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Home My WebLink About2011-00560 - roofing � ' CITY OF ORONO PERMIT NO.: 2011-00560 � 2750 KELLEY PARKWAY � ORONO, MN 55356- �ATE IssuEn: 06/30/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1379 PARK DR PIN : 07-117-23-42-0038 LEGAL DESC : SAGA HILL REVISED : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 24,474.00 APPLICANT PERMIT FEE SCHEDULE 413.00 SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 12.24 12366 RIVER RIDGE ROAD BURNSVILLE,MN 55337- MAIL-IN FEE 2.00 (612)861-7000 TOTAL 427.24 Minnesota State License#: 20593656 PAID WITH CC# 1521 OWNER BURGER, CHRIS&MARY 1379 PARK DR MOUND, MN 55364- 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 reques[ed in conformance with the State Building Code.This permit may be revoked at any time for du cause. � .! �� .�� Applicant Permitee S�gnature Date Issued By Signature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. JUN-30-2011 06:37 From: To:19522494616 Page:2�2 � � City of Orono Buiidiu�g Permit Application for Internal Work (windows, doors� siding, re-roof, etc.) Mailing Addr�ess: permit number. "� � G O�Q�,O PO Boz 6B Crystel Bay,MN 55323-006B Oat�recefved: � � SUeet Address: Received by: 2750 Kelley Parlcway plan review t�e: ��° Orono,MN 55356 Total Fee: �� '} -7 ��l� Main: 952-249�600 Fax: 852-248-4616 www.ci.orono.mn,�� O` This application form must be completed in full and all requlred information must be submitted. Incomplete appllcatEons will be returned. (Please p�n� GENERAL INFORMATION: Job Site Address: �� Will thls be a Parade of Homes, Remodele�Showcase Ho e or other Display Home? Y�s No 1/yesy a sr+eciel everM pennit is requlred with Polioe Oepa�tn+eni and Ciy Council eppioval 60 days prhor to the event. SAultle Dus s c�wU!be requiied uNess epp6can!demonsb�tes sutficient on,s�7e perfring is evailable. Non pelmitted evenl8 will not be allowed CONTRACTOR I APPLICANT INFORMATION: Name: /d/ State License# Expiretion Date: �j�?/�a Lead Certiflcadon Number. Explration Date: � (for work on homes that we►se consbu�ted prfor ro 1978 Phone: / . , � (o�ce) (cell) Mailing Address: / �j y City: ZIP: �� Contact Person: �¢�„/61�� j,�,l�,��/� _ Applicant is: nVa / Homeowner �ciR►�o�a� Email and/or Fax: �/��g� ��,,��.�hg��¢,'�r�. Goy,e7 PROPER7Y OWNER INFORMATION: Name: Phone(day): • � Address: /��9� A,�. �Y �/V� ZIP: �j�l� Email and/or Fax PROJECT INFORMATION: Type of ProJect: Any earth movement may nqu�re ❑Daor(s) ❑Remodel ❑Water Damag� MCWD revlew 8 permlts: Minnehaha Creek W�tershed District(MCWD) ❑Window(s) ,�� ❑Repair ❑Slorm Damage 16202 Minnetonk�Bbd g ❑Restoration ❑Other:(specify) Deephaven,MN 55391 []Sidin \�� Phpne: 952�71-0590 �Re-roof �;�'� 0 Fire Dam�ge F�ax: 952-471-0882 � www.minnehah��r ek.orn Overelt Pro)ect Descri tlon: B�� - � Estlmated Construction Valuatuon of Project(excluding land) $ �� c��. �-I � APPLICAIdT ACKPIOWLEDGEMENT: • Agrees to provide e�l infiorm�tion required or requested by lh�Building Department; . Certifies that the Intortnatloro supplled is we and correet to the best of his/Ner knowledge. The applicanl recognizes that they are solety responsible for submitting a complete appllcatlon being aware that upon fallure to do so, the slaif has no altemative but to rejecl fl untfl It Is complete; • 8ome or all of Ihe intormadon that you are asked to provide on this application is classified by State law as eilher prlvate or confidential. PMvate data ia lnlormaGon whfch generally cannot be glven to lhe public but can be given to the subjed oi the dats. Confidenbal date is infnrmalion whlch generelly cannot be givan to elther the publlc ot the subJect of the da�a. Our purpose and intended use oi this Information Is to annually update our records and records af olher govemmenlal agencies re ulrad law. Ii u ret e u I t �nfa tlon e a Ilcation ma not be fssued. AppliCant's Signature: � Date: [/��jJ��_ �- - `� D TE TIME ✓ CITY OF ORONO CALLED IN �� INSPECTION NOTICE SCHEDULED 3� -� PERMIT N0. a�//-DOS� COMPLETED ADDRESS �37�I C�Gu-� �'l� OWNER TE�EPHONE NO. g5� ��5 32 S v CONTRACTOR Slmd» GO7'1.8� � DESCRIPTION �� 2D0 � — /LD �4�c 6-�,�" � 0 FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING � MECHANICAL FINAL ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL Z OWNERICONTRACTOR TO MEEf YOU:_YES_NO c�., COMMENTS: � W a o � C �//� �- �J i�•� � � 0 � W � Q � 2 W � W � � d W ❑WORKSATISFACTORY:PROCEED c�ARAJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C�/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL�NSPECTOR �CITATION ISSUED �INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 Owner/Contractor on sit : Inspector. White CopyllnspectoPs File Canary CopylSite Notice