HomeMy WebLinkAbout1999-011629 - reroof ,
�' PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 = - " �.
Permit Number: � � ' � ' '
Crystal Bay, Minnesota 55323 Date Issued: `�'- T`��:`-�
(612) 473-7357 i�;`:`{�:`=+:``=�`=:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS; �
FEE SUMMARY:
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AP LICANT/PE MIT E SIGNAT E ISSUED BY:SIGNATURE �.C.L�
Total Fee: $ Date Received:
Entered By: �,�, Permit#: l/��� � �
CITY OF ORONO - BUILDING PERMIT A.PPLICATION �
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All information must be submitted in full before plan review will be started. .
� . . (please print all information) . .
THE APPLICA�'T IS: � � (circle one) : OS'YNER OR ONTR.ACTOR . �
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JOB SITE ADDRESS: / v �0�e I6 nP� � ll'�v� ZIP: i,
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iE OF O��'ER: � C PHONE: (ho�me)��T%., DD.v�'j D S�-� �
NA11� a �.��e.� �
/� (work) � ��/��_�
MAlI�I�tGADDF.ESS: p U, �Sa� '�al CITY: /�/G�UG rvle_ ZIP:J�'�-3-c�--L
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CONI'RA.CTOR: o � PFIONE: G,�1- �'� ��`
CONTACT PERSON:�,,�„��v�,�o d����� MOBILE/PAGER: nfi�i � // (�i -��3�g�Z
MAZLI�'G ADDRESS: �i o o �,�c.�is��� g!��l CITY:SI�c.a�.�c P�,� �� _S.��r l
STATE LICEIh'SE: # � � �c7 .P f� 3 -3/�� `�J
ARCHITECTlEhTGIl`'EER: PHOti'E: .-
i1�IA.II�ING ADDRESS: CTTY: ZIP:
� NAME: REGISTRA.TION#
TYPE OF tiVORK: New Addition Accessory Structure _
Move Remodel/Alteration Land Alteration_
PROPOSED tiYORK(describe in detai�: � �b� �� � �� ��o�, FL�`���
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARA.GE STALLS: ATT. DET. � � . � .
UATION excluding lan�: $ J . � � � �J �
E.ST ,n'i IA,TED CO�ISTRUCTION VAL ( , .
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformanc with the ordinances and codes of the City and with
the State Build�n� Code; that I unders ' is ot a pemut and work is not to start without a
permit; and th�t the work will be in a d ith the appro�ed plan.
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APPLICAIr'T'S SIGNATURE: DATE: 7L_____-
NOTE! rade Q Homes events require separate permit approval by Police Department and
� City Council 60 days prior to the event. Non permitted events will not be allowed.
�
Sec.13.04 RIGATS OF S'�lBJECTS OF DATA ' �
Sutd. 1. Type o[data. The righcs of iadividual oc whom the daa is swced or ro be smred shall be u sec fonh in ctiis secdom
� Subd.2. IntormaGon nquIred to be Yivm iadividual. An iadividual uked to supply privare or eoafdendal dara coccerning himself shall
be infocmed o`: (a)the pucpau aad iarended use of the requesred dan widiia the collecCag 3nte agenry,polidcal subd.ivision.or satewide rysum;
� (b)whec�ec he caay refuse oY is,legatly t,equ'�r:d co suppiy.the r:quest.-d data:(c)any la;owa coauquecce uising from his supplying or refissing tc supply
privac�or coti.der.cat data;and(�che idendry o!ocher penoas or earides aucharized by sn�e or fedanl law to rCceive the d3�a. Zhis requiremeac shall
not appiy when an iedividua!Is uked to supply invuagarive daa,pursuaat oo secdon 13.82,subdivisioa S.oo a taw enfoccemeac officec. . . -
'[�e eenmissioner of revenu� mav oiace che nodce r_auir:d undu this subdivision in the individual income mx or omoenv raz refund
insciueaons inscead of on chose forms. �
Subd.3. Aecas to data bp fadividual. Upon requesc w a izsponsible auehoriry,an'mdividual shail be infocmed whether he is rhe subject
of stoc:d dsa on individuals.and wheche�ic is classified u public,Qrivam or conF.deadal. Upoa his furrher tequest.an iadividual who is che subjecc
of stoced private or public daa on iadividuals shall be shown the daca wuhouc any chacge to him and;it he des'ires,shall be infocmed ot the eoateac
and meaaiag of efiat data. Ahe�an individual has beea shown che priva�e dara aad iaformed o[ics meaaiag,che data need not be disclosed oo hua fa�
siz mondu thecealur unless a d'ispute or acdon punvanc w this secdon is pending or addidoeal daca on the individual has beea collected or ereac�d.
