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HomeMy WebLinkAbout2009-00858 - roofing CITY 0 ORONO PERMIT NO.: 2009-00858 2750 KELLE PARKWAY ORONO,MN 55356- DATE ISSUED: 11/30/2009 (9$2) 249-4600 FAX: (952)249-4616 ADDRESS : 505 OLD CRYSTAL BAY RD S PIN : 04-117-23-31-0003 LEGAL DESC : AUDITOR'S SUBD.NO.230 : LOT 022 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 7,000.00 NOTE: TEAR OFF REROOF APPLICANT PERMIT FEE SCHEDULE 147.50 NORDKAP CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 3.50 1881 STATION PARKWAY TOTAL 151.00 ANDOVER,MN 55304- (763)607-4845 Minnesota State License#:20635312 OWNER HARMANN,DAVID&MONA 505 OLD CRYSTAL BAY RD S LONG LAKE,MN 55356 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 inspeptions are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / 3� / O9 adja // /30/Oy Applicant Permitee Signature Date Issu d y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 4'4- City ��f Orono Building P = rm t App ration for Internal Work (win;® owe, door- siding, t�e-roof, etc:) M=ling Address Permit number: - '�V- PO Bqx 66 , t Crystal Bay,MN -:423-0066 Date received: .n y' a. St et Addnss Reined by.. 'i pa ooh 2750 Kelley Pa. 'y plan�eviewfee � - .° o � .- Orono,Mtst 66366 ` Total Fee Main: 952 249-4600 F- : 952-249.46'16, , www.ci.orono,mn.us. This application form mus I be completed in II and ell require ed information must be submitted. Incomp 1.to applications:f'ill be returned. (Please-print) ' GENERAL INFORMATION: .Job Site Address: �$`a5 S eta 1l C 1 lit'►7 O Ilhls be.a Parade of Homes, Re •deters Sliowc a H©me dr other Display"Name? 0-Yes If yes,a special event permit is required with •lice De No pcient 0t dt►s €ity council approval 60 flays p►ior:t the event SfiuEge hu services' --,., ; required unless applicant demons -fes'sufficient on s lacing is available N©n pertttitted events will not/14311W o CONT '2A.CTOR/APPLICANT INFOR TION: Name: Ivas�wap « Nsiu�c to SLC State License# 2abtp%S31 'L . r Expiration D e Phone. �.. 'V.3- '1 t:'I : =t 4 d it Ice) ( h Mailiing.Address: i BBBt 1a ah,,-, i, �.; , : Contact=fie son: �•' � IP 5 w r �1a © Applicant is Dutra -,o /, , FHomeowner .> lci/tot Email and/or Fax: s PROPERTY OWNER.INFORMATION: Name' L ,fl1P,sz r►rsa 5 Phone°(day): gS'Z ypc �.,4, Addre iii a\d ays}�..t 13 tis 'D � 0 lP ►�S Email end Fax T. ,� F `. {� ' !R�. T 1NI=;6k1' I ATION: i. .. p r T. Type off j ect q ,-.„,„4,e �rt '21--1,1-'9°114), I Remodel Q Water D:r 9 llinrnehali�af e' V ate. i'Drg ct(MC1 / , WIq�(s� ��epair Irl Btd►�ii`� i• �e � =,---,e-'-, �� (,� � �� rt �• &ifa � N�5 1f , o siding 0--,R esto tion ❑Other w, ofy h"bnet; 2- 1r0 Its-roof_ I Fire Damage ` 5 7.1 t ex it �—"ha�ld t�# - ,i, Y roject5Descriptlon. t "timated Constructi©n Valuation of P •jecf(excluding APPLICANT/ CF l {' O4EMEN.T • Agrees to provide all in ormation requi, . or requested by,;�eBuilding Department, • Certifies the information supplied s true and correct'. the best df his/her knowledge The;*applica re nines that. ey r , are�solely that th infer for submitting :-,complete epplirati.e being aware`athat upon failure`to do<so,thus ff h s neap.a title but to refect it until itis complete; Some or •all of the information{that yo are asked to pro •e on this application is classified by$ , - ' 'State jaw,esti either, iv or confidential Private data is informati.n which generally' .nnot be given to the public but can,:'be Ygiv n to the subject the data. Confidential data is nformatio ,which generally riot be given' °.ta either the public or the subject of`the d'a`fo u purpose and,intended use of this info matron is to annu-., update our records and records of other governmental agencies;,, required by law. If you refuse to suppl,,the information,th =pplication may not be issued. Applicant's Signature: „ 1M ! Date: J( /3o/O I Last Updated: 05-04-2009