HomeMy WebLinkAbout2003-P06554 - re-roof � �
� � PERMIT '
C I TY O F O RO NIO Permit Nu ber:
2750 Kelley Parkway- PO Box 66 P06554
Crystal Bay, Minnesota 55�23 Permit Typ : Minor Alterations
(952) 249-4600 Date Issue : ��iv2oo3
SITE ADDRESS: 213 Shevlin Dr
Wa ta,MN 55391
PID: 03-117-23-34-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Pernut Type: Minor Altdrarions Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#: ,
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit�Fee: $ 153.25 Valuation• $ 7,500.00
State S�urcharge Fee: $ 4.25
TOTAL FEE: $ 157.50
APPLICANT: TNT Home I�rovements OWNE : Eric&7ennifer Martinuzzi
1276 Sasper Road 2135 Shevlin Dr
Shakopee,MN 55379 Wayzata,MN 55391
THE UNDERSIGNED HEREBY�QUESf S PERMISSION TO MAKE THE L IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WO IN STRICT COMPLIANCE WITH ALL C OF ORONO ORDINANCFS AND SfiATE OF
MINNESOTA BUILDING CODE�tEQUIREMENTS.
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APPLICANT PERMITEE SIG ATURE SSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required)�1-At�plicant, 1-Monthlv Renorts, 1-Assessin , 1-Finance Page 1
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" � Total Fee: $ 5 � � I Date Received: �'�7—� 3
Entered By: � Permit#: �<o S�1-1
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CITY bF ORONO - BUII..DING $ERMIT APPLICATIOleT
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All inform�tion must be submitted in full fore plan review will be started.
(please print all in rmation)
THE APPLIC IS: (circle one) OWNE� O RACTO
JOB SITE ADDRESS: a I 35f S�-��'`� � , ZIP:
���� ,R v�rt�nr�. I � PHONE: ome) ° �Z- 25'�--b(�`/ O
NAME OF OWN�R: .��LK r I�" (h l5
(work)
MAILING ADDR�SS: a 13 S� S�\� ^ � � CITY: c�vto�r o ZIP:
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CONTRACTOR: �� �t7 w^� w^�°(�`o v � PHONE: �( 2 ` 5�� - 2 l b p
CONTACT PERSQN: �O t�� (��(s � OBILE/PAGER:�,o�^�
MAILINGADDRFSS: ��fn3 E. �l i`�-.� CITY: Sl^h(�o,�u!ZIP:.SrS3�
STATE LICENSE: #2 o z 2[� 7�3
ARCHITECT/ENG�ER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New tlddition � Accessory Structure
Move RemodeUAlteratio� Land Alteration
' /Z� /ZoD �
PROPOSED WOItK(describe in detain: �sr '�• �
STORIES: SQ.FEET OF EACH OOR:
NO. OF BEDRO MS: GARAGE ST LS: ATT. DET.
ESTIlVIATED CO�TSTRUCTION VALUATION(e cluding land): $ �5�n
I hereby apply for a�building perm.it and I aclrnowledg that the information above is complete and
accurate; that the wbrk will be in conformance with ordinances and codes of the City and with
the State Building �ode; that I understand this is not permit and work is not to start without a
permit; and that th� work will be in acc nce with the approved plan.
APPLICANT'S S GNATURE: DATE: �"` � � �
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NOTE! �.r events require separate ermit approval by Police Department and
City Council 60 d s prior to the event. Non permi ed events will not be allowed.
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Sec.13.04 RIGFTTS OF S[JBdECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is swred or to be stored shall be as set forth in this section.
Subd.2. Information req�rired to be given individaal. An individual asked to supply private or confidential data conceming himself shall
be informed of: (a)the purpose and inunded use of the requesud data within the collecting rtate agency,polidcal subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown coasequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of o[her persons or entides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative dara,pursuant to secdon 13.82,subdivision 5,to a taw enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or nropertv tax refund
instrucdons inscead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of swred data on individuals,and whether it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data without any chazge to him and,-if he desires,shall be informed of the content
and meaning of that data. After an individual has been shown the privace data and informed of iu meaning,the data need not be disclosed to him for
siz months theroafter unless a dispute or acdon pursuant to[his secrion is pending or additional data on the individual has been collected or creaud.
The responsibie authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may roquire the requesting person to pay the acwal coscc of malcing,certifying,and compiling the copies.
The responsible andioriry shall comply immediately,if possibte,with any request made pursuant to this subdivision,or within five days of
the date of the request,ezcluding Saturdays.Sundays and legal holidays,if immediau compliance is not possible. If he cannot comply with the request
within diat time,he shall so inform the individuai,and may have an addiaonal five days within which to compiy with the roquest,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data Ls not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise rhis right,an individual shall notify in wricing the responsible authority describing[he nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found ro be inaccurate or iacomplete and aaempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correcc. Data
in dispute shall be disclosed only if the individual's statemenc of disagreement is inciuded with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant w�e provisions of the administradve procedure act relating to
contested cases.
DATA PRNACY ADVISORY
In accordanee 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
confidentiai information.
You aze 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 supply data, but refusal may require that the City deny the permit or license.
3, The information may be shared with other local, state or federal agencies 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 rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address ,
Ciry State Zip Phone
I understan rights as stated above.
Signacure
rS�� ✓
l DAT IME
CITY OF ORONO CALLED IN 7 Z-�
INSPECTION N TIC SCHEDULED _���� •? 30
PERMIT NO. J`�S COMPLETED ` R
ADDRESS /3 J� ��
OWNER CONTR. �/�� '���'�'`�
TELEPHONE NO. �2- n7 p 0 02 ��d
� DESCRIPTION � -' /���.
� 01 FOOTING 11 MECF�ANICAL RI 18 EXCAV/GRADIN ILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/W DS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVA
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTI
Q OS FINAL 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 R MOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWR MOVAL
� OWNER/CONTRACTOR TO MEET YOU:_.,,YES_NO
� COMMENTS:
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��WORKSATISFACTOR1f:PROCEED ❑PROJECTCOMPLETE
W CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF UPANCY
0 ❑CORRECT WORK,CALL FOR REINSPEdTION TEMPORARY
V BEFOREC�/ERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIW HOURS. p PHOTOTAKEN
INSPECTOR WILL RETURN p CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECT�R
❑INSPECTIONREQUIRED.CALLTOARRl4NGEACCESS.
Call for t next inspecipon 24 hours in advance. (952) 249 600
OwnerlContra
Inspect .
White CopyMspector's Filei Canary CopylSfte Notice
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