HomeMy WebLinkAbout1995-007425 - tear-off/re-roof PFRMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - � Permit Number: -
Crystal Bay, Minnesota 55323 _ .. . ,.,._ _
"(612) 473-7357 Date Issued: _
SITE�ADDRESS:
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FEE SUMMARY:
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APPLICANT/PERMITEE SIGNA URE ISSUED BY:SIGNATURE
Total Fee: S �/ � � � � � DateReceived:
' " 1 DateAoproved:
Entered Bv: ��� ; pe:-s.it 1: �%�! <' �.:
CITY OF ORONO - BU"ILDI�G PER�IIT APPLIC�TIO�t
AI,L L��'ORtiI�TIO\r l�n;ST BE SLBI�IITTED �T FLZL BEFORE PL��t REVIEtiV tiVII..L
BE ST:�RTED
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THE �,PPLIC�v�'I' IS: (c:rc.e one) O`V�ER OR�CONT CTOR�.
JOB SITE ADDRESS: JI �O �(�(�-���D �-i�C_�E ZIP:
N�I�IE OF OtiVNER: �l ►"Yl � �.`�.fi� �� PHO�IE: (home)
(work)
I�IAIL�TGADDRESS: CITY: ZIP:
COv'TR�CTOR: ��U S►t�{ �A� �,�����'��S`r'' PHONE: ��Zc� — q-4- Z��
1�iOBII.E PHO�E/PAGER:
1�IAILING�DDRESS: 3�-�—�}-�S't �` S CITY: ✓hlr1,•�r��ot-��ZIP: S� c�,6
STATE LICENSE: n �,'��
�RCHITECT/ENGLv�EER: PHO\�E:
CITY: Z��
l�1AILL\G�DDRESS: REGISTRaTIO�t n
\r�i:�LE:
TYPE OF WOKK: New Addition Ac,cessory Structure
�tove Re:nodeL�:�lte:ation jC T�i Alterarion
PROPOSEDtiVOR�i(describeindetail): '��4� ��- i�%��/f--�v �� �-Stt����--�
STORIES: SQ• �T OF EACH FLOOR:
\TO. OF BEDROOI�IS: G�R�GE ST:�I.LS: �TT. DET.
ESTL`IATED CO�'STRL'CTIO`V�I..U�TION(eYcludin�land): S 5��c
I hereby apply ior a buildina permit and I acknowledQe that the information above is complete
and accurate; that the work will be in conrormance �vith the ordinances and codes of the City
and with the State BuildinQ Code; that I understand this is not a permit and work is not to start
without a permit; and that the work wiil be in accordance �vith the approved plan.
! DA'TE: �Y' �'c 7'9S-
APPLIC�NT'S SIGN�TURE: '� �� .
NOTE! Parade o Homes events require separate permit a�proval by Police Department and
City Council 60 days prior to the event. Non-permirted events will not be allowed.
� 4
Sec.13.04 RIGHTS OF SUBJECTS OF D�T�
Subd. 1. Type of data. The righrs of individual on whom�he data is stored or to be scored shall be as sec forth in this secdon.
Subd.2. Information required to be�ven indi�idual. �n individua!asked to supply privace or confidenaal dara conceming himself shall
be informed of: (a) the purpose and in[ended use o[the �quested data wi[hin the collecring'state agency, polirical subdivisioo, or statewide system;
(b)whe�her he may reiuse or is legally required to supply che requesced dara;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidendal data:and(d)the identiry of o[her persons or enddes authorized by state or federal law ro receive the data. This requirement shall
not apply when an individual is asked to supply invesdgaave data, pursuanc to secaon 13.82, subdivision�, to a law enforeement oificer.
The commissioner of r venue ma� olac� �h� nodc� r�auired under this subdivision in the individual income taz or oropem taz reiund
instructions instead of on those forms.
5ubd. 3. .�ccess to data by individual. lipon request to a responsible auchoriry,an individual shall be informed whecher he is the subjec[
of stored data on individuals, and whecher it is classuied�s puolic, pnva[e or conndendal. L`pon his further reauest, an individual who is the subject
of stored private or public data on individuals shall be shown �he data wi[hout any charge to hun and, ii he desires, shall be informed of the content
and meaning of tha[data. ?.frer an individual has been shown the priva�e data and iniormed of irs meaning, [he data need not be disclosed to hun for
six mon[hs thereahec unless a dispute or ac[ion pursuan�to this secnon is pending or additional data on the individual has been collected or created.
The responsible au[horiry shall provide copizs of[he pm ate or public data upon request by the individual subject ot the data. The responsible authoriry
may require the requesang person to pay che actual cos�s of making, cera[yinz, and compiling rhe copies.
The responsible au[horiry shall compiy immedia[ely, if possibie, wich any request made pursuan[to this subdivision, or wi[hin five days of
the date ot the reques[, excluding Sa�urdays,Sundays and legal holidays,if immediare compliance is not possible. If he cannot comply with[he requesL
within[ha[time,he shall so iniorm the individual,and may have an additional five days wi[hin which ro comply with the request,excluding Sarurdays,
Sundays and legal holidays.
Subd.d. Procedure when data is not accurate or complete. An individual may concest[he accuracy or compleceness of public or private
data conceming himself. To exercise this rieht,an individual shall no�ity in wri�ing the responsible auchoriry describing[he nature of the disagreement.
The responsible auchoriry shall wi[hin 30 days eicher: (a)correct the data found to be inaccurace or incomplete and attempc to norify past recipients oi
inaccurate or incomplece data. includine recipiencs named by [he individual; or(b)nodfy the individual tha[he believes [he data ro be correct. Data
in dispute shall be disclosed only if the individual's staeemenc of disaereement is included wi[h the disdosed data.
The determination of the resQonsible authori[y may be appealed pursuant to the provisions of[he admuustrarive procedure ac[ relating �o
contested cases.
D�T:� PRIVACY aDVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inTorm you that your request
for a permit or license from the Ciry of Orono or any of its departmen[s may require you to furnish certain private or
confiden�ial information.
';ou are r.ocified t:at:
1. The information you Turnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, buc refusal may require that the City deny the permit or license.
3. The inTocmation 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 rioh�s under �1.5. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
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Address
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C�ry Stace Zip Phone
I understand rights as stated above.
�I. � �
Signature
DATE TIME
CITY OF ORONO CALLED IN �'� ��` �� - `� ��J� �'��
INSPECTION NOTICE , � _ ,,- SCHEDULED ��' � `j�� /c'� ' `%���
PERMIT NO. � � �`� COMPLETED
ADDRESS �� ,� _ ��i'� �� � E. ,� ,` �
OWNER �l �,,_ � � CONTR. "�� ( �/<<�'t��t �� ���- f .
TELEPHONE NO. ' "
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� DESCRIPTION i F� /
lli 01 F04TING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
y� iS2 FRAMING � - 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
���. _—�-
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTORTOMEETYOU:�YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
� ❑CORRECT VYORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r, pHOTOTAKEN
INSPECTOR WILL RETURN �
❑STOP ORDER POSTED.CALL INSPECTOR r' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next nspection 24 hours in advance.473-7357
OwnerlContra on 't :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice