HomeMy WebLinkAbout1999-012271 - replace windows � � � PERMIT .
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 Permit Number: 'Y"3 �' ''�` �";=
Crysta� Bay, Minnesota 55323 '-`�•��s�
(612) 249-4600 Date Issued: -:::# -. ;,:,m;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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�Pf'I ICAN i P MITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information must be submitted in fiill before plan review will be started.
(please print all information)
TI� APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �g`Z� U�ho�/�h� �� ZIP: ��32/
NAME OF OWNER: �eph �a�csc�er�da-�,-PHONE: (home) �7l- ��30
(work)
MAILING ADDRESS: �.5� v`��h� T�i-: CITY: O!�'o�r o ZIP: ,����i��
CONTRACTOR: �1iLn.� Y, ra-G e'vr PHONE: �72�- �?�!�
CONTACT PERSON: l `—' h n a��- MOB /PAGER: ��'�-g��cc�
MAII.ING ADDRESS: .` CITY: � ZIP:y��
STATE LICENSE: #
ARCHTTECT/ENGINEER: ---- PA���
1�ZAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration�_ Land Alteration
PROPOSED WORK(describe in detain: r'
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STORIES: �_ SQ.FEET OF EACH FLOOR: 1� ��-/
NO. OF BEDROOMS: �� GARAGE STALLS: ATT. ,2 DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ `�����
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a perrnit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: 1�� !���'�
NOTE! Parade o�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.
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Sec.13.04 RIGH'TS OF SLJB.TECTS OF DATa
Subd. 1. Type of data. 'Ihe righc�of individual on w6om the data is s[ored or w be stored shall be as set forth in this section.
Subd.2. Informaaon reqirired to be giren iadividual. �1n individual asked to supply private or confidendal dara concerning himself shall
be informed of: (a)[he purpose and in[ended use of rhe requesce�data within�he collecdng i�te agency,polidcal subdivisioa,or sracewide rystem;
(b)whe[her he may refuse oY is legally required to�uppty the requested data:(c)any known coasequence arising from tus supplying or refusing to suppty
privau or confidendai data:and(d)the idendry of ocher pecsoas or entioes authorized by srare or federal law to receive[he data. This requiremenc s6a11
not appiy when an individual is asked to supply invesd¢adve data,pursuanc to secdon 13.82,subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav pla� the nodce rewired under this subdivision in the individual income tax or aropertv raz refund
instrucdons instzad of on those forms.
Subd. 3. Access to data by individual. Upon request ro a responsibte auchority,an individual shall be informed whether he is the subjecc
of scored data on individuals,and whe�her it is classified as public,privace or confidendal. lipon his further request,aa individual who is the subjecc
of stored private or public data on individuals shall be shown rhe data wichouc any charge to him and,�if he desires,shall be informed of the content
and meaning of[hat data. Afur an individuai has been shown the private data and informed of iu meaning,the data need not be disclosed to him for
six monrhs thereafter unless a dispute or acrion pursuant to chis secdon is pending or addidonal dara on the individual has been collected or created.
The responsibie au[horiry shall provida copies of fie private or public data upon request by[he individual subject of the data. The responsible authoriry
may require the requesring person to pay[he acaal cosu of making.certifying,and compiling the copies.
The cesponsible authoriry shall comply immediate(y,if possible,with any request made pursuant to this subdivision,or within five days of
the dace of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply with the requesc
within rhat time,he shall so inform the individual,and may have an additional five days wi[hin which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate
data conceming himself. To exercise[his right,an individual shall nodfy in wri[ing the responsible au[horiry describing the nature of the disagreement.
The responsible auchoriry shall within 30 days eit2:er: (a)correcc[he data found to be inaccurate or incomptete and attempt to nodfy past recipienu of
inaccurate or incomplete data,inciuding recipiencs aamed by the individual;or(b)nodfy the individual that he believes the data to be comct. Data
in dispuce shall be disclosed only if[he individual's statement of disagreement is included with[he disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to
conresred cases.
DATA PRIVACY ADVISORY
In accordance 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 fumish certain private or
confidential information.
You are notified that:
1, The informacion you furnish will be used to detemune 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 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.
�, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
Fint �id�z Last
Address
City State Zip Phone
I understand my ri�hu as d above.
S�gnacure
DATE TIME
CITY OF ORONO CALLED IN � �'S
INSPECTION NO/�TICE SCHEDULED �� `�'`-' `- �J G
PERMIT NO. f��•CoZ �I� COMPLETED 1=' '�.�Q �_
r
ADDRESS � Z -
OWNER CONTR.
TELEPHONE NO. �� _'���f' 'CP�o
� DESCRIPTION �,G��n�r�
L� 01 FOOTING 11 MECHANICAL 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 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-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 PLUM 36 FOUNDATION/REMOVAL
Q OWNE CONTRACTOR O MEET YOU:��ES_NO
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d �ORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
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� ❑ CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE COND�TION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR 17 CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector. ��.�� �����
White Copyllnspector's File Canary CopylSite Notice