HomeMy WebLinkAbout1997-009180 - tearoff/reroof s PERMIT
•, CITY OF ORONO PERMIT TYPE: - -
2750 Kelley Parkway- P.O. Box 66 �'�--=�=�`y�=
Crystal Bay, Minnesota 55323 Permit Number. �:;��;;=;i_s
(612) 473-7357 Date Issued: ;_,-� r: -_ :_-::-�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE 'f��
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Total Fee: $ Date Received:
Entered By: Permit#: �
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ���Ci _���i�c��F:� L����''�-� ��, ZIP:
NAME OF OWNER: ,��� -�1��` �_�c�5�% PHONE: (home)
(work)
MAILING ADDRESS: ����� �S�-�t- �� �'. CITY: �����> ZIP:
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CONTRACTOR �-�' � � l %�r�.� PHONE: ;�.� `s
CONTACT PERSON: ;:,� MOBILE/PAGER: ��� - /� �?�
MAILING ADDRESS: l(��I �; i�� S%: ��' CITY: c� �f`ii•v' ZIP: '�-`�,3�/3
STATE LICENSE: # �'��;�;
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detai�: `!/c�.��;- �.��� �'�;� ��f`1 Cr.��—: _
STORIES: �a�i SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ ��,C� �i� _
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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 work is not to start without a
permit; and that the work will be in ac ordance with the approved plan.
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APPLICANT'S SIGNATURE: i =� � DAT'E: J� / � - ��
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[7BJECTS OF DATA
Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information req�rired to be�ven individual. An individual asked to suppty private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting 3tate agency,political subdivision,or stacewide system;
(b)whether he tnay refuse oY is legally mquired to suppiy the requesud data;(c)any known consequence arising from his supplying or refusing to supply
private or confidenaal data;and(d)the idendry of other persons or enaries aurhorized by state or federal law to roceive the data. This requirement shall
not apply when an individual is asked to supply invesagarive data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav alace the nodce required under this subdivision in the individual income tax or prooertv taz refund
insttucaons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible aurhority,an individual shall be infocmed whether he is the subject
of stored data on individuals,and whether it is class�ed as public,private or con6dendal. 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,shall be informed of the content
and meaning of that dara. After an individual has been shown the private dara and informed of iu meaning,the data need not be disclosed to him for
six months thereafur unless a dispute or acaon pursuant to this secaon is pending or addiaonal data on the individuai has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individuat subject of the dara. The responsible authority
may require the requesting person to pay the actual costs of making,ce�tifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediau compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidonal five days within which W comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or private
dara conceming himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccunu or incomplete and aaempt to nodfy past recipients of
inaccurate or incomplete data,including recipients named by[he individual;or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disctosed data.
The deternunadon of the responsible authoriry may be appealed pursuant to the provisions of the administraave procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, 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:
1. 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 Ciry deny the permit or license.
3, The information may be shazed 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 M.S. 13.04 (available upon request) to review private data on yourself.
6, Your full name is required to process this application or permit
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I under my rights as stated ve.
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Sig mre
DATE TIME
ClTY OF ORONO CALLED IN
INSPECTION NOTICEl SCHEDULED " 97 / ' d
PERMIT N0. ��B V COMPLETED _� I'�,
ADDRESS
OWNER CONTR.
TELEPHONE NO. �l 3 3- 3�3�
� DESCRIPTION . �'o ���
� 01 � 11 MECHANICALRI 18EXCAV/GRADINQJFIWN�
�Q 02 FRANR 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 77 SITE INSPECTION
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= 05 FINAL 14 SEWER Fi00K-UP 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER flEMOVAL
� 10 PLUMBINQ FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d C WORKSATISFACTORY:PROCEED - PROJECTCOMPLETE
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� ❑ RRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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O �i�RK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
O STOPORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 4 hours in advance.473-7357
OwnerlContractor on site:
Inspector. .�
White CopyMspector's File Canary CopylSite Notice