The cespoasible autlsoriry ahallprovide eopies of che privac:or public daa apon requat by�he iadividual subjecc o[che data. The respoasible auchoriry
may cequire rhe cequesdng person to pay the acncal coscs of tnalcing,cecdfying,and comp�ing che eapiu.
The cesponsible auehoriry shall eomply immediacety,if possible.wich aay cequac made pursuant to�his subdivisioa,or wiehin five days oF
the date of the ceqaes�eacluding Sanirdays.Sundays and legal hoiidays,it imcnediace compliaace is not pouibte. If he eannat eomply wirh ttie requesc
wichin d�at dme,he shaU so inform the individual,and may have an addidoaaI five days wichin which w comply wich the requac,exciudin'g Saturdays,
Sundays and legal halidays. . .
Subd.4. Proeedure when data L�not aceurate or eomplete. M individaal tnay eoncest the accuracy or eompletecuss of public orprivate
dam concerning hlrtuelf. To execcise�his right,an individual shall nodfy In wridng ehe respomible auehoriry descn'bing the aatune of che disagteemeac
'Ihe respoosibte aurhoriry shall wiehia 30 days ei�her. (a)correcc che data found oo be inaccunte or incomplete and atcemp�to aodfy pasc ncipienes of
inaccurace oc incomplece daca,inciuding recipieacs named by the individual;or(b)aotify the individual thac he believes the daa to be correec Data
in dispuce shall be disclosed only if�t►e individual's statemenc of disagreement is included wi�h the d'uclosed daa.
The decerminadon of the responsible auchoriry may be appealed pursuanc�the pcovisions of ct►e adminisaadve procedute act relating to
contesad cases. � • •
DATA PRTVACY ADYISORY �
� In accordance wich M.S. 13.04,Subd.2, "Ri�hcs of subjects of data"�we would like to inform you that your requesc
for a permit or license from the Ciry of Orono or any of its depaztmenu may require you to furaish certain private or
confidential information.
You are notified that:
1. 'Ihe informatioa you furnish will be used to determine your quali6cation 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 may be shazed with otfier local,stace or federal agencies to the e.ccent necessary to pracess
the permit or license. �
4. If your requested permit or license rcquires Couacil acdon to approve� some information may become
. pubiic, . . . _ . . . . .
5. You have certain righa under M:S. 13.04�(availabte upoa request) to review private data on.younelf.
6. Your full name is required to process this application or permic.
F'ast �fiddle Lasc �
Address �
Ciry Sace Zip Phaae
I und rsc d st t ove. r
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Sigcumre
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC^E� SCHEDULED r�- —�`����`
PERMIT NO. 'I�P X"\ COMPLETED ��-�� l Z ' -3d
ADDRESS � � ��F' ����i � � ` ,
OWNER CONTR. �e��\� Q �=���C�
TELEPHONE NO. � `S— a'7'�
� DESCRIPTION �� ����
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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14 SEWER HOOK-UP O6 PROGRESS
h 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d JLQ�VORK SATISFACTORY:PROCEED �ROJECT COMPLETE
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� � ❑CORRECT WORK&PROCEED C� ISSUE CERTIFICATE OF OCCUPANCY
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O �l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. — pHOTOTAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
C STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor on site:
I n spector. .���G�-"�'���=�-P.�'��
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