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Home My WebLink About2013-01062 - roofing SRI" El CITY OF ORONO * 2 8 1 3 - 0 1 0 6 2 2750 KELLEY PARKWAY DATE ISSUED: 10/10/2013 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 3640 NORTHERN AVE PIN 17-117-23-34-0017 LEGAL DESC TOWNSITE OF LANGDON PARK LOT 007 BLOCK 010 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ROOFING-ASPHALT ACTIVITY O/S BUILDING-UNDEFINED VALUATION : $ 1,500.00 NOTE: VALUATION OF PERMIT:$1500.00 ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 57.50 GARDNER, SCOTT STATE SURCHARGE(VALUATION) 0.75 3640 NORTHERN AVE WAYZATA,MN 55391- TOTAL 58.25 PAID WITH CASH 58.25 OWNER GARDNER, SCOTT 3640 NORTHERN AVE 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 does not 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 confloman ith the State Building Code.This permit may be revoked at aqy time fo. e cause. ;r J.0 10 A plicant P2rmlfee Signature Date Issued By Siture ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: 2750 Kelley Parkway Plan review fee: Orono, MN 55356 `ekESHO�� 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: I1 � ' 1 Job Site Address: O 4V ' V�'�YZ06 MO, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes MNo 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. CONTRACTOR/APPLICANT INFORMATION: Name: State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 978 Phone: (cell) (office) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INF RMATI N: _ Name: tuftwdso Phone (day): ? _ Address: C City: ZIP: 55jq Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: A -earth m6vement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: e-roof,asphalt *'Repair+*C p,� ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) S 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ = 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 infor ati is to annually update our records and records of other governmental agencies required by law. If you refuse to supply th for tion,the application may not be issued. Applicant's Signature: i �' Date: I L-) Owner's Signature: — i Date: hlD 13 Last Updated:03/06/2013 -�®DATLO TIME V CITY OF ORONO CALLED IN (( INSPECTION yOTICE / SCHEDULED D -� PERMIT NO. Q'0(3'- 6 10 Y/Z COMPLETED ADDRESS 3(0 VO A)&r41LXA-r( IqG-f—'-v OWNER Sc.&ff 6L% L EPHONE NO. 95Z 4171 12-00F CONTRACTOR DESCRIPTION Teac W El FOOTING El PLUMBING FINAL ElEXCAV/GRADING/FILUNG Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS Oy ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL 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 OWNEWCONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc cW. j 0 cc 0 W cc Q W Z W Uj RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W RRECT WORK&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 ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours In advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copylinspector's File Canary Copy/Site Notice LC--Y— DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE ED PERMIT NO.�D � SCHEDULED `l ADDRESS OWNER TELEPHONE NO. CONTRACTOR DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKE SH OR y ❑ FRAMING ❑ MECHANICAL FINAL � [_1 TREE REMOVAL 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 _ ElDEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W Q_ cc J O Cr O LL W cc Q 2 W Z W J O LU � ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC01/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN G CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: / Inspector_ White Copyllnspector's File Canary Copy/Site Notice