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Home My WebLink About2003-P06982 - re-roof PERMIT `C ITY ��F O RO N O Permit Number: 2750'Kelley Parkway- PO Box 66 P06982 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: iiisi2oo3 SITE ADDRESS: 2785 Shadywood Rd Excelsior,MN55331 P I D: 21-117-23-24-0054 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 9�•25 Valuation: $ 3,900.00 State Surcharge Fee: $ 2.45 TOTAL FEE: $ 99.70 APPLICANT: Incline Enteiprises Inc OWNER: Mr. &Mrs Thomas Casey 26175 Birch Bluff Rd 2785 Shadywood Rd Shorewood,MN 55331 Excelsior MN 55331 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUI DING DE RE IREMENTS. i � `� ' ICANT PERMITEE SIGNATURE I SUED BY SIGNATURE Covies: 1-File(Signitures Required), 1-Anvlicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1 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) ---------------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OW ER OR�CONTRACTOR ____ . JOB SITE ADDRESS: , �� ,5� �_� �C " JJ�� ,�� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 0 No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: �v�v� �G- S �� PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: ��I�7-� �,n��,�,`,;z� ��. � PHONE• �'S� ' '-/7/y��S— CONTACT PERSON: �'S,�I MOBILE/PAG R:. <j� -� /�'y 7� MAILING ADDRESS: ,�� '�"�;�, ��- CITY: S� �� ,�' ZIP: �s�3� STATE LICENSE: # �ZG�)��31 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration_� Land Alteration PROPOSED WORK(describe in detai�: �� `�'f— �- .�- ��-`, � 6 �� `�- � c� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $_ �S�C� 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 t start ithout a pernut; and that the work will be in accordance with the approved plan. � � APPLICANT'S SIGNATURE: DATE: ��-�� Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data. The rights of individua]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 indi�idual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)t6e purpose and intended use of the reqaested data within the collecting state agency,political subdivision,or statewide s}•stem;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigad�e data,pursuant to section 13.82,subdivision 5,to a law en(orcement o[ficer. The commissioner of revenue mav olace the ootice reauired under this subdivision in the individual income tar or orooertv tai re[und instructions instead of on those forms. Subd.3. Access to data by individual. Upon rec�uest to a responsible authority,an individual shall be informed whether he is the subjeM of stored data on individuals,and whether it is classi£ed as public,private or con£dential. Upon his further requcst,an individual who is the subject of stored private or public data on individuais shall be show n t6e data without any charge to him and,if he desires,shall be informed o[the content and meaning of that data. After an individual has been show n the private data and informed of its meaning,the data need not be disclosed to him for six months therea[ter uoless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of mal.ing,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,orwithin five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have zn additional five days within which to comply with the request,excluding Saturdays,Sundays and Iegal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may wntest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authorih�shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients o[ inaccurate or incomplete data,including recipients named by the 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 disclosed data. The determination of the responsible authorih-may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. D�TA 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 pri��ate or confidential information. You are notified that: 1. The information you furnish��ill 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 City deny the permit or license. 3. The information may be shared�ith other local,state or federal agencies to the extent necessary to process the permit or license. 4. If�-our requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under�I.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this a lication or permit. �,�1!`/L �� G Firs Middle � Last 2��j ^ � ✓ Address �,1 �'� -�/' ;S 3,�-.� C�tY � State Zip Phone I understand m}-rights as tated ab e. • Signature / V DATE TIME CITY OF ORONO CALLED IN �'/-7'�'-� INSPECTION NOTICE SCHEDULED ,(f-iZ t��-�'� PERMIT NO. '� �� ? COMPLETED ADDRESS__:� 7.�5� .�Gc�tc�c�'/lo' OWNER �� CONTR. �slr��-H� TELEPHONE N0. �9�2-- -��'�- y'`/ � 7 � DESCRIPTION �-�:� � 01 FOOTING 11 MECHAN AL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 W BD. 12 WATER HOOK-UP 17 SITE INSPECTION OS INA � 14 SEWER HOOK-UP O6 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 J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � J O � � O � W � Q � 2 W � W � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE w ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � �CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnedContractor on�ite: Inspector. White Copyllnspector's File Canary Copy/Site Notice Co�� DATE TIME CITY OF ORONO CALLEO IN INSPECTION I SCHEDULED � __��'� PERMIT N0. � �y— COMPLETED ADDRESS �78-5 5 d OWNER CONTR. �-�-��-- TELEPHONE NO. � � DESCRIPTION �e�L� �� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL 2 OWNEFiICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � a � j o ,, � � 0 � W � Q � W � W � j O W� VI�RKSATISFACTORI(:PROCEED ❑PROJECTCOMPLEfE W �CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERINCa PERMANENT O CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the nex inspection 24 hours in advance. (g52) 249-4600 OwnerlContra i e: Inspector. White CopyAnspector's Fik Canary CopylSite Notks � o�f a �� TIME CITY OF ORONO CALLED IN __Z� INSPECTION NOTICE /� SCHEDULED 'Z-i PERMIT NO.�� `1� COMPLETED ADDRESS � • o� � g � S�Q�'�Ll.)(_KXY ' OWNER � CONTR. `�� l i'lQ F� � TELEPHONE NO. � �o� ' �I � — � �� y[� /'�'� � DESCRIPTION _ ��1 'i' l� �� t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 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 Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: ��(�yy� Cfl,l.�/�� (�.1/1.�� I'1/►QS�� f� �.Q��l$�]' fCS� tfY' j O a � O � W � Q � Z W � W � � � d W� ORKSATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUiRED.CALL TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952� 249-46�� OwnerlContf�etvr o ite: Inspector. White Copyllnspector's Fi Canary CopylSite Notice