HomeMy WebLinkAbout1999-011849 - temp sign �, PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 - -_
Crys� Eiay, Minnesota 55323 PermitNumber: -:;= -.;-r .
(612) 249-4600 Date Issued: �s� ;,:_;u•_�
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SITE ADDRESS:
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REMARKS:
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CONTRACTOR: OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ..G,�
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�Total Fee: $ Date Received: ` /.-`�� �ty
Entered By: �" � Permit#: /�<a�� �
OF ORONO - BUILDING PERMIT APPLICATION � �
CITY �
All information must be submitted in full beFore plan review �-ill be started. . �
� (please print ali information) . .
THE APPLICA2r�T IS: � (circle one) . OtiVNER OR CONTI�ACTOR � � � .
��`�f � ;�,;=�j�'��G� '�`-� G��%-5�`�fI: `7?—��'� i
JOB SIZ'E ADDRESS: � �� ,
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NA�IE OF Oti'YNER: ,. �` /L ��l`Z'`�-- PFiONE: (home)
. ' �work� � riz� l� � ����.
I1�IA.IL�G ADD�'•ESS: ,�. "���,�z—� CI1'Y: ZTP:
CONTRACTOR: . PHONE: "
CONTACT PERSON: MOBILE/PAGER:
MAII.1i`'G ADDRESS: CIT'Y: ZIP:
STATE LICE�TSE: # �
A.RCHI'I�ECT�E\TGI�i TEER: . PHO�TE:. ��
iVI�.lI.Itii TG ADD�tESS: _ CITY: ZU':
. ��; REGISTRATIO�t#
TYl?E OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
�� �' - ^ /' - ��'�I�,/',�� � �
PROPO ED'��O (describe in etai�: ��G v�'"��`�'G �� .� � G <✓ l �
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STORIES: SQ.F'EET OF EACH FLOOR:
NO. OF BEDROOvIS: GARA.GE STALLS: ATT• _____ DET. � � � . . �
ES'I' .Il-i IATED CONSTRUCTION VALUATION (excludi.ng land): $ �
I hereby apply for a building permit and I acknowledge that the information above is complete and
accura[e; that the work will be in conformance with ihe ordinances and codes of the Ciry and with
the State Buildi.n� Code; that I understand this is not a permit and work is not to start without a
pernut; and thac the work will be in accordanC�with the approved plan.
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APPLICA.�'tiT'T'S SIGNATURE:f���""s,'4 G� DATE: l
� , ,r �
NO?'E! Parade Qf Home� events require separate permit approval by Police Department and
� City Counci160 days prior to tke event. Non permitted events x�i11 not be allowed.
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Sec.13.Q4 RIGKTS OF StT$JECTS OF DATa - - •
Sabd. i. Typ-o[data. T�e righcs of individual on whom[he dara is scoRd or ro be smr.d sbalI be u sec forch in this secrion.
Sutd.2. Iatormation reqtrirrd to be given iadiridual. ?n individual asked W supply privac.ar eoafidendal daca eoncerning hiaueTf sha?1
be in,°or¢::d of: (a)the parpose acd imm�ded use of che rcquest�3 daca withia[he eollecdn3 St�t�agenc.y.poliacal sutdivision,or samwide rystm•
:(b)whec�e:ho:..ay r.hcsc or is.legally requir_d to suPP1Y.che r_quesud dsta:(cJ a:y Iaiowa eaas:queece arisiag frnm his si:ppiying or refusiag w suppty
, pcivue oc eo:i::der.caI da�;ar:d(d)t�e ideadry af o�erFenoas orecddes ae�Wocized by su�.�or fcae_'!e:;:a r_:eive tae d3�. Zhis rquirc�eat s��
not a�piy w;.ea an i,:dividuaI is asked co suppIy iavesdgarive data,pucsuant to secdan 13.82,sut,+division 5,w a Iaw enfoccemeat o�cer. . •
'C�e eenmis5ionec of revenue mav olac- the noac- rauird und-r chis subdivisian in the individual income caz or oroaem t�z teEuad
inscrucaons msuad of an those focros. .
