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Home My WebLink About2009-00464 - roofing ' � CITY OF ORONO PERMIT NO.: 2009-00464 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/07/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 2060 NORTH SHORE DR PIN : 10-117-23-31-0003 LEGAL DESC : LTNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 9,500.00 NOTE: THIS PERMIT INCLUDES REMOVING AND REPLACING SHINGLES AND ALSO REBUILDING CHIMNEY. APPLICANT pERMIT FEE SCHEDULE 191.75 RIGHT WAY ROOFING INC STATE SURCHARGE(VALUATION) 4.75 14050 23RD AVE N PLYMOUTH,MN 55447 TOTAL 196.50 (763)550-0130 Minnesota State License#:3999 OWNER GODFREY,LYLE&NORMA 2060 NORTH SHORE DR WAYZATA,MN 55391 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 dces not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied wittt 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 due cause. l l ��L�/�.ra, � `,/.G� � ��l U� Applicant Permitee Signature Date Issued y Signature Date ' SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. y. . ,. -��,. ,� ��qseyr j +$,r'Tv w�;: '.�fl,8�ic.'�vy.•' :...�;� ��`�.'y � 'piH $ � -'� �� R +�.h. ...... _ _ . _ .. - @,�'�M ' � � '� City of Orono � �, �k � Building Permit Application for Internal Work �'� �4 .- (windows, doors, siding, re-roof, etc.) � ��; Mailing Address: � ��' 0 � Permit number: �; � �4v ,��\ PO Box 66 � �,� /Q o\\,1 Crystal Bay, MN 55323-0066 Date received: � �� :�� // * �� .'� " Received by: � ��. � ( ��4�;� a � Street Address: � '��d� � � 2750 Kelle Parkwa Y Y Plan review fee: �' �t`�kESH`�% 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) � ,�; GENERAL INFORMATION: �; ✓�.�=3 / -� �'� Job Site Address: :�7�'.�;C� /7�,�t-! Sl�''� ,�',c3-�- C��u /yjh `� t ,, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No ��' lf yes, a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wil/be � required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed. � CONTRACTOR/APP ICANT INFORMATIO : , ,.� �< � � Name: �� c� _ c State License# �' Expiration Date: ,� j p g Phone: � 3�.� - �� office lo/,�,- 7 -- < < cell `' Mailing Address: y D " '`' : Cit : �c��h ZIP: '��/ ��, Contact Person: �,��- �f,�� S Applicant is: Contractor / Homeowner (Circle One) `�' Email and/or Fax: ri �i/if-�-.ur � � ��,,�r�r� ;� j- '� �� ? PROPERTY OWNER INFORMATION: ��: . G� / o��/e � �_; Name: � � � � s�,;' Phone (daY)� ��.;�3-.71�7 l�o�C.Y� << , Address: o-?l��/� /�a�'� f✓�.� �i'.�1� CitY� �i2��rJ, ZIP� .55..�9 -��;5 Email and/or Fax _ :'.�:;; � FV; PROJECT INFORMATION: �fi;� Type of Project: Any earth movement may require �� ❑ Door(s) ❑ Remodel MCWD review&permits ❑Water Damage .; Minnehaha Creek Watershed District(MCWD) ;` F,t,� ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd �r: Deephaven, MN 55391 �� F` ,� ❑ Siding ❑ Restoration ❑ Other. (specify) Phone: 952-471-0590 . Re-roof Fax: 952-471-0682 F �-t-' , ❑ Fire Damage www.minnehahacreek.orp �;: Overall Project Description: y�v � l�s��Q��z�� i y��'��,5 .�� < C i' � � /s . x� Est�mated Construction Valuation of Project (excluding land) $ --�f�pD,��j �,� ��; � `' M� ,,�:' APPLICANT ACKNOWLEDGEMENT: _ ��'� • Agrees to provide all information required or requested by the Building Department; �s,V • 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 information, the a lication ma not be issued. �� ; i$� �� ;�: ApplicanYs Signature: �c�/�,�� —„�� Date: d��l�� :. � � Last Updated: 05-04-2009 �" �z; __ �,a'.$ `l ; ��"� + €� y. 'r �. .y � F�4h gw�-�,g�, r t�,,7�� aa�� F 1. �'�} -. �.t '�^� .� � ti ^��r �. �:.i .�� . ._.�� .�. � .,��:��, ,.��:.,...�a�.��...,�_�� >_�,��.�_.�.rr��..:.�,a�.,�rr��..�'��.�g�.�. � _��