HomeMy WebLinkAbout1990-002824 - tearoff/reroof � �ERMIT
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�� � �' ���� �5 ��w�� PERMIT TYPE: E�t�I�UI}�I�
1335 Brown Rd. South • P.O. Box 66 Permit Number: ��i.��'�:'��
Cryst-' �^ � "�,�innesota 55323 Date Issued: ii�i�:��f'�{�
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FEE SUMMARY:
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CONTRACTOR: _ -- ��`�i i��»�� '— I OWNER:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
"` *`' ' CITY OF ORONO - BIIILDING P$RMIT APPLICATION
Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit#:
ALL INFORMATION MIIST BE SDBMITTED IN FQLL BEFORE PLAN REVISW WII,L BB STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
T� APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITl; ADDRSSS: �G�U �ly-bt GtlU 0� ''�i / Z IP:
(work)
NAI� OF OWNSR: �CI�4..�(/ �l•t��t� PHONS: (home) �/L ?��
MAII�ING ADDRESS: CITY: �c�C�S��r•� ZIP:
CONTRACTOR: r/''1'►+� �u !Z-�q LS S PHONE: g� �9�
MAILING ADDRESS:__j'1►('Z� y�o ���C, CITY: ��i�"�"'��v`'`�'''/ ZIP: J�.��
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : 'u�"�"j�'�� �`'��.d�� ��
� � e �t��- �,z.-u c,--o.���� 2Y�%kt�'-...�CcJC /v��r/� � � fA�f
ti�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF B$DROOMS: GARAGE STALI�S: ATT. DET.
B,.STIMATED CONSTROCTION VALIIATION (esclnding land) : $ �2� �
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 wil 1 be in acc nce with the approved plan.
APPLICANT'S SIGNATQRS: DATE: 23 q
til.I w. � a
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CITY of ORONO
Post Office Box 66•Cryatal Bay,Minne�ota 55323•Municipal Officee
•
� - � � On the North Shore of Lake Minnetonka
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 supp3y data, but refusal may require that
the City deny the permit or I.icense.
3. The information may be shared with other Iocal, state or
federal agencies to the extent necessary to process the permit or
license.
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 private
data on yourself. �
6. Your fu11. name is required to process this application or
permit.
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First Midd e L st
�"7 �-�!
�2�2.� �G --.`' �`
Address
(.�/�1'�� /���- �� � O
City State Zip
� - �.�.�- 2� 2�
Phone
I underst d my rights as stated above.
Signature
BUILDING 8c ZONING—473-7357 • ADMIlVISTRATION�FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
• . � �, r
�_p,� RIGHTS OF SIIBJECTS OF DATA �
gubdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information r�d tO � ��� ����L An.individual asked to
• himself shall be informed of: (s) the
� ' supply private or confidential data concerning state a eney,
purpose and intended use of the requested data within the coll T� or � iegally
political subdivision, or statewide system; (b) whether he ma„
required to supply
the requested data; (c) any known consequence arising from his
supplying or refi�sing to supply private tgte orl federal la w o re�eive the data.1tTlus-
other persons or entities autw�ne�bndividual is esked to supply investigative data,
requirement shall not apply
pursua�t to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue m8 olert taX re°und lnstruct�otisuinstea thos
subdivision m the individuel income tax �r r
on those orms. . - -— - � .
A�� � �� � ��yl�. Upon request to a responsible
Subd. 3.
authority, an individual Shall be informe�h ublic, pr'vat eor eonfidential.e IIpon his
individuels; and whether it is elassified p ublic data on
turther request, an individuel who is the subject of st t�e�mri��if he desires, shall
individuels shall be shown the deta withou����t �� �ter an individual hes b�en
�e informed of the content and meaning t� �� need not be disclosed to
shown the private data end informed of its meaning, u��t to this section is
him for six months thereafter unless a diSPute or action p
� ending or additional data on the individu e �ate or public dataruponarequest by
� responsible authority sha]1 provide copies of th P �ible authority may require the
the individuel subjeet of the data. The respo
requesting person to pay the actual costs of making, certifying, and compiling the
copies. immediately, if possible, with any request
The responsible authority shall comply of the date of the request,
made pursuant to this subdivisionnd le �tholideys, if�immediate compliance is not
excluding Saturdays, SundaYS � �th the
ossible. If he cannot comply with the requ eL �t�wi�ntw ch toh oC mply form the
p hsve an additional fi YS
individusl, and tnaY 5��� �d legel holidays•
request, exeluding Saturdays,
te or complete. An individuel m8Y
Subd. 4. Procedure when dtta is not acc�a himself. To
contest the sccuracy or comQleteness�of public or private da the�nresp�e authority
exereise this right, an ind�v�duel she� notify � ��e authoritq shall within 30
describing the nature of the disagreemenL The respo
days either: (s) correct the data found to be inae��a��°�uding ree�ipi��ngmedt by
notify past recipients of inaccurate or incomp
the individusli or (b) notify the individuel ln�'v dualb sistatementof disagreement is
Data in dispute shall be disclosed only �f th
• included with the disclosed data• � 8ppealed pursuant to the
' The determination of the responsible authority m o contested.cases.
provisions of the administrative procedure act relating
� DATE , TIM
CITY OF ORONO CALLED IN � - �P��l �'__�
INSPECTION NOTIC� SCHEDULED .2—?'p� �"�—
PERMIT N0. � a' COMPLETED "�—G �
ADDRESS a� O
OWNER �u- uQ- CONTR.
TELEPHONE NO. �� � � 7
� DESCRIPTION -
� 01 FOOTING 11 MECH ICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125''WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 L BD. 12 WATER HOOK-UP 34 TREE REMOVAL
2
Q OS FINA 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
iNSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTIONREQUIRED.GALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on s'�e:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice