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Home My WebLink About2011-00400 - roofing � CITY OF ORONO PERMIT NO.: 2011-00400 ' 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: OS/3U2011 ' 952 249-4600 FAX: 952 249-4616 ADDRESS : 1367 NORTH ARM DR PIN : 07-117-23-41-0065 LEGAL DESC : SAGA HILL REVISED : LOT 000 BLOCK 013 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACT[VITY : O/S BUILDING - UNDEFINED VALUATION : $ 7,000.00 APPLICANT PERMIT FEE SCHEDULE 147.50 PAR CORP STATE SURCHARGE(VALUATION) 3.50 6393 82ND ST NE MONTICELLO, MN 55362- MISC FEE 0.00 (763)238-7717 TOTAL 151.00 Minnesota State License#: 20636796 PAID WITH CC# 3229 OWNER THEISEN, LINDA 1367 NORTH ARM DR MOLJND, MN 55364 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o 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 goveming this type of wark shall be compied with whether or not s ified herein.This permit will expire and become null and void if c struction authorized is n�t commenced within 180 days of d date of issuance,or if co fruction is suspended for a period of 180 ys at any time after wo ias commenced. The applicant is responsible or assuring all requir mspections are requested in conformance ith the State Build Code.This permit may be revoked at a y time foy ue cause. ' . / � � 31 � !l / / Applicant Per rtee Signatu Date Issued By Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED AB < City of Orono � Building Permit Application for Internal Work , (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �v�,� PO Box 66 Q \ 0 Crystal Bay, MN 55323-0066 Date received: �� ' Received b .� '�:�w �, � Street Address: Y� �'�n � `°� Gti`� 2750 Kelley Parkway Plan review fee: L�ESH��'� 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. (P/ease print) GENERAL INFORMATION: Job Site Address: '' � � 1J�r t�.. �, (�;� _ 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 Police Department and City Counci!approval 60 days prior to the event. Shuttle bus service wil!be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �'� � ,�� C ��'�� L��v� State License# �,�, ��,�� c.��, Expiration Date: 3 � , � �"� Lead Certification Number: Expiration Date: (for work on homes that were construcfed prior to 1978 Phone: 7� �-� ��3�5 --� Z I7 (office) (cell) Mailing Address: - y� �C� City: �})�f„�,:,�� ZIP:S�� Contact Person: �,�„- � ;c�� (_��G,�� Applicant is: C ntrac o -/ Homeowner (Circle One) Email and/or Fax: �,��, � ��.�� ' l c� .�"� _� �; r�ti-, PROPERTY OWNER INFORMATION: Name: L, 1✓� ��r.� �'l��s�N 47 Phone (day): cl S Z - '��-- (a��75 Address: 13�; 7 �1,�c'� -f �% u v ,z� bJ�-_ City: c-rz-:--d c.; ZIP:�S'"�r � 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 r � ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: � �� ?� �: `_ Estimated Construction Valuation of Project(excluding land) $ -�G�C%. C: G 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 appficant 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 generall an t be given to either the public or the subject of the data. Our purpose and intended use of this information is to nnua)�pdate our reco and records of other governmental agencies re uired b law. If ou refuse to su the inform ionvtiie a licatiom m � be issued. ApplicanYs Signature: �..� Date: �' S! ��// Last Updated: 03-01-2011 / q TIME " CALLE� �� I CIN OF ORONO —�–�y-� � INSPECTION OT CE SCHEDULED � PERMIT NO��`� �DD �� COMPLETED ADDRESS I 3�� /�� ' '` �m � r OWNER TELEPHONE N0.76 3 � Z 3�'-7 7� 7 CONTRACTOR � � DESCRIPTION �� D/ l � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETIANDS � y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ FiADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W a o ' � ,�yu n a � 0 � W � Q � z W � W � � � �RKSAT{SFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL AETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-46�0 OwnerlContra�tor on site: Inspector. � White rM••�'_-- � „ (n A�E TIME � C:ITY OF ORONO ��'��1 �%/�LLED IN `-” � "'/ �' � INSPECTION NOTICE f'yy�SCHEDULED �L � PERMIT NO.�1� I -�`t�COMPLETED ADDRESS � �� ,� VY� �� ' OWNER TELEPHONE NO 7�' �"��7 CONTRACTOR � �; DESCRIPTION �� 1�._ I � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � J O a � O � W � Q � Z w � W � � d W� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED SSUE CERTIFICATE OF OCCUPANCY Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: Inspector. r ' White Copyllnspector's File Canary CopylSite Notice