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Home My WebLink About2009-00327 - roofing CITY OF ORONO PERMIT NO.: 2009-00327 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 06/17/2009 952 249-4600 FAX: 952 249-4616 ADDRESS l : 225 NORTHGATE RD PIN \ : 36-118-23-41-0048 LEGAL DESC : NORTHGATE TWO : LOT 001 BLOCK 004 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 6,600.00 APPLICANT PERMIT FEE SCHEDULE 147.50 ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUATION) 3.30 5145 INDUSTRIAL ST SUITE 103 TOTAL 150.80 MAPLE PLAIN,MN 55359 (763)479-8700 Minnesota State License#:3247 OWNER WEBB,ELIZABETH 225 NORTHGATE RD 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 conformance with the State Building Code.This permit may be revo d at any time for due cause. Applicant Permitee Signature Date Issued By Signature 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: 0,11 PO Box 66 I, 0 Crystal Bay, MN 55323-0066 Date received: ath, Street Address: Received by: 2750 Kelley Parkway Plan review fee: L�kE3HOg� 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: Job Site Address: ;2-2-5- Will 22SWill this be a Parade of Homes, Remodel rs Showcase Home or other Display Home? ❑ Yes No 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: -,4L5.&, t^o ✓e br, State License# a0(o 315-7q Expiration Date: 3 3/ 10 Phone: 7&3 !aj 9200 (office) W.3 #_2Y 03,p 9 (cell) Mailing Address: ,/ Cit : ZIP:ss3s Contact Person: Co►•t e Applicant is: ontrac or / Homeowner (Circle One) Email and/or Fax: ?63 4-79 6600 PROPERTY OWNER INFORMATION: Name: Q)*ZekeA BoYty Phone (day): 2572 4/73 012 Address: S,QMt City: ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ElDoor(s) ElRemodel ❑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 Re-roof ❑ Fire Damage www.minnehahacreek.org Overall Project Description: 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 information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information,the application may not be issued. Applicant's Signature: �tY� Date: 6Z/ l Last Updated: 05-04-2009