HomeMy WebLinkAbout2006-P10437 - re-roof PERMIT
C�TY�7F ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10437
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: l0/12/2006
SITE ADDRESS: 3596 Shoreline Dr Unit#
Wayzata,MN 55391
P��� 17-117-23-43-0107
DESCRIPTION:
Proposed Use: Commercial-Business
Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterarions Pernut Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 83•25 Valuation: $ 3,000.00
State Surcharge Fee: $ 1.50
TOTAL FEE: $ 84.75
APPLICANT: Northrup Roofmg&Remodeling OWNER: Patricia Dongoske
4400 Nicollet Ave. 3596 Shoreline Dr
Minneapolis,MN 55419 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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�APPLICAN ERMITEE SIGNATCJRE UED BY SIGNATURE /�
Copies: 1-File(SignaturesReguired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
Oct 10 2006 9: 29RM HP LASERJET FRX 612-825- 1900 p. 5
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Total Fee: � ��I� 7� Date Received: � � " I D- C�,6
Entered By: Permit#�: /�..I O�3 7
CITY OF OR NO - SUILDING PERMIT APPLICATION
All information mus be submitted in full before plan review will be started.
(please print all informatian)
THE APPLICANT IS: circ[e o�e) OWNER O CONTRACTOR
JOB SITE ADDRESS: �� S r ZIP: SJr 3 q�
Will this be a Parade of Ho es, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No If yes, a sp cial event permit is req�ired with Police Department and City Council approval
60 days prror ro the event. Shuttle bus service wil!be required unless applicant demonslrates
su�cient site parking is available. Non permitted everrts wil(not be allowed
NAME OF OWNER: i abr � PHONE: (home) �52-`f71- `��f3�}
(work)
MAILING ADDRESS: 5 S�lore�in� Dr. CITY: fiD� ZIP: 5 ��(
CONTRACTOR: � r � e�i PHONE: !�l Z-SZS �33 S 3
CONTACT PER,�ON: � � ` BILE/PAGER: �oI2�<�}-.�,�,3��
MAILINGADDRESS: '�o ef U� . CITY: S ZIP: SS
STATE LICENSE: # 33 EXPIRATI4n'DATE: 3�3 t/07
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CI'I'y; Zip;
NAME: REGISTRATION: #
TYPE OF WORK: New Ho e Additian Accessory Structure
Move H me RemodeUAlteration (ie: Siding, Windows)
Any ea th movement may require MCWD review an permits !
PROPOSEDWORK(describ ir�detai�: _ ej'17oV� a R�ola�p [�c�
STORIES: Q.FEET OF EACH FLOOR:
NO. UF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCT ON VALUATION(exduding land): $ 3��7Q� .� G
I hereby apply for a building perm t and I acknowledge that the informatian above is complete and accurate;
that the work will be in conforrn ce with the ordinances and codes of the City and with the State Building
Code;that I understand this is not perrnit and work is not to start without a permit;and that the work will be
in accordance with the approved lan.
APPLICANT'S SIGNAT DATE: �O I U b
31
Oct 10 2006 9: 29RM HP LRSERJET FRX 612-825-1900 p. 6
Se�.13.04 RIGH'fSiOF 9U8JECT8OF D TA
3ubd. 1. Type of dats. Tha right of individaal on w6om tde dna ia storod or ro be stored shell 6e as aet forth ia this section.
Subd.2.Infom�tion roquaed Oo given individual.An individwl asked to supply privste�confidentiai d�te conceming hanself sball ye
informed of'. (a)the purpc►ce and intended u oft6e cequested data witbia the eolleeting atate agency,political sabdivision,o�statewide sys�em;(b)
whu6erhe may refuse or is legally roquirod t aupply tha requested data;(c)any lo�own conaequence arisiog[rom hie supplying ar refosing to supply
ptivste ar wnfideutiel datp;wd(d)the idon ' of other peraon�or entidos authoriud by sbsbe or fede�al law to naive ttte dsta. This roquirertunt ahsU
mt apply when an individusl is askod to s ly investigative data,pursuant to aection t 3.82.subdivisioa S,to a law en8orcen►ent officer.
iastructioea inslaed of on those femns.
