HomeMy WebLinkAbout1991-003531 - repair siding/door PERMIT
CI���F ORONO PERMIT TYPE:
, 1335 Brown Rd. South • P.O. Box 66 Permit Number: F';���-�3��'��'
Crystal Bay, Minnesota 55323 Date Issued: ���'```�$� �`�`}=;�:'i
(612) 473-7357 ""°��'� � �''�_�i'�f
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CONTRACTOR: OWNER:
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APPLIC /PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� CITY OF ORONO - BQILDI�'JG PERMIT APPLICATION
Total -F�e:' $ Date Received:
Date Approved:
E.-�tered By: � � �� ����
Permit#: � ' _> l
�LL INFORMATION MIIST BE SIIBMIT�'ED IN FIILL BEFORE PLAN REDI�W i�1ILL B$ STARTED
(See Check-off List Enclosed)
PSE APPLICANT IS: (circle one) �OWNE or CONTRACTOR
ros sz� AnnRsss: /y_s`� S�10��C;�� .� l�J�1���v��1 z IP: 5.�:�y !
(work) yl'.S -�yy�
� OF OWNER: n��u.��CE �, a/dJ�iE/✓��✓� PHONE: (home) 9ZZ-ic�3S J
+lAII,ING ADDRESS: /�/ZO �i�l�i✓S /� CITY: //�",�p�l� ZIP: �5�'�9/
:ONTRACTOR: PHONE:
4AILING ADDRESS : CITY: ZIP:
'YPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/____________ � Renovate Land Alteration
�ROPOSED WORR (describe in detail) : �vz„J �
/��Q,�� liOC��
'�TORIES:_� SQ. FEET OF EACH FLOOR: '�f� r�}�.�t.U,��
!O. OF BSDROOMS:� GARAGE STALI�S: ATT.� DET.�
�
'STIMATED CONSTRUCTION VALIIATION (ezcluding land) : $ '�c�?. c��
hereby apply for a building permit and I acknowledge that the information
bove is complete and accurate; that the work will be in conformance with the
rdinances and codes of the City and with the State Building Code; that I
nderstand this is not a permit and work is not to start without a permit; and
hat the work wil 1 be ' dance with the approved plan.
PPI.ICANT'S SIGNA � - DATE: I' / ,�' ( I
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- CI�'I' of ORO�TO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
�
� - � � 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 3.ike 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 supply data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other local, state or
federa.I 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 privat�
data on yourseZf.
6. Your full name is reguired to process this appl.ication or
permit.
,/�c�E -Jo r�l�/ �i� 2 [So�
First Middle Last
�C� 7 �S I-1�i��"D��)� �v� �S�
Address
� �C S ��I�-� �~-S `� � �
City State Zip
4Zz_- � o3s� - "
Phone
I understand my rights as stated above.
ignature . '
� ,
BUILDING&ZONiNG—473-7357 • ADMINISTRATION Fc FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
I
SI3.04 RIGHTS OF SIIBJF•CT5 OF DATA � - - '
'vision L Tppe of data- The rights af individuels on whom �e �� � .
Subdi
stored or to be stored shall be as set forth in this section.
gubd, 2. Informatioa requir�d
to be givea individuaL An.individusl asked to
• t8 within the collecting state agency, .
• su ply private or confidentiel data concee in�himself shall be informed of: a e
P v refuse or is 1egaI1Y ,
purpose and intended use of the req t�� (b) whether he ma„ from his
political subdivision, or ststewide sys . �o� consequence arising o f_
required to supply the requested dat8, ;.(�� �Y ;�d {d) the identity , . � -
�uppiying or refusing to supply private or confidentiel da�+ �' �ve data,
entities authorized by state or federal law to receive the data- This_
other persons or 1 investiga �
requirement shall not apply when � �dtola law en oresmentuofficer.
pursuant to section 13.82, subdivision 5,
The eommissioner of revenue ma la�t t� re°una�nstructio�n�tegdh°S
subdivision in the individual income tax or r� er
on those orms. - - � --- " � .
Subd. 3-
Acce� te data by in�ivi�� �Pon request to a responsible ,
authorit , an individuel shall be informed whe b�C h riva eeorueonfidential.e Pon �
y ublic data on
individuals; and whether it is classified es p : P
to him and, if he desires, shall
further request, an individusl who is the subjecL of stored private or��u� � besn
individuels shall be shown the �� WithO of�hat data. After an ind�
�e informed of the content and meaning � �� n�d not be �isclosed to
shown the private dats and informed of its ut��BBC�on pu�s�t to this sectien is
him for six months thereafter unless a �P n request by
� endin or additienal data on the individuel h�8te or public datarupoegted. The
p g rovide copies of the p require the
responsible authority shall p onsible authority maY � the
the individusl subjeet oftrie actuel�co ts of makir�g, certifying, end �°mp g
requesting persan to pay -
copies. it ssible, with any request
The respensible authority sha1T comoly immedistelYof th date of the request,
made pursuant to this subdivision, or within five �Yslmmediate compliance is not
excluding Saturdays, BundaYS and legel holideys,
ossible. If he cannot comply with the request within that time, he sha11 so in�o� the
p h av e a n a d d i t i o n e l f i�e d a Y S W�th�n w�ch to comply
individuel, and m S tur d s y s, S u n d a y s a nd Ie gal holidays. -
request, excluding
te or comQlete. An individuel maY
Subd. 4. Proced�e when data fis not accura �s�. To
contest the accuracy or completeness�of public or private data concerning
the responsible authority
exercise this right, an individusl shall�notify in wri�e authority" shall within 30
describing the nat�u'e of the disagreemeaL"� 'The resP° ete and attempt to
days either. (a) cert'ect the data found to be inaecu�'ate oc inaetnPl � i�� named by
notify past rerapients of inacc hetin�v�duel Pthat he tbelieVes the data to be correct.
the individual; or (b) no y eement is �
ute shall be �sclosed or�lY if the individusl's statement of disaSr ;
Da� � �p t to the � E
• included with the diselosed data. m8y � appealed pursuan
' The determination of the responsible authority to contested cases.
provisions of the administrative procedure act relating - -- .,
_ . �
,
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DAT� �/, TIME
CITY O�ORONO CALLED IN � cf,��� l l
INSPECTION NOTICE , -� SCHEDULED �;.-r;.,,:_._
PERMIT NO. -���) COMPLETED �'-w � K
ADDRESS � `T�� ���� C,�-ti'��:__.I_� ��� ���,��
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION �/C�( i 1 C�
� 01 FOOTING 11 MECHANICAL RI - 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24I25 WOOD BURNER/FIREPLACE 19 LAKESHORE/WETLANDS
Z 04 WAL D. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL— 13 METER SETITURN ON 17 SITE INSPECTION
� 07 SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �J WORKSATISFACTORY:PROCEED �PROJECT COMPLETE
�❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
C CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra�qq site:
Inspector. U
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