HomeMy WebLinkAbout1999-011771 - replace door ;y PERMIT
�ITY'OF ORONO PERMIT TYPE: �;, ,�
2750 Kelley Parkway- P.O. Box 66 ����' �=f�;=i��
Permit Number. �;�;i �;'; s
Crystal Bay, Minnesota 55323 Datelssued: ia;=;;'=;�;,'�:°-:
(612) 473-7357 . _. .. _ . _ ...
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CQNTR ACTQR: �- . . . _. .. _.-�.�-�:�. - =T� . �i;:: .OWNER:
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE �,
��kTY OF ORONO � 6124730510 09/24/96 14:00 �I :02/03 N0:522
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Toral Fe�: S,_,_, 3 � Date Received:
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�ITY OF OROlr10 - BUILDING PERMIT APPLICATION
At�fnfoe�nadon must be submitted in full before plan review wfll be started.
•, (p�tease prfnt all�r4formarion)
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TH� KPPI:ICAN'I' IS: (clrcle one) OR�I�TER 0 ONTRACTOR
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JO$ SITE ADD�SS: I��� �o,� ��•md �d . znP: s��`�1 "
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•. NAME OF OWNER: , '�.R�1 PHONEi \r"�"�,�jj f�• / �/� �[JLV"f
(W01'�C) — r
MAILING ADBRESS: ,�(e�-�,� f�.'�QO�CITY: ZIP:_S�z.�J
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COl'�ITRACT4R: RENEWAL BY ANDERSEN '
. COIVTACTPERSON: 350-73RD AVE. NE y
. , ��G����------ fRIDLEY, MN 55432 Z��
(612) 502-4777
�b"rA1'� LICENSE: A! LICENSE #20130983
. ARCHTI'ECT/F1�TGIIY�ER: MiONE:
M�LING ADDRFSS: C�7'Y: ZIP: . .
NAME: REGYSTRATt4N�
TYP'� OF WORK: New Addition Aoc�sory Stcu�caue
Mov� Remodel/Alteration,� Land Altsration
PRO � WORK(descHbe in detai�: 1 c�,�r� � ^^,
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ST��: SQ.P'B�T OF EACH FI.00�:
1�T0. OF BED$OOMS: GARAGE STALIS: ATT. DET.
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FSTIlViATED CONSTRUCTION VALUATION(excludfng lan�: $ �}, 3��
I hdreby apply for a building petmit and I acknuwkdge that the informetion above is comptete and
acc�uate; that d�e work wlll be in confor�nance with the ordinencxs and �od� of the City and with
, ' the State Building Code; that I u�deretand thjs Is not a permit and work is not ta starc wlthout a
petmit; and that the work will be in accocdan�e with the spproved plan. �
APPI.ICANT'S SIGNAI`IJRL: DATSs � g•��
11�OTE! p��.q�H�ev��ts r�egvfne ae�rota parmtt opproval by Police Deparb�tent asd
[.Y�y Coanci160 d4ya prlor b the avent. Non perm�tted�ve►Ws w�U not be allowed.
RPCPIVP�I Timn Cnn 9A 1 �A9Aluf Ari�� Timn C�� 7A 1 . 17A1(
TY OF ORONO � 6124730510 09/24/96 14:00 � :03/03 N0:522
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S�c.13.04 RIGIiTS OF SIlHJBCTS OF D�TA
Subd. l. 'Type ef�. 'fAe�1�hts of InAlvidud oo vrhom th�daa b seorod or�o be soo�ed ihall be u uc for�h In d�u�don.
Subd.1. IaroaaNl��tiqsdnd ta ba�iodhtdmd. M ladlvidud asked ro�uppiy privta or�nffdenti�l daa wnasrnln8 hinwlf,d�s11
bs inMmbd of: (�)du purpote and intended uu ot d�e nquauod d�ta.ridJn du eolkod�ln�a aaeaoy.poUdeat iubdiridon,oe�rowMe sywun:
(b)�rl�ad�er M nny rell�a ot i�IagWy teqvired m supply d�raquemd dw;(cy�ny knoam eon�equeme uising fmm hts eupplyl�or rellult�y ro supply
ptivau or waMeadol dw;and(d)�he idenriry of od►e�persont or endaes�ud�o�by su�e or tedeni lew m recetve�he ds�a. '!bd e�equlrcmeac shdl
noe a�ly whee an indiridud ii�sked ao mpply In•e�ri��dve daa.punu�n�an aeden]3.82,Nbdivision S.ro s I�w enforcemarc ol�r.
