HomeMy WebLinkAbout1999-011522 - tearoff/reroof PERMIT
CI T_Y OF ORONO PERMIT TYPE:
�2750 Kelley Parkway- P.O. Box 66 -��..;;€_w�7��.:�
Cr stal Ba , Minnesota 55323 Permit Number: _
Y Y s�;± i�s��.�
(612) 473-7357 Date Issued: , _ _
:_'t F�.'_u..'`_. _.
SITE ADDRESS:
_._�:_3=�::_� _:,�,�+�t`���_;�,���r �;��
y-;-!
� . . . . , j '?-7 j ; s...r--„, _—tii_)i 'r�
DESCRIPTION:
;�:�;;;E_���i���=�°:�;i_��
-��.��. i 3�s.i?� �`����rs i t. i y��� °��i=—;��<i�:`�=i#�t•f;M�i;�i��
�.( E.i:• r,,—:-
�'��_.�: 1;_.F�.i I V ;�_i i'�:, � a��F= 5..�_�.'�'L._F���{"
�:r�t�•_l.�I:� (_:swts��a tt�-=�1 F�l!_� . ii`.!�����#!�I����;�_
REMARKS:
FEE SUMMARY:
. :�;f i_i::;j;i_,;�: ��;; 1i:(i
�::�=,_ ��-�:= :�� �•� _c
-_��,_:�-�.a t���c;: -� ��
______ { �,�,��:�:
I {wFT.;i. I :—Y'aia �w 1 �iS , i�t�i
CONTRACTOR: �— ;�;���� i 9�.^�-�t. — _ . . �.._=�:: . OWNER:
�_{'s.'. . :�, #�:€�t11(.��`''( }�`tTt'S_:��(v� 7 -�ii:�s�.;,_��;'�� s;'i:. `���,�:... r..,r��-:_.._.dFfi,� _i:�.:�-;;�
=':�l`?� f i T s`yi`�!`:�:'•t i�i� i;} ix — �_ _.,4. . :_�t'�i-i�t'�`4`;E�!i—+�� ;;°I�
�'{:1L�1_� i����_�iv�L Sf�i�> L i 'i�"�s` ��it'iF��� � � � —'{
L �! �. . .. . __ .. _ ... ..
;. .r.E s._.° _ -_`�:�_ .. l.j..ie 1`��"�':i i.�.r i
�€;� �,F;�:;��'°��s������ ����,��.'+` �°Et����'���"��` ��F�`���'.. _ d#tt.� �,_� �.,,�:�:. ._. `_ . . ._��?:._ ;,�� f.,_.=��: ._:t��'°��
.. :�e�ir S_T��f�{,,,,r� �S��f✓� �r.1�.�5...�� fN4..�f.,�-.{.f���.�� i�"�i}.�_i...y����r¢#_�.{�'•: . �}`d •:z i i"�.���:� 4.:�_�� f�`j._':t"'.i�:i..�.... ?�!.�. �y�a i"�'....�__ S:��� f"��
� «i..h``�_tt ..�. . �.. .. ._ ...._ .... �<�S�3 !� �SS l�.�i�url,f__'�#„i� '�i A`.}F'3��.��.4t_.. _ _ _, ?�t�;�.:�{��'.`.�."'? _i �
i
i
ICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ���l
' i
Total Fee: $ Date Received:
Entered By: �`�(� Permit#: �Yl>� 1--�'
. f
CITY OF ORONO - BUII.DING PERMIT APPLICATION �
�
All information must be submitted in full before plan review w•ill be started.
(please print all informntion)
------------ _--_--- _ --- -- —__- ___ ---- ------------=--=.
�-�—:--------
THE A.PPLICAl\'T IS: (circle one) Oti�NER Oh-CONTRACTOR
} _
JOB SIT'E ADDRESS: � � fl J � ti'� -� ZIP: �.S-� " �
� � /�
NAME OF Oti�TER: '' --��C�{�1 C_��S'�:� -, / PHONE: (home) � 7 /— �� y,�
(work)
��a.�TG�D�ss: �8c� c�.crrY: z�:
CONTRACTOR: �;� PHONE: ���-- �,��3 � _
CONTACT PERS N: " Ni0 ILE/PAGER: —SS �
MA.ILl�'G ADDRESS:�(��`� l"�I�/.�L,��� CITY:f " � � ��� � .vr• ZIP: ��t s'� J
STATE LICENSE: # � � c, ��,� Q� �
ARCHITECT/EI\'GItii TEER: PHONE:
MAILItii TG ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF VVORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED tiYORK(describe in detai �� �� � �c� �
n: 1�,
STORIES: � SQ.F'EET OF EACH F'LOOR:
NO. OF BEDROOiI�IS: GARAGE STALLS: ATT. DET.
ESTIi�IATED CONSTRUCTION VALUATION (excludi.ng land): $ ��� ('�
I hereby apply for a building pernut 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 Build�ng Code; that I understand this is not a permit and work is not to start without a
permit; and thac the work will be izx acco d Ge wi the appr ed plan.
i
PLICAi�'T'S SIGNATURE: ' � / , DATE: �—�y_9 9
AP ,
NOTE! Parade of Homes events re � ire separate permit approval by Police Department and
City Council 60 days prior to tke event. Non permitted events will not be allowed. �
Sec.13.04 RIGFiTS OF SUgJECTS OF DATA '
Subd. 1. Type of data. 'ihe righc�of individual on wham[he daa is sroced or to be stnced shalI be as sec forch ia chis secrion.
Subd.2. Intormation reqcrired to be givea indiridual. ?�n individual asked to supply private ar coafideadal data conceraing himself sha21
be infora:ed o,`: (a)the purpose and inrended use of the requused dara within the eoIIecdng 3tate agenty,polidcal subdivision,or sratewide rysum;
(b)whethec he may refuse or is.legalty requir.d to supply the rquesud data;(c)any known caasequ:nce arising from his supplying or refusing to suppiy
privste or conndeada.I dara;and(d)the ideadry af ocher peaoas or enddes auchocizcd by stace or feder311aw to receive the data. 'Ihis requirement shall
noc agply when an ir:dividual is asked ro supply invesdgadve daca,pursuant ro secdon 13.82,subdivision 5,co a law enforcement offrcer.
"he_ee:-�missioner of revenue mav oface che nodce r.�uir:d under this subdivision in the individual income taz or oropertv taz refund
inscrucaons inscead of on those forms.
Subd.3. Access to data by indiriduaI. Upon rcques�to a responsible authority,an individual shall be inforraed whtther he is the subject
of stor.d dat►on individuals,and whecher ic is class��d as public,private or conF.dendal. Upon his furcher request,an iedividual who is che subjecc
of stor.d priva�e or public dara on individuals shall be shown che dara wichoue any charge to him and;if he desires,shall be infocmed of ehe eoneanc
and meaning of that dara. After an individual has been shown the privace dac;and informtd of ic�meaning,the data need not be disclased to him for
six monrhs thereaher unless a dispute oc acrion pucsuant to this secdon is pending or addidooal dam on the individual has been collecced or creaced.
'Ihe cesporuib[e auchoriry shall p�ovida copies of the privam or public data upon request by the individual subject of[he dara. Tha responsible auchoriry
may require che requesring person to pay the accual coses oi making,eerdfying,and compiling the eopies.
The responsible auchoriry shall comply immediacely, if possi6le,wich any requesc made punuant to this subdivision,or wi�hin flve days of
the date of the cequese,excluding Satutdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the requesc
wi[hin chat dme,he shall so inform[he individual,and may have an addidonal five days wi[hin which to comply wich the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or eomplete. An individual may cont�st the accurncy or eompleteness of public or private
data conceming himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreemeac.
The responsible au�horiry shall within 30 days either: (a)corroct[ha dara found to be inaccurac�or incomplece and aaempc to nodfy past recipiencs of
inaccurate or incompla�e data, including cecipiencs named by cht individual; or(b)noafy the individual thac he believes the dara to be correct Data
in dispuce shall be disclosed only if the individual's statemenc of disagrcement is included wirh the disclosed data.
The decerminadon of the rtsponsibla auchoriry may be appealed pursuanc to the provisions of che adminiscrarive procedure act relating to
contested cases. -
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Righ�s 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
confidencial information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permi[or license requested.
2. You may refuse to suppiy data, but refusal may require that the Ciry deny the permit or license.
3. The information may be shared with ocher local, state or federal a�encies 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 ri�hts under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process chis application or permit.
J��� � �- ��
Firsc ? �tiddle Lasc
.�� � �'1//.���-.�,nJ
�.d �� ��� r���; ,SS�L- � �1� ��9'���E
�Ciry Sace Zip Phone
�
I understand my ri;ht§�as stat d ove.
�_ � � � _ �
s����«
DATE/ TIME
CITY OF ORONO CALLED W ����(�S
INSPECTION NOTICE SCHEDULED � / �/� '��
PERMIT NO. //�-Z x"" COMPLETED l�
ADDRESS � C 3',
OWNER CONTR. ��r �
TELEPHONE NO. —�'�5 - �-� �✓ �
� DESCRIPTION �:�.���.��
L� 01 FO 11 MECHA AL RI 18 EXCAV/GRADING/FILLING
�
02 FRAMING,� 13 MECHANICAL FINAL 19 L4KESHORE/WETLANDS
�
O LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
�
W
a
�
J
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
j ,
d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O �1 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR c CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac s' e:
Inspector v'-----------
White Copyllnspector's File Canary Copy/Site Notice