HomeMy WebLinkAbout2009-00316 - roofing CITY OF ORONO PERMIT NO.: 2009-00316
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 06/15/2009
(952) 249-4600 FAX: (952) 249-4616
ADDRESS 1 : 425 OLD CRYSTAL BAY RD S
PIN j : 04-117-23-31-0001
LEGAL DESC : AUDITOR'S SUBD.NO.230
: LOT 020 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : : ROOFING-ASPHALT
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION 1 : $ 17,000.00
I
APPLICANT PERMIT FEE SCHEDULE 295.00
PLYMOUTH ROOFING&INSULATION STATE SURCHARGE(VALUATION) 8.50
17525 CTY ROAD 24
PLYMOUTH,MN 55447 TOTAL 303.50
(763)473-3397
Minnesota State License#: 5358
OW4ER
LAWTON,W&P
425 OLD CRYSTAL BAY RD S
LONG LAKE,MN 55356
AGREEMENT AND SLORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specificatioapplicable City approvals,and the
State Building Code. This permit is r only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and o dinances governing this type of work
shall be contpied with whether or not pecified herein.This permit will
expire and become null and void if struction authorized is not
commenced within 180 days of the a 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 al -quired inspections are
r-•uested i conformance w', :S. • g Code.This permit may be
revok-, .tan is r cue
ss , t '" I G/ /s/ - O j it // / /
'ermi e ignatu Date Issued Signature eI' ' !ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A:i VE.
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2 1 S {
City of Orono .r� .
?�'. .,4 4 -,,,IV41
, Building Permit Application for Internal Work x .
(windows, doors, siding, re-roof, etc.)
Mailing Address. K 'A
Permit number:
‘-1 (3.4.01\\ PO Box 66 Crystal Bay, MN 55323-0066 Date received: . W
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Street Address: Received by:
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��t ,y � Gtiti 2750 Kelley Parkway Plan review fee:
�kESH04`� 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: L�-c�`� Soles{-, et:D C _ lR L -6i Aad / �1c- r
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? L Yes , ‘ lo
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: I D
Name: y L y mC, LA-71-i\ -7---' 6 6i�1 rt) ,tet-.T-E'I S l 1.,), /t-C
State License# 53-5-g- Expiration Date: 3/3//„2n/o
Phone: 73- 7.3— 3132_-7 (office)
"� l-•(� - 7/g-0?S-7 (cell)
Mailing Address: 1 75 5 ( Lt..tl-t� •1_<,,,,-A D.y City:PL . L ZIP:SS-V}i7
Contact Person: ID-ft"—E- / Applicant is: �ntractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: j-<+k YNAV - lti ( t' It%
Phone (day): Z. - L-7.7-- .35L , I
Address: tf� 5 �c cry old .S7�k �y l��Qc� City: ;(,1j �ak ZIP: 5 5- 3
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review &permits
❑ Door(s) E 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
Re-roof
❑ Fire Damage www.minnehahacreek.orq
Overall Project Description: Tr,,...,�r,__Rectc,-E . „_5�. .,ttvc, iCtiecy cifock9('
Estimated Construction Valuation of Project (excluding land) $
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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 sus sly the information, tJ —d pli : •n ••-y not be issued.
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Applicant's Signature: - ,, `ti 4 Date: Com—1, a.\,
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Last Updated 05-04-2009
ATE TIME V
CITY OF ORONO CALLED IN p P
INSPECTION NOTICE �/'�2 SCHEDULED Co/(0/69
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PERMIT NO. C l jA0,21 ,kOMPLETED1 1
ADDRESS ` � D(CL CC S ( Ft/ S,
OWNER CONTR. I CR"*1 kWh
TELEPHONE NO. . 025 /(q
DESCRIPTION
ear - 0C-4:
❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
h ❑ INSULATION 0 WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
• ❑ WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION
• 9 FINAL 9 SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v 0 DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP
LU ❑ PLUMBING RI 0 SEPTIC FINAL 0 HARD COVER REMOVAL
❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO WET YOU:_YES_NO Q
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4tZ WORK SATISFACTORY:PROCEED PROJECT COMPLETE
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W ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
(..) BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
111 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: 4l 6„.„._
Inspector. 1 /
White Copy/Inspector's File Canary Copy/Site Notice