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Home My WebLink About2010-00966 - roofing CITY OF ORONO PERMIT NO.: 2010-00966 �w 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 10/07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3860 NORTH SHORE DR PIIv : 08-117-23-33-0095 LEGAL DESC : CRYSTAL BAY VIEW : LOT 000 BLOCK 007 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 5,000.00 APPLICANT pERMIT FEE SCHEDULE 118.00 SIMMONS,BRETT STATE SURCHARGE(VALUATION) 5.00 3860 NORTH SHORE DRIVE MOUND,MN 55364- MISC FEE 0.00 TOTAL 123.00 PAID WITH CC# 7249 OWNER SIMMONS,BRETT 3860 NORTH SHORE DRIVE MOLJND,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 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 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �� /�J / �7 / /d / / Applicant Permitee gnature Date Issued By S' ature SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOV YRy iR City of Orono �� , Building Permit Application for Internal Work � i (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: �j,�,�. PO Box 66 0 � Crystal Bay, MN 55323-0066 Date received: "`'�� Received b � � '�:,4;; �, I Street Address: Y� .�,� �� `�� ti 2750 Kelley Parkway Plan review fee: �� `�kEsxo�`'� 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. w� Incomplete applications will be returned. (Please print) GENERAL INFORMATION: ''��; Job Site Address: � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No ,� !f 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 demonstrafes sufficient on-site parking is available. Non-permitted events will not be allowed. .�� CONTRACTOR/APPLICANT INFORMATION: ,� Name: �7�� = - �t�.�., zf <� State License# Expiration Date: � Phone: (office) (cell) � Mailing Address: City: ZIP: �� Contact Person: Applicant is: Contractor / Homeowner (Circle One) � Email and/or Fax: :� ,� PROPERTY OWNER INFORMATION: � Name: ��1-�- � r�-.,�..��5 � „�: Phone (day): (�I� - 3�� 50 '�� Address: "� � Col� ,N i,<<�. � Cit : - , ,� ZIP: ;�S��( ''� Email and/or Fax � 1��+} � i�,-� �-}--� �,�<„r��,L�,,,.` '� � PROJECT INFORMATION: � Type of Project: Any earth movement may require ,� MCWD review&permits ;� ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 (�f Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: j� - �aaT o�.-�,� Estimated Construction Valuation of Project(excluding land) $ ,j��,v�j 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 information,the a lication ma not be issued. Applicant's Signature: �i-'' � , � Date: I(� �- �`�C.� Last Updated: 05-04-2009 � � /D=A TIME CITY OF ORONO CALLED IN INSPECTION NOTI E SCHEDULED � �� PERMIT NO. �'D �� COMPLETED ADDRESS 3�d,/t/�7'�. �S� �'Z/ OWNER ��Su��ELEPHONE NO. ��1 a�—�I'lo'-�ZDS� CONTRACTOR ��t/ >; DESCRIPTION '`-� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOILOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W a J O � � O � W � Q � Z W � W � � d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECdI/ERING PERMANENT ❑CORRECTUNSAFECONDITtONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on si : Inspector. � � S � White Copyllnspector's File Canary CopylSite Notice _�/' V / ATE TIME CITY OF ORONO CALLED IN Xi � INSPECTION OTICE SCHEDULED ��✓ PERMIT NO. �! COMPLETE ADDRESS OWNER TELE NO. CONTRACTOR �; DESCRIPTION �v / I �/v►' L ��V� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W C � J O � � O � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED t�ROJECT COMPLETE � ❑CORRECT WORK&PROCEED �; ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CQRRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�0 Owner/Contractor on site: Inspector. White Copylinspector's File Canary Copy/Site Notice