HomeMy WebLinkAbout1999-011275 - reside/fasc/soffi etc PERMIT
CIT�Y OF ORONO PERMIT TYPE:
.2750 Kelley Parkway- P.O. Box 66 �:it f=;..�;3 i;s_
Crystal Bay, Minnesota 55323 Permit Number:
Datelssued: `_��� F�����-
(612) 473-7357 � _ . ., _. . ._ -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMIT E SIGNATUR� ISSUED BY:SIGNATURE
Total Fee: $ Date Received:
�Entered By: Perm.it#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------------------------____ _____---------------- ------- - ----------------------------
THE APPLICA2�'T IS: (circle one) OWNER OR CONTRACTO
JOB SIT'E ADDRESS: � 6 -� � {'l�� �t � U�'C 6 �l ��_ZIP: j�� 3 (
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NA1�iE OF OWIV'ER: ���L��tC�r'� i� �D i,���'1 PHONE: (home) �� f-�1��i ��
(work)C ��z. �(��c�-- �c��'�
�IAILI�i�G A,DDRESS: �� �S ��t��C�t,,i�ec,��. k�'� CI1'Y:(��'� i��c.�,c ZIP: ��� s"- � _> >
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CONTRACTOR: � 4i �- (,�!�s� (��'u-�,-��F t�: S� �1�����: IhL PHONE: �:�(; - I � �,_
CONTACT PERSON: MOBl E/PAGER: S���-
MAIL�'GADDRESS: I �--� i � y� �� ./� �•i CIT'Y: 6' 1���-,���tl� ZIP: �s y`��-- �-��v
STATE LICENSE: # r���
ARCHITECT/ENGItii TEER: PHO�'E:
MA.II,LVG ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration i� Land Alteration
PROPOSED WORK(describe in detai�:�2 w���L f` Y�I^���`�=- �='`����°, �`1 s ` '`` , �°-j�-' � r
��ir �ft,�s � ��ci�s���:���,�`�S
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�i IATED CONSTRUCTION VALUATION (excluding land): $ L L ��`( �
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 Buildin� Code; that I understand this is not a pernut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
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APPLICANT'S SIGNATURE: ; ���t-{ �i.�-r��_ DATE: � ��
NOTE! Parade of Homes events require separate permit approval by Poliee Department and
City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
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Sec.13.Q4 RIGHTS OF S'LJB.JECTS OF DaTa '
Subd. 1. Type of data. The righcs of individual on whom the data is sroced or to be scored shall be as se[fonh ia this secrion.
Subd.2. Information reqirircd to be given indiridual. An individual asked to supply privare or confidenaal dara concerning himself sha11
be infocmed of: (a)the purpose and inrended use of the requesud data wichin the collecang Statt agenry,polirical subdivision,or sca;ewide rysum;
(b)whe�:er he rray refuse or is.legally requir.d�o supply che rquesud data;(c)aay Irnown coascquence arising from his supplying or refusing tn supply
priva�e o�conndenoal data;and(d)the idendry af other persoas or enodcs authocized by s[ate or fedecal taw W receive the data. 'Ihis requiremenc shall
not apply when an individual is asked to supply invesdgadve dan,pursuant to secdon 13.82,subdivision 5, co a faw enfoccement officer.
The ee,^.imissioner of revenue mav viace the nodc- r�uired und:r chis subdivision in the individua! income rax or prooectv taz tefund
inscrucdons inscead of on[hose forms.
Subd.3. Access to data by individual. Upon requcs�to a cesponsible auchoriry,an individual shall be informed whether he is rhe subjecc
of stored daca on individuals,and whechu it is class�.-d as public,privace or confidenaal. Upon his funher requesc,an individual who is the subjecc
of stored private or public dam on individuals shall be shown the dara wichout any charge to hicn and,'if he desires,shall be infocmed of the content
and meaning of[hat data. After an individual has been shown[he priva�e dan and informed of it�meaaing.�he dara need aot be disclosed to him for
siz monchs thereafter uriless a d'upute or acdon pursuanc to [his secdon is pending or addidonal dara on the individual has been collected or crcared.
'Ihe responsible auchoriry shall providt copies of the priva[e or public data upon request by the individual subject of[he daca. The tesponsible authoriry
may require the requesdng person to pay the accual coscs oi making,cerdfying,and compiling the copies.
The responsible au[horiry shall comply immediately, if possible, with any tequest made punuant to this subdivision,or within five days of
the date of che request,excluding Saeucdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot comply with the request
wichin that dme,ht shall so inform the individual,and may have an addidooal five days within wluch to comply with the request,exc(uding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest tht accu2cy or completeness of public or privace
dara concerning himself. To exercise chis right,an individual shall roafy in wriang[he responsible au�horiry describing the nature of the d'uagreemenc.
The responsible authoriry shall within 30 days eid:er: (a)correct rha data found to be inaccurace or incompiete and attempt to nodfy past recipienes of
inaccurate or incompleta data, including recipiena named by the individual:or(b)nodfy the individual thac he believes[he data to be correcG Data
in dispuce shall be disclosed only if the individual's stacer,.en�of disagreement is included wi[h the disclosed data.
The decerminaaon of the rosponsible au�horiry may be appealed pursuant to the provisions of tha adminisaarive procedure act nlating to
concesud cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hcs 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 permi[or license requested.
2. You may refuse to supply daca, but refusal may require that the City deny the permit or license.
3. The information may be shared wich o�her local, state or federal a�encies to the ettent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some informa[ion 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 applicatio❑ or permit.
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I undGrstand,my ri;hts �s stated above.
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D TE TIME
CITY OF ORONO CALLED IN 3 `�r 5
INSPECTION NOTICE SCHEDULED �
PERMIT NO. �/07 7'Y COMPLEfED
ADDRESS O�G��J� � �.�-��A
OWNER CONTR. �L Q�L t
TELEPHONE N0. �_�O ' ���S
� DESCRIPTION �'n .�_—O-�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q F 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOPORDERPOSTED.CALLINSPECTOR �CITATIONISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedCoRtr ite:
Inspect
White Copyllnspector's File Canary CopylSite Notice
,
DATE E
CITY OF ORONO CALLED IN `�- , -� C � Y-�2�
INSPECTION N ICE SCHEDULED -� �—
PERMIT NO. COMPLETED �_
ADDRESS ��S ��
OWNER �� /'v'U�U�'�� CONTR.
TELEPHONE N0. 5� � '' l � �J�
� DESCRIPTION _�-Q� d� '�'LLI.0 ,i.�-'tQ��
l� 01 FOOTING 1 CHA AL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 LJ�Q� 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINAL ' 14 SEWER HOOK-UP 06 PROGRESS
� DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance.473-7357
OwnerlContr or n i :
Inspector. 1
White Copy/lnspector's Fil Canary CopylSite Notice