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'llu� cnmmis��gner f revemu �v elus�e noc�ce reauind under t1i�s�yQ�tvist�_,gi_n,ihe ind�ldusl �ncotne ax or orooeicv rs:,�rolS�rid
.__._ loucucdont in�,,,,(cn �o torm�. "
SuOd.3. Aeee�t ts d�ts bp iodhidwl. Upoe rcqueu ro�rewan�ipk�udariry.�n iodi�fduat�hsil M infonned wlather he b ths stbJeee
d�wrM dau on individwla.aad wNfiar u u cl�ssifiCd u public,ppvua or conAde�id. Upon hn llud►er aquat,mf Uadividual avho 1�the subjact
ef aond priv�oe pubUo dw on iodividuds shaU be�hown rhe�Sn wid�ou�nry ehar�e w him u�d;iF he de�iea.�hdl be intortned oP�e conrenc
�nd�j ot d��e d�a Aher on iadi�idu�l har bean shown U�e prl���a dw uid in[orn�ed of In meania`.d►e tha aeaQ ooc b�diubsed co him for
ii�e aandu dterost�r uNa�a di:puoe or�cdon punuuu ao�hts seedon is pendla�or addi�oml d.ra on the individud h�i been oollec[ed oc ereawd.
The npomibl���dipri�y�U provide eopies of rhe privare or publlc daa upon rcquese br�he individwt abJeoc of dro dara. 71�e rapans�ble�utAoriry
auy e�eMhe dN reqw�/P���MY d+e aead cos�s ot m.lcina.eerqyin�.ud eompiliu;da wpi��.
The oesponeibN wdwdry.�hall comply immsdivtely,if po»ibk.Mith ser request made purwwvnt oo d�la�ubdivi�ion,or Midde A�s days o(
d�dua of du roquee�.exeludi�9awtdays.SundAys�nd le�d holld�yt,if biunediue�ompl�nus u not po�s'ble. 1�he cema��mply�vi�h d�e nqws�
�vid�in duc da�s,ho�ll�o inform die lndividu�l,�ad nuy ha�e;n�ddirion�l flve d�ys w1�in which m eompl�wffi rhe requeac�exchidlt�Soourdsys.
�ri�nd I�;d holidty�.
3�bd.�. proeedue.MMn daia ts net aeeunte er eompkte. An indiv�dud nuy conoen d�e ucuaay or coihplerones�of publk or pdvue
d�a eoaoernln�bimself. To ucerci�a dus Mght.�n indii�idud shall aoaly in Mrit(n��he ra�onaibk sudwdc,y de�cribl�db nemro o(d�e dla`nemenc. .
Tht tapnarlble�uthoriq►dnit widiin 30 d�ys either. (a)cotncc d�e dam found to 6e inaocytrate or h+eompleee�nd�toempe eo notif�r pue ce�lpkn�a eE
imoeue�a or iRcartyflete dpa.fncludin�ceoipientt n�med by d�e Indivldual;or(b)aodly d�e n+dividual tMt he belleva fie d�m�o M aoRae� Daa
ip ol�we iAsll be diaclaed ody if d++a indlvidusl's tu�emea�of dla`teemenc is i�with�he dieclosed d�s.
91►e dets�mi�don o1 the roaponsible authoriry m�r be appeated penwnt eo 1h�p�o�fab�u ol dte adminiswdve procedure tct rel�tin�w
wnte�oed etsea. .
' pATA PRN�CY�I,R,�$QitY
Ia�ecordsnce with M.S. 13.04,Subd.2, "Itighcs of subJecia of da[a', we would like w iaform you that your nquest
for a permk or ltcense from the City of Orono or a�y of i�s depaetments may require yvu to !'urntsh artatn private or
confidential inPormation.
You are na[18ed that:
1. The inforn�edon you Purnish will be used to determine your qualificacion for the permit or iicenae requesced.
2. You mey► rafuse to cuppiy daca. bur nit�sal may require thac the City deny tha petmit or licen�e.
3. The informAtien rnay be ihaced wich o[h�c loe�l. state or ftdCral agenciaa to the excent neeessary to process
the permic or liawe.
• 4. . 1f your requeeted permit or license requirec Couneil aetioa co appmve. wme infanast[on ma�y beeocr�e
' publk.
S. You have eercain righcs under M.S. 13.04 (available upon request) to review prfvate data on youca�lf.
6, Your full name is nquired to process tbis ipplfcatioA or permic.
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' I•uadentand my d above.
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CITY OF ORONO CALLED IN �b DA�T�E� �� /�IME
INSPECTION N /TI E SCHEDULED �b� - .� d�
PERMIT NO. ( COMPLETED � .r`�<'�
ADDRESS O
OWNER ��.�'�''f CONTR. �-�-e�
TELEPHONE NO. /�— � � �' ����
� DESCRIPTION � ���'`� a
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA-_L__ 14 SEWER HOOK-UP 06 PROGRESS
Z�� __..._—.
� 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 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W��NORK SATISFACTORY:PROCEED /�ROJECT COMPLETE
�
W O CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �- pHOTOTAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
�
Inspector. �,�t2�
White Copyllnspector's File Canary CopylSite Notice