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Home My WebLink About2011-00436 - roofing ` CITY OF ORONO PERMIT NO.: 2011-00436 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 06/08/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 4680 NORTH ARM DR W PIN : 06-117-23-23-0006 LEGAL DESC : UNPLATTED 06 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 16,000.00 NOTE: TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 280.25 GIERTSEN COMPANY 8385 IOTH AVE N STATE SURCHARGE(VALUATION) 8.00 GOLDEN VALLEY, MN 55427- TOTAL 288.25 (763)546-1300 PAID WITH CC# 9298 Minnesota State License#: 1796 OWNER WESTFALL, MYRON&PATRICIA 4680 NORTH ARM DR W MOUND, 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 no[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 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance the St e Building Code.This permit may be revoke an ime for e use. n � / � / �/ �,� '�� pplicant Per itee Signature Date Issue�' y Signatu Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ! City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: (7 —" � Og,D,�.O PO Box 66 Crystal Bay, MN 55323-0066 Date received: _'�� / � a � �, Street Address: Received by: '�',F, "�� ti 2750 Kelley Parkway Plan review fee: 't.9,kESx�4,� Orono, MN 55356 �[ Total Fee: 1`h� � �� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us ��`t" 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: �(��C� /l.��rf/-, ,�'�-j /�� U�"L��U , Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes �flo If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��i��c'-'r� �i�/�!�n v� State License# / 7��, Expiration Date: .:j=`ur Z Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: `7 ; 3--5-�(�`-/�GC< (office) (p i 1--7O� - �S_� (cell) Mailing Address: �� /�''� /�-�,� /`/ City:� /�� ZIP: � 7 Contact Person: ��j,�j�� f�� j f�,� Applicant is: Contracto / H eowner (Circle One) Email and/or Fax. � ��- �z��, - �,(1,�? PROPERTY OWNER INFORMATION: j� Name: �1��J'� L�r�� J�j�'Sf 7 t`L �� _ Phone(day): � -.,�5 3 -�7,j' Address: �1�� ,Q��i-�-� m �I-�� CitY� �YOYI U ZIP: � � (�`�-' Email and/or Fax PROJECT INF()RMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review 8 permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑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: �'r'--yz;o� Estimated Construction Vatuation of Project(excluding land) $ %l�, C��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 I the informatiQn,the a ication ma not be issued. ApplicanYs Signature: y� - Date: ��7�� Last Updated: 03-01-2011 TE TIME ✓ CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED � PERMIT NO. o�� - � �COMPL ED / �- ADDRESS �tO� �J OWNER TELEPHONE NO.��-7�3 -g�� CONTRACTOR / ✓� I��.II-t�vt� � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � 2 W � W � � ��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on ite: Inspector. � � � White Copylinspector's File Canary CopylSite Notfce �J I� " '" DA E TIME �/ CITY OF ORONO cA�LED IN � INSPECTION NOTICE SCHEDULED - �� -�( PERMIT NO.��-D�5�3(a COMPLETED ADDRESS T�BO /UDY'�'�'i �� - � . OWNER TELEPHONE NO. CONTRACTOR Glef''Z`S+e�- � DESCRIPTION ��-e �� FOOTING ❑ PLUMBING FINAL p EXCAV/GRADING/FILLiNG Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVA� Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ 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 y COMMENTS:�� - `� ��+ � W a � J O � � O � W � Q � 2 W � W � � G • � ❑WORKSATISFACTORY:PROCEED �9JECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector. c � White Copyllnspector's File Canary CopylSite Notice