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Home My WebLink About2009-00071 - roofing CITY OF ORONO PERMIT NO.: 2009-00071 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 02/18/2009 952 249-4600 FAX: 952 249-4616 ADDRESS 2490 OLD BEACH RD PIN 21-117-23-22-0005 LEGAL DESC SHORE HILLS LOT 004 BLOCK 000 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 25,000.00 NOTE: REROOF TEAR OFF PERMIT APPLICANT PERMIT FEE SCHEDULE 413.00 TWO STUDZ CONTRACTING INC STATE SURCHARGE(VALUATION) 12.50 2105 DANIELS ST LONG LAKE,MN 55356- MISC FEE 0.00 (952)224-4495 TOTAL 425.50 OWNER MANION,BRIAN 2490 OLD BEACH 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 fol a period of 180 days at any time after work has commenced. The applic is responsible for assuring all required inspections are requested. conformance wi the State Building Code.This permit maybe revok d any ti a for du e / 67� 6�t�� ant erm to tgna Date Is ed By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 01/07/2009 03:26 7634258859 MPS PAGE 02 City of Orono Building Permit Application for New Structures or Additions UaNPO OX as Permit number, DO�I- 600 7/ Q Crystal Bay,MN 65323-OM Dale received: / O Shw1Address.' Received by: 2750 Kelley Parkway Plan review fee: Orono,MN 55356 Main: 952-249.4Wo Fac 9S2-2494618 www.ci.omno.mn.us I Total Fee: This application form must be completed in full and all required Information must be submitted. Incomplete application will be netaurned. (Please print) GENERAL INFORMATION: Job Site Address: VWII this be a Parade of Homes, Remade ere Showcase Home or other Display Home? Yes No !ryes,a*WW evW permit is required with Pallas Dgwrtrnent end My Caundl approval W days pilar to the event ShuEde bus eerviloe wX be required unites app/Amt donmamos su8fdew on srla powng is et/ai ft No4oamnHed aventa wql nal be ellawad. CONTRACTOR/AP F ON- Name: State License# Expiration Date: - Phone: - - Lam—pi Call Mailing Address: h `� C ke P: r6' Contact Person: tri Applicant is: Co or / Homeowner (ewe oil Email and/or Fax: , tiAA A- OYA.9 PROPER' Y OMT NFORMATION: Name: a f1 Phone(day). Address: L - Ci ZIP: r Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone(day). Address: City: ZIP: Email and/or Fax. PROJECT INFORMATION: .Type of Protect Z Proposed ilea 3.Structure Type 4.Samoa Disposal& New Construction [3Single Family with Roffice/commardal Residence Welter SuPP1y Addition aaaahed game Garage/Aeoessori Bldg. ❑Public Sewer Arxessory Budden Single Family with Deck Relocation ,�,(A� detached garage ❑Private Sewer Other(specify) 1tUJ" Multiple Family!Condo [3 Warehouse Public Storage ❑Public water "Any earth movement may require ❑Commerdal Other(Spedhr) Private Well 111t:MID re [Iview&permt�. Industrial Mlnrr¢fmlre Create watershed Otatrtet(Mcu ml rj Other.(specify) 152M MkmMarft Ow Osepnererh,MN 88391 Phone: W-4714O590 Feat 99-171.0882 Estimated Construction Valuation(excluding laril) S DOD. D d - 16- 01/0?V2009 03:26 7634258859 MPS PAGE 03 STRUCTURE INFORMATION: 1.Struchn Dlnwrmlone 1.StrucUM Dimensions(continued) L Type of Construction a.Length(R,)n Number of bedrooms= ❑Wood/Frame Masonry b.Width(R.)= Number of garage stalls: Metal Attached= ❑Pole Bldg. Areas M samara teat Detached o ICF " On-site Prom a gasamenta Off-sh Prefab d. 1 u Story - Other(please specify): a,2nd Story= f. 'h Story = g.Total Area= REQUIRED SUBM11TALS: All of the information must be submitted in order for your applicedon to be rocessed: Nota .. Enclosed App9table 13 Pe It A catlon G E P osgd MINIM Plans pR MN State Emw Code Calculatlano and Me nivel Cale Requirements Form D S~ meeting all reimmenta D Hardcover loulati s [] SeNc System Site Evaluation Report 13 Q! Pe D lD Welland Buffer Impromment Plan D En Insered Plans for Retainina Walls 4 feet or above Plan Review Fee D P IOther APPLICANT A OWNER ACKNOWLEDGEMENT: • Agrees to provide all Information required or requested by the Building Department, • Agrees to pay the City of Orono for engineering consultant review oasis In excess of SM.and • Certify that the Information supplied Is true and Coned to the Crest of Mather knowledge. The applicant and owner recognize drat they are sot*responsible for submitting a oomph to appilostlon being aware that upon failure to do so,the staff has no alternative lotto valect n wdll R is oompkete. • Acknowledge the Escrow Agreement is completed and signed. • The Owner hereby acknowledges and agrees to this application and further authorlae reasonable envy onto the-property by City Staff,consultants or agents,for purposes of investigation of this request • Some or all of the inforrnatlon that you are asked to provide on this application Is classified by Stats luta as either private or confidential. Private doth Is information which generally cannot be given to the public but can be given to the subject of the data. Confidential date is information which generally cannot be given to either the public or the,subject of the date. Our purpose and intended use of this InIbimallop is to annually update our records and records of other governmental agencies required by law. if You Tule to,8001V the Infohnation.the application may not be issued. Applicant's Signature: Date; Applicant's Signature: Date Owner's Signature; Date: Owners Signature: per: 01/a7./2009 03:26 7634258859 MPS PAGE 01 �1b lnspee�cns CLI)nj '�'^'� (pra - 5g9 - 5 �/ 3