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Home My WebLink About2011-00343 - roofing � + "`� CITY OF ORONO PERMIT 1v0.: 2011-00343 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE 1SSUEn: OS/16/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1180 NORTH ARM DR � PIN : 07-117-23-14-0067 � LEGAL DESC : LOMA VALLEY : LOT 001 BLOCK 001 NERM[T TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 4,200.00 NOTE: TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 118.00 ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUATION) 2.10 51451NDUSTRIAL ST SUITE 103 TOTAL 120.10 MAPLE PLAIN,MN 55359 (763)479-8700 Minnesota State License#: 20631575 OWNER �:� PANKONIN, BRAD& MARCIA � 1180 NORTH ARM DR MOUND, MN 55364 AGREEMENT AND SWORN STATEMEIYT The work for which this permi[is issued shall be perfonned according to � the approved plans and specifications,applicable City approvals,and the � State Building Code. This pemlit is for only the work dcscribcd and does not grant permission for additional or related work which requires separate permils. All provisions of laws and ordinances governing this type of work � shall be compied with whether or not s�ecified herein.This pennit 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]80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conf mance it the State Building Code.This permit may be revoke t ny ti for d c se. � � �`� � � c�-l / l l �� Applicant Permitee Signa ure Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , �'1 �� aa`� • � - Cit of Orono f � r `�� Y .��. . �,� Building Permit Application for Internal Work �� (windows, doors, siding, re-roof, etc.) �� j' Mailing Address: � �� ir g,�,� PO Box 66 Permit number: �C�/ `('C�,� � � i � O Crystal Bay, MN 55323-0066 Date received: �� i �e� � � a ��4,;�. s, Street Address: Received by: � I �'�n � �;"'�, �� 2750 Kelley Parkway Plan review fee: �kESH04'� Orono, MN 55356 • � ---- 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) I GENERAL INFORMATION: � Job Site Address: � �C� ��l �✓� �. `� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes °� 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 sufficient on-site parking is available. Non-permitted events will not be allowed. r.� CONTRACTOR/APPLICANT INFORMATION: � �� Name: � '�(�� g�.� 4 State License# ZO 6 3(S7 Expiration Date: ,"�' � Lead Certification Number. Expiration Date: � (for work on homes that were constructed prior to 1978 �� <�� Phone: `76 • '7 � - � 7�� (office) � cell � ( ) � Mailing Address: s�ys �" J.S� , �, d City: � � ZIP: �_� �g, ; � Contact Person: ��.� Applicant is: Contractor Homeowner (Circle One) Email and/or Fax: '�� ,cf�9 _`�� ' PROPERTY OWNE�R INFORMAT�ON: � "� � Name: �� l � � Phone (day): �js'� � y� _ ��(�,6 � � Address: �� g� ��,( �,�'� (� � City: C7(�-flfJ� ZIP: � ; Email and/or Fax � ' �� ! PROJECT INFORMATION: �� ;i Type of Project: Any earth movement may require � MCWD review& permits: � � ❑ Door(s) ❑ Remodel ❑Water Damage M Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd s° ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 Re-roof ❑ Fire Damage Fax: 952-471-0682 � www.minnehahacreek.orq � Overall Project Description: = � Estimated Construction Valuation of Project(excluding land) $ L� '� O. — � y � '�- 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 r 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 o efuse�o su I the inf ma ion,the a lication ma not be issued. �,� ,. �� " �O `�� ApplicanYs Signature: ��' Y Date: �. Last Updated: 03-01-2011 � _ _ . _ . _ __ ;� �� C D �_ TIME � � � 1��/�� CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED � ` f _(�_ PERMIT NO. vZ C7 I� -��3 4� COMPLETED ADDRESS � � gC� N �4 rm �fZ ° OWNER TELEP ONE�O.��6�c^��/v�� CONTRACTOR `�-�L� �CG�P^ >; DESCRIPTION �� l I'na� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE�NSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER hi00K-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEEf YOU:_YES�NO � COMMENTS: � 4 �� 11/�-� � ��t""l�_�✓ ��.i ""� �.��-�� o I�C�� L�..�/�-� ��-/a-�-�e_� '— �. � Q,�F w/r� cc�,v�� -�C� �-�� c �fi�� l � � C�cl� .� ' S c_ G.��v l c -- Q � W -C �c1 �r S --��, �,q.� f�-� � ,'��,� �-( � �-r-��-�-t,�'-r' /�� .� (�-��r3(�, � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY �u � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN u CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. �)"q '�1 � � t �►(��f� (J � Call forthe next inspection 24 hours in advance. 5Z� Z49-460� Owner/Contractor on site: r—i ,� Inspector. 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