HomeMy WebLinkAbout2006-P10285 - re-roof PERMIT
CITY�OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p10285
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
9/5/2006
SITE ADDRESS: 2690 Rainey Rd unit#
Wayzata,MN 55391
P��� 04-117-23-43-0016
DESCRIPTION:
Proposed Use: Residential Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 421.55 Valuation: $ 27,670.00
State Surcharge Fee: $ 13.85
TOTAL FEE: $ 435.40
APPLICANT: Allstar Construction OWNER: Julie&Chad Lindbloom
8401 73rd Ave N-Suite 80 2690 Rainey Rd
Minneapolis,MN 55428 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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� APPLICAN ER E SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
� Total Fee: $ �i�a �'��r Date Received�• ��i��j
Entered B : ;� Permit#: /—�" -� � `
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�zt all ii�formatio�i)
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THE APPLICANT IS: (circle one) OWNER OR NTRACTOI�'
JOB SITE ADDRESS: ,2('9 Q (�,,;�,,� �� Oro,�� zIP: �53��
Will this be a arade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes No If�,es, a special event per�n�:it is reguir��ed tivith Police Department and Ciry Coirncil appr�ova!
60 days prror to the event. Shz�ttle bats service ivill be reqi�ir•ed unless npplicant de���onstrales
saE�cient on-srte parking is availnble. Non per•mitted events will not be allowecl.
NAME OF OWNER: ���i�P �r✓tcJ�I o� ;n�1 PHONE: (home)� y7�.� y��9
(work)
MAILING ADllRESS: ����� �a��/ �Q�� CITY: Q�a�,� ZIP:
CONTRACTOR: f���� ('�er�.�r�;�,� PHONE: `1� - "'• �"
CONTACT PERSON: (���� C1;�t MOBILE/PAGER: �" � `'
MAILING ADDRESS: �� 7,��;,«;�-v�� ;;�" CITY: Nr. �I�,i�� ZIP:
STATE LICENSE: # '��� EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) ��
Any earth movement may re ui e MCWD review and permits !
PROPOSED WORK(describe i�i detain: ��� ����i�z�o�,-�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACH�D DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): � ��� ���
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a permit and�vork is not to start without a permit;and that the work���i ll be
in accordance with the approved plan. �
APPLICANT'S SIGNATURE: �� U� DATE: G �. �
3t
Sec.13.04 RIGATS OF SUBJECTS OF DATA '
Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. [nformation required to be given individual.An individual asked to supply private or confidential data concerning himselfshall be
informed o£ (a)the purpose and intended use ofdie requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data.This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
7'he commissioner of revenue may place the notice required under this subdivision in the individual income tax or�ro�r y tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible suthoriry,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shal I be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months thereatter unless a dispute or action pursuant ro this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the date ofthe request,excluding 5aturdays,Sundays and legal holidays,ifimmediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate orcomplete. An individual may contest the accuracy or completeness of public or private data
conceming himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The
responsible suthority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bel ieves the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The detertnination of the responsible authority may be appealed pursuant to the provisions oFthe administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. I3.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
t. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve,some information may become
public.
5. You have certain rights under Nt.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Lxst
Address
Cily State Zip Phone
I understa rights as state ove.
Signaturc
Reset Form 32 �
ATE TIME V
CITY OF ORONO I CALLED IN �
INSPECTION N I��g.s. SCHEDULED �-O� o?%Oa
PERMIT Nb. COMPLETED
ADDRESS � D Ct,l�1'i �
OWNER CONTR. ��Sz�Gl2�
TELEPHONE N0. ��3 �79 " � 7� v
� DESCRIPTION ��� � !��
� ❑ FOOTWG ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAI ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBI ❑ FOUNDATION/REMOVAL
� OWNE CONTRACTOR TD MEET YOU: YES NO
��., COMMENTS:
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W� ❑WORK SATISFACTORY3 PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CAL�FOR REINSPECTION TEMPORARY
V BEFOREC�/ERING . PERMANENT
❑CORRECT UNSAFE�DITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WlLL ETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.,GCALL INSPECTOR
❑ INSPECTIONRE4UIRE�.CALLTOARRANGEACCESS.
Ca11 for the hext inspectipn 24 hours in advance. (g52) 249-4600
OwnerlContractor a�n site:
Inspector. . ��,_J ��Q
WhHe Copyrinspecto�'s File Canary CopylSite Nodce