HomeMy WebLinkAbout2010-00736 - roofing CITY OF ORONO PERMIT NO.: 2oiaoo�36
.� - 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 08/19/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 930 PARTENWOOD RD
PIN ; 08-117-23-21-0007
LEGAL DESC : PARTENWOOD
: LOT 003 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 8,875.00
NOTE:
REROOF(2)FLAT ROOFS-INSTALL GUTTERS
APPLICANT pERMIT FEE SCHEDULE 177.00
LES JONES ROOFING INC. STATE SURCHARGE(VALUATION) 5.00
941 W 80TH STREET
BLOOMINGTON,MN 55420- TOTAL 182.00
(612)881-2241 PAID WITH CC# 9068
Minnesota State License#: 6560
OWNER
HURR,MALAND&JO ELLE
930 PARTENWOOD RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Buiiding Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
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
revoke at any time for due ause.
��I'.lLt.f�t�! �'i /g� /p �i /�'i /D
Applicant Permitee Signature Date ss y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
From:LES JONES ROOFING 1 952 881 7009 08/18/2010 15: 18 #249 P.002/002
City of Orono
Building Permit A�plication for lnternal Work
(windows, doors, sidin , re-roof, etc.
MailinBAddress� Permlt number• c.��/�'�� ��G�,��.�
�r�,j� PO Box 66 •
0 Q Crystal Bay, MN b5323-0066 Date received: � �/�i`�/� '
St�eefAddress: Received by: ��.�
�� � 2750 Kelley Parkway Plan review fes:
oa�' 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. (P/ease prinf)
GENERAL INFORMA7101�I• � ,
Job Site Address: � f C.�Z,
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes o
If yes,a special evenf permit!s requ/red wfth Pollce Departmenf end C/ty Council approvel 60 deys prlo�in the ev�nf. ShutHe bus sarvice // e
required unless app!lc&nt demonstrates s�eient on-s/te park/ng is available_ Non perml[fed events will not be allowed.
CONTRACTOR/APP ICANT If�OaRhMATION: �� ��-
Name: ,_/ '
State License# �J Expiration Date: 3 �
Phone: -� a, office
cell
Malling Address: `g� C� . �P: . s �
Contact Person: �� Applicant is: ntracto / w H eowner (Clrcla One)
Email and/or� S _ _
PROPERTY OWNER INFORMATION:
� Name:
� Phone(day):
Address: ,�.t,�, �va �-e-
Ci : di'1f� ZIP:
Emai!and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may requlre
❑Door(s) ❑Remodel �CWD review 8�permlts
❑Water Damage
❑Wfndow(s) ❑ Re alr Mfnnehaha Creek Watershed District(MCWD)
P ❑Storm Damage 18202 Minnetonka Blvd
❑Siding ❑Restoration Deephaven,MN 55391
❑Other:(specify) Phone: 952-471-0590
e-roof ❑Flre Damage Fex. 952-471-0682
www.minnehahacreek ora
Overall Pro'ect Description: Q�yF G� Yd0•�5 — ir��.t.Q s
Estimated Construction Valuation of ProJect(excluding land) $ g�ry�- �rj
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 oomplete applicatlon being aware that upon failure to do so, the staff has no altemative
but to reject it until It is complete;
• Some or all of the information that you are asked to provide on this applicatlon is classified by State law as either private or
�nfidential. Private data is information which generally pnnot be given to the public but can be glven to the subject of the
data. Confidential data is information which generalfy qnnot 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 ulred b law. lf ou refuse to su I the' ation the a licativn ma not be issued.
Applicant's Signature: ����c�� Date: g— /D — /d
Last Updeted: 05-04-2009
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