HomeMy WebLinkAbout1996-008027 - overlay/re-roof ,� ,� PERMIT
' CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �;a�7��y�����
Crystal Bay, Minnesota 55323 Permit Number: ���;,�;r x:;�7
(612)473-7357 Date Issued:
t_l�%:�:�,�'�:t��
SITE ADDRESS:
:'li!i� ��T�� t�VE t�E
L`;;V
F. � . P�. _ �'?—�.�:_,—�:�c—:=:i—i ytjs'�.
DESCRIPTION:
��:i�'�'�;!��'i�;F--�t:i iF
���il��ii��� F`Wrr,•►it. TYF�N °=