HomeMy WebLinkAbout2012-00603 - roofing � � ' CITY OF ORONO
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2750 KELLEY PARKWAY DATE ISSUED: 06/26/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 601 PARK LA
PIN : 06-117-23-41-0048
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 014 BLOCK 006
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOI�i TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 11,500.00
NOTE: VALUATION OF PERMIT:$11500.00
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 THE SIGNS MUST BE REMOVED.
APPLICANT pERMIT FEE SCHEDULE 221.25
MARK T SEASHORE CONSTRUCTION STATE SURCHARGE(VALUATION) 5.75
1523 LAKE PULASKI ROAD TOTAL 227.00
BUFFALO,MN 55313-
(763)232-2316
Minnesota State License#: CR386373
OWNER
RUDD,SHANE&KRISTINE
601 PARK LA
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 inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time fo du�
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Applic t Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
i:i;i
�, � - '• �E�}/ Q� O�'OiIO
B�ilding Permi� Appfica�ion for Maintenance / Renovation
(windows, cioors, siding, re-roof, etc.)
Mailing Address: Permitnumber. f�
�4?v 0,� PO Box 66 `
/� � Crystal Bay, MN 55323-0066 Date received: � z�'-�
�<�,
, ��
� ��;� s, Street Address: Received by:
�''".� �';� Gti 2750 Kelley Parkway Plan revi e:
�9�Esxo4`� Orono, MN 55356
Total Fee: ��� v(�
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.
Incompfete appfications will be returned. (Please print)
GENERAL INFORMATION:
$"�' Job Site Address: rjQ r�� C l �t��
�;` Will this be a Parade of Homes, Remodefers Showcase Home or other Display Home? ❑ Yes ❑ No
� :
If yes, a special event permif is required with Polrce Department and City Council approva/60 days prior to the event. Shuttle bus service will be
` required unless applicant demonstrates sufficrent on-site parking is available. Non-permitted events wif/not be al/owed.
�..;
'` CONTRACTOR/APPLIC NT INFORMATIOI�:
���. Name: hr� Sc��s �,6� C� nst
State License # C 2 3� 63�3 Expiration Qate: v'3 (�3 � -��3
Lead Certification Number: QQ��,�� Expiration Date:
�'"' (for work on homes fhat were constr cted prior fo 1978
¢�3' Phone:
�6'�- 23"Z- Z3i.6 (office) �63� Z3� "Z'3�6 (cell)
;�`. Maifing Address: 1523 �1��; ��(. y: ��'E`1(a Z�p: S53 t
Cit
VF; Contact Person: M��� (L Applicant is Con racto / Homeowner (Circle One)
' - Ernail and/or Fax:
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` " PROPERTY OWNER INFORMATION:
L Name: S'�,�,m� Q�:��r�
;., Phone(daY): q S�- �t�3� 'Z`lB$
�,
�: Address: (��, i P�r ��
h ,: <<�e - City: Lo�a j�1r.c ZIP: s �.�
�,w;° Email and/or Fax
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PROJcCT INFORMATION:
��' T e of Pro'ect:
YP J Any earth movement may require
� ❑ Door(s) ❑ Remodel MCWD review&permits:
❑ Fire Qamage
,� �Re-roof, as halt � Minnehaha Creek Watershed District(MCWD)
p ❑ Repair ❑ Storm Damage ; 18202 Minnetonka Bivd
�:-
��` ❑ Re-roof, cedar Deephaven, MN 55391
, ❑ Restoration ❑Water Damage
❑ Re-roof, other s eci Phone: 952-471-0590
( p fy) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682
❑Window(s) i www.minnehahacreek.orq
Overall Project Description: �'�"��� ,�-t-f � �,., �-}�,,,; • ,� G�,:�{ t r ,,. �P
Esfimated Construction Vaivation of Project ( xciuding land) $ �� Sc�c d
�'";'
;�" APPLICANT ACKNOW�EDGEMENT:
�;
• Agrees to provide all information required or requested by the Building Department;
� • Certifies that the information suppfied is true and correct to the best of his/her knowledge. The appiicant recognizes that they
� ' are solely responsible for submitting a compfete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
;v • Some or all of the information that you are asked to provide on this application is classified by State law as either private or
+,` confideniial. Private data is information which generally cannot be given to the pubfic but can be given to the subject of the
data. Confidenfial data is information which generaliy 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 f the inrormafion,the a� iication ma not be issued.
ApplicanYs Signature: m� S�� Date: 6 �2�5"� J Z
�ast Updated: 08-Q9-2011
DATE/ TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. o'�61a 'Do6G3 COMPLEfED 6 � -/
ADDRESS �O/ P�'/� L.1 .
OWNER TELEPHONE NO. i
CONTRACTOR �crK `i' SeGS�e/e �'e.��t..
�; DESCRIPTION _ ��- ��'F
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING �
� ❑ POURED WALL � MECHANICAL RI ❑ LAKESHORE/WETLANDS i
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
¢ 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION II
❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS I,
J �INAL ❑ SEWER HOOK-UP ❑ COMPLAINT I
_ ❑ DEMO-SITE O SEPTIC MAINT. �FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: , , ' j
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� O WORK SATISFACTORY:PROCEED j�MqOJECT COMPLEfE
W ❑CORRECT VYORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY
V BEFORECO'VERIN4 PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN �
INSPECTOR WFLL RETURN I
❑STOP ORDEH POSTED.CALL INSPECTOR ❑GTATION ISSUED I
❑INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. �
Call for the next inspection 24 hours in advance. (g52) 249-4600
Owner/Contractor on site:
Inspector. '�- _
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