Sutd.3. Aecess to data by indiridual. Upon request to a responsibte auchoriry,an individual sball be inforzned wht�her he is che subjeu
of stor_d dia an individuaLs,aad whe�her i[is elassified u public,private oc eonF.denaal. Upan his furcher r_ques�,aa icdividuaI wha is the subje:�
a!stor.d priva:e ar public daa on individuaIs shall b�shown the dac�wi�haut iny charge to him and;if he desires,sha11 be informed of che eoacenc
ar.d m:aning of chat data. Ahe�an individual has been shown the priva�.dae ar.d informed of irs meaaiag,the daca necd not be disclosed to him for
siz monchs eher_afur unless a dispute or aeaon pursuant to ehis se:aon is pending oc addidoaal da�on the individaal has been eallec`d or erea4d.
The respansible authoriry shall�provide eopies of the pcivac:or public daca uFon request by the iadividual subjcct oC che daa. Tha tespocuibie auchoriry
may requir_ �Fce r.qu:sdng person to pay the accual eosts of makinz,earifying,ud comp'ding the eopia.
The resgansibie auchoriry shall eompty immediatety,if possibie,wich aay reqaat made pursuanc co this subdivision.ac wichin flve days oE
the dace o(the requese,excIuding Santcdays,Sundays and legal hotidays,if immediate compliaace is not possible. If he eannot compiy with tfio request
within that dme,he shall so inform ehe individuaI,and may have an addiaoaaI five days wichin which ro campty wich the request,exciuding Satucdays,
Sundays and Ie3aI holidays. . .
Subd.4. Proeedure when data is not accurate or eomplete. An icdividual may eont�st the accurdcy ac eompieteness ofpabiic orpri�•ace
daca concerning ti�msetf. To ezetcise this right,an individual shaIl aadfy in wridn�die«spoa.s�le auchoriry dosedbing the nanire oFthe disagreemeac. .
The tesporesible authoriry shall wichin 30 days eick:cr: (a)eocrecc che data Caund to be inaccurat�or incompiece and ata:mpt to nodfy past recipiencs of
inaccurate or incample�e data,including rccipieacs named by che individu�t;ar(b)aodfy che individual thac he believes the data to be correcc Daa
in dispu�e shall be disclosed onIy if the individaal's scatemenc o!disagreem:nt is included wi�h the d'uclosed dara.
. The de�:rminaaon of ehe rasponsible authoriry may be appealed pursuant to the provisions of tha adminisQadve pro<;dus act relating to
eonter•r.d cases. � . -
DATA PRIVACY ADYISORY
In accordance with M.S. 13.04,Subd.2, "Rights of subjeccs of data"�we would like to inform you that your request
for a permic or license from the City of Orono or any of ia departments may require you to furnish certain private or
confidential 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 Ciry deny the permit or license. �
3. The information tnay be shazed with ocher local,state or federal agencies to the eYtent necessary to process
the permit or license. �
4. If your requested permit or license requires Council action to approve, some information may become
. public, . . . . . . . .
�S. You have certain ri�hts under M.S. 13.04�(ava.ilabte upon request) to review private data onyouurself. . _
6. Your full name is required to process this application or permit.
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Fitsc / .�.y �fid e Iasc -
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Address /� � _ / /�
Gt/G�'�f`L— LL�- �' `' -'`� 1 -/ �/ -G'� �—I
Ciry Sace Zip P�one
I understand my ri;hts as stated a ve. ,
�l:G`L � , L'�\
Signscure
DATE TIME
CITY OF ORONO CALLED IN � ^7�7
INSPECTION NOTI E Q SCHEDULED 9
PERMIT NO. � �/ COMPLETED � � ✓` �
ADDRESS � � •
OWNER CONTR.
TELEPHONE NO. '�7 .'s• �! 3!� �
� DESCRIPTION ��e .n - ��_'
lL 01 FOOTING 1 ECIiANICAL 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 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� -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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS: �',��o �
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d�IORK SATISFACTORY:PROCEED �P OJECT COMPLETE
�� ❑ CORRECT WORK&PROCEED /" ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY :
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP OROER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contractor on site:
Inspector.
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White Copyllnspector's File Canary Copy/Site Notice