Sobd.3. Accass lo dsla by wdivid l. Upon iequost to a responsible authority,an individual efiap be infarmed whethar he is the subject of
sbored data on individuala,aad wbetber it is cl aifud as publie,private�confideatial. Upod his further requost,an bidividual who is t6e eubjectof
sto�private or public data on individuale a I be shovm iha data without any charge to him and,ifho desires,shell ha informed of tbe coatent and
m�eniog olthat deta. ARer m iodividual heo cen shown t6e privste data and infomied of ila meaning,the dsta nad not be disclosed to him for six
rnonths tlur�eRer uniees a diaputa oraction p rw�ant to d�is section is pending or additional data on the i�dividual 1�been collecTed or created. 'Ihe
r+eaponsible audwrity s6sil pmvide cogies of e private or public da�upon request by the individual wbject ofthe data. 'ftie�esponsible autl►�ity
rnay roquira the requating person ta pey dia tual costs ofmaking.canifying,and compilmg the wpiea.
Tiu reeponeible anthority sbell co ly inuc�ediately,if posaible.with any requaatmade pwsuaat to this subdivision,orwithinfrve�ys of
the date of tha raquest,exclading Seturdays,S s and legal holidays,if iauriediate complianoe ia no1 poasible.]Fhe caona com�ply wid►the rtquest
within thet time,he ahall so inform tbe mdivid I,and may bava an additionel Ptve daya within wbich to cc�oply witfi Iho request,excluding Sal�udays,
Smdsys and Icgal6olidsys.
Subd.4.Procedurewhoadetais accura6eorcomplete.Anindividuslmayoontesttheaeeuracyorcompletene�aofpublicorprivatedata
conca'ning himselE To ezeroisc t6is right.en 'vidual shall notify in writing Me responsible authoriy describing t6e�ture of t6e dise�eement. The
responw'ble authority ahall within 30 days e' r: (e)cocroct tha dem found to be inaccurate or inoomplou and atbemp�to nodFy paet recipients of
inaccum0e ar incomplde deta,i�luding rociy' ms namod by the individual:or(b)natify the individual thet he boliavas the daea to be conect, Data m
diapute shall be disdosed oaly if the mdividu 'e s0atwnent of disagreaneot is iacladod with dro disclosed dam,
The dotertaioatioa oP tfie roapoosi audwnty mey bo sppealed pnrsuant to tlio pravisions ofthe administrative procedure act rolaang to
wnfaeted casos.
12ATA PRIVACY ADVISORY
In accordance with M.S.13.04, ubd.2,"Rights of subjects of data",we would like to mforrn you thas your request
for a permit or license from tbe City of Orono or aay of its depar�nents may require you to fiu�nish certain privnte or
confideatial information.
You are notified that:
1. The information you ish will be used to deteimine your qualification for the permit or license
requested.
2. You may rofuse to su ly data,but refiisal may require that the City deay 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 'cense.
4. If your requested pe it a license requires Council action to approve, some inforrnation may become
public.
S. You have certain righ uode�M.S. 13.04(available upon request)to review private data on yoursalf.
6. Your full name is rey 'red to process this application or permit.
�t NORTHRUP R00 ING & REdM00ELING �t
4400 NICOLL T AVENUE SOUTH
Aaaress (612i 25•3353
C�h' State Zip Phone
I uuderstnnd my righta se stated a ve.
Si�uture
32
� TE TIME,/
CITY OF ORONO CALLED IN -� �
INSPECTION ICE �J SCHEDULED � /d' Dt��4�1i1
PERMIT N0. / COMPLETED �
ADDRESS
OWNER CONTR. /�
TELEPHONE NO. O l ' '�I '
� DESCRIPTION �D
� ❑ FOOTING � MECHANICAL ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINA ❑ FOUNDATION/REMOVAL
� OWN ONTRACTOR TO EET YOU• YES_NO
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W� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on ite:
Inspector._��� �
White Copyllnspecto�'s File Canary CopylSite Notice