h�heac►��k_o��
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Overall ProjeCt De�cription•
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�stimated Conat�uction Valuation of Pro'cct cxcludin land S ,_� ��..r�)�
APPLICANT ACKNOWLEDG�M�NT:
•---.._...._.... .._._.... .. . . . . .. .... ......---
� ���•� Agroes to prpviqe all iniolmati0tl reqUif+ed oP requested by the BuildinS�C7eparvneM:
• Ccrtific3 thot thc infprmation aupplied ia true end correct tv Gie I�eat oF his/her knowledge. 'fhe applicarrt recognizes tfiat they
are solely respon�sible far submilting a compl�te 3pplicotion boing�qr�th�t upon failurs ta do so,ths steff has no alternetivs
t�ut to re)ect�t unm�t�s oomp�eie;
• Somo or all oi the illfol'matiorl t118t you afe asked to DrovlOe on thls appllcaqon IS Gassmed by 5t3te law 8s @itY�er private or
confidential. Privat� data is inFormation which genorally cannot be given to the public but csn be given to the subjsct of tha
data. Co�fidential data is information which generelly connot be gi�ron to eithe�the public or the subject of the dats. Ou�
purpose ana mtenovo use oT t�ls Intormation Is to annually updat.� our records and records of other govemmental agencies
re uired b law., If yqu r�fuse,to s� the i�fvrtna'on a I'c 'o m e i�s,y,eQ.,„ ,,, .,„_.,..
Applicont'�Signeture: ..... ... '��' �� � Catv:
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I.dst Updateci: 08-09-2011