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Home My WebLink About2011-01159 - roofing ' ' CITY OF ORONO PERMIT NO.: 2011-01159 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuED: 09/30/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 555 OXFORD RD PIN : OS-117-23-41-0024 LEGAL DESC : KLITZKE ADDN : LOT 001 BLOCK 001 PERMIT TYPE : M[NOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 11,000.00 NOTE: VALUATION OF PERMIT:$11000.00 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 TI-IE SIGNS MUST BE REMOVED. APPLICANT pERMIT FEE SCHEDULE 206.50 J BENSON CONSTRUCTION 3230 GORHAM AVE STATE SURCHARGE(VALUATION) 5.50 ST LOUIS PARK, MN 55416- MISC FEE 0.00 (612)920-0717 TOTAL 212.00 Minnesota State License#: 4740 OWNER KLITZKE,CORNELIA 555 OXFORD RD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMEIVT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and thc State Building Code. This permit is fo�only the work described and does not grant pennission 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 au[horized 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 revoked at any time fo e c se. ry � l 3�l Z� (j O Q�t-- `� l�� l �l Applicant P itee Signature Date �� Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ,`x ..,:F" � k� '�� }a- �a,�,��"., . . City of Orono �`��5 � CP Building Permit Application for Maintenance / Renovation r� ��y '� . (windows, doors, siding, re-roof, etc.) ; �, � Mailing Address: �p/�_ U/��9 z �,�. PO Box 66 Permitnumber: „ x' /O O Crystal Bay, MN 55323-0066 Date received: �� fi � �, d �` (,� � ya �� , � StreetAddress: �Received by: � � ��1- �,. �',�,t � t �' �ti 2750 Kelley Parkway ' Plan reviewfee: � 9kESH�4� 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) ti� ,� GENERAL INFORMATION: �� Job Site Address: f' �� x��ir� /��c r� � � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No ;:x � If yes, a specia!event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shuttle bus service will be �� required unless appficant demonstrates sufficient on-site parking is available. Non-permitted events wil!not be allowed. ;� > _:� CONTRACTOR/APPLICnANT INFORMATION: � ` Name: ,� [J e r� 5 �r� ��r � �i�w��o� � ,;,; State License# � -�y p Expiration Date: 3 -- 3�-�2 :� �,; Lead Certification Number: Expiration Date: "� � (for work on homes that were consfrucied prior to 1978 � F� Phone: � .�j'� '�I 2�%�� J j � (office) �S � — ,� � 3 '- i'i� Z (cell) r�°�� Mailing Address: '3 Z, � p �'j�,- q ,,,,, �,,� City: S'�. C�,u, s � IP: ' L, �fZ ��5 '�z � �� Contact Person: � �� Applicant is: on rac o / Homeowner (Circle One) - Email and/or Fax: L Q� /� �, nr.L, a � ca v e . c_c�d`� �,�; PROPERTY OWNER INFORMATION: Name: ��y r n � �i G K�i T7�C e '= �. Phone (day): �1�Z- `�d �C��pB � Address: Qx o,� � City: ��, 4, ZIP: ' ^,j Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits: � ❑ Door(s) ❑ Remodel ❑ Fire Damage Minnehaha Creek Watershed District(MCWD) a° ` � Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd � t ,:, ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 �� Pho ne: 952-471-0590 �' ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 � ❑Window(s) www.minnehahacreek.orq K='. �; Overall Project Description: ,� Estimated Construction Valuation of Project (excluding land) $ //� D o U ; ;;,, 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 sofely 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 re uired b law. If ou refuse to su I the information,the a fication ma not be issued. � , � �= ApplicanYs Signature: � Date: / — �G%•-;/� ,�. , �; `!; Last Updated: 08-09-2011 : _ . ' __ _ __ � . ,�r.E. C/ DAT TIME " CITY OF ORONO CALLED IN / � � INSPECTION NOTICE��5�-/ SCHEDULED � � PERMIT NOc-�U �/ / COMPLET ADDRESS �-� �X (�. �� OWNER TELEPHO O.��d� -�a��7�' CONTRACTOR � DESCRIPTION � �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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 Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q ti Z W � W � � d WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑C RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. � l�`� �g White Copy/lnspector's File Canary CopylSite Notice �a� DAT TIME ✓ CITY OF ORONO CALLED IN �� INSPECTION NOTI E SCHEDULED f D_$_// � PERMIT NO,o�-4 "O COMPLETED ADDRESS SSS D�,�'��7/CV l� OWNER T LEPHONE NO. �5Z �"�1� 99l Z- CONTRACTOR � DESCRIPTION /—�� '-"'`� ' � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q � POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C o � � � ��,� !�'�,..� a � 0 � W � Q � Z W � W � j � ❑WORK SATISFACTORY:PROCEED ��ROJECT COMPLETE W ❑CORRECT WORK&PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �; pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice