HomeMy WebLinkAbout1992-004586 - interi struct repair �_ PERMIT
. _
�ITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: ������G IhlC;
��i� ,r-
Crystal Bay, Minnesota 55323 Date Issued: i#;:�i c�r,�i
(612) 473-7357
SITE ADDRESS:
'�'f,�4 ';HA[7YW�1��G RD
:T�;
f'. I . �I. � f 7-117—�_:—��'—i�c.�i�;;
DESCRIPTION:
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REMARKS: �5�'��'��
FEE SUMMARY:
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CONTRACTOR: — AF�F�1 i c�n t. — ��1". L I C:. OWNER:
'�T�.1l�DAHi_ C:i'tN`�T�'�JGT I i t�y 1:;�r;�r;7�:r i�i yt_�;�'�17 HAC:M::IVEY Ci I NA
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� ' � + CITY OF ORONO - BUILDING PF�Z�LZT APPLICATION
Total Fee: $ Date Received:
Date P.pproved:
Entered By: ' �
Permit�:��
ALL INFORMATION MDST B$ SIIBMITTSD IN FIILL BEFORE PLAN REVIEW WILL BB ST�IRTED
(See Check-off List Enclosed)
------------------------------------------------------------------------------
TSE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDRRSS: aI �'� ��J��G. fi�/��'iC�'� /��l' ZIP:
(work)
NAI�II: OF OWNER: L PHONE: (home) y�/-�'1y�.5�
HAILING ADDRESS: S�J ' CIT�= O�fY'�L��3 ZI�'=
CONTRACTOR: PHOIJS: �6�o ��'i
,
�IAIZING ADDRESS: ��",'�� /"e�l y1 7T�/lo �- CITY: � � ZIP:
STATS LICENSE: �T,� #(�('"� �„2�l l�
ARCHITECT/ENGINEEFt: PHONE:
MAILING ADDRESS: CITY: ZIP:
Np��g: R$GISTRATIOF �
TYPE OF WORK: New Addition Accessory Structure Move
. Demo Remodel/Alteration Renovate�_ Land Alteration
PROPOSF.D ORR (describe in detail) :
, f �
� r` S �1/� �vlf Ol.l
STORI$S: �� fz SQ. FE$T OF EACB FLOOR:
NO. OF B�ROOMS: GARAGB STALLS: ATT. DET.
ESTIIKATED CONSTRIICTION VALIIATION (ezclnding land) : $ �,.��4��
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
�hat the work will be in accordance with the approved plan. ,
�
APPI.ICANT'S SIGNATORE: , DATE: g O�S�Z-
�
.. �, • ._.
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CITY of UROl�TU
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADPISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
Iicense 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
gualification f or the permit or Iicense 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 locaI., state or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public. -
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself. �
6. Your full name is required to process this applicatian or
permit.
S�'J�-� �
First Middle Last
�v�'f /"e n /7 �Uc � �
Address
,f� �G�'? �-"/`� � I?�1 !�! �"J�`��-3
City State ZiP
��� --�67�
Phone :
I understand my rights as stated above.
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BUILDING&ZONING-473-7357 • AD!NINISTRATION&FINANCE-473-7358 • PUBLIC WORIFS-473-7359
ASSESSING
_ .,
513.04 RIGHTS OF SIIB.TECTS OF DATA - -
gubdivision 1. T�e cf data- The rights of indivfdusls on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be given ind���' An.indi�►iduel esked to
• ' su 1 rivate or eonfidentiel data concerning himself shall be informed of: (a) the
PP y p state agency,
purpose and intended use of the requested �t whethe hee ma� refu e or is legally
political subdivision, or statewide system; from his
required to supply the requested date; (�� anY
known consequence arising
supplying or refusing to supply private or confidential data; and (d) the identity of
other persons or.entities authorized by s Vadu��e�kedlto supplyein est g�ve� da a
requirement shall not apply when an indi
pursuant to section 13.62, subdivision b, to a law enforcement officer.
The commissioner of revenue me role�� t� re°und u structio uinsteadhos
subdivision in the individusl ineome tax �r
on those orms. . . . --- - -
Subd. 3. Acces� to �a�8 bY in���L �P°n request to e responsible '
authority, an indivi du e l s h a l l b e i n f o r m e d w h e t h e r h��teeor eonfident a1.e Upon h i s
individuals, and whether it is classified as public, p ublic data on
further request, an individuel who is the subject of st to�mri��e if he desires, shall
individuels shall be shown the daLe withou�f an�y t�� �ter an individual hes been
6e informed of the content and meaning � �� need not be �isclosed to
shown the private data end informed of its u��action pursuant to this section is
him for six months thereafter unless e �SP
� � pending or additional data on the indi�f uh h�ate�or p blic de�tarupcn request by
responsible authority shall provide copies P o�ible authority may require the
the individual subject oft�e actual.costsh of malcing, certifying, and compiling the
requesting person to pay
copies. immediately, if pessible, with any request
The responsible authority shall comply of the date ef the request,
made pursuant to this subdivision, or within five �Ys,mmediate compliance is not
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot comply with the request within�t�tn w�eh toh mply w�h the
individuel, and may have gnS��� �1 g��oLdays.
request, exeluding Saturdays,
Subd. 4. Procedure when datn is not accurate or complete. An ��mself. To
contest the accuracy or completeness�oi public or private � the�nresponsible authority
exercise this right, an indi�d� s� notify u'► ��e authoritq shall within 30
describing the nature of the disagreemenL The respo
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 individuel; or (b) notify the individuel that he believes the data to �ement is
Data in dispute shall be disclosed only if the individual's statement of disagi'
• included with the disclosed data- ealed ursuant to the
' The determination of the responsible authority to contes ed cases.
provisions of the administrative procedure act relating
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � � %
PERMIT NO. � COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� OIFOOTING 11 MECHANICALRI 16WELLTESTPUMP
Q 02 RAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
y 03 INSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q OS FINAL 13 METER SETlfURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
W 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 10 PLUMBING FINAL 23 SEPTIC FINAL
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� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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d WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� CORRECT WORK E�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract on ite:
inspector.
Whlie Copyllnspector' File Canary CopylSite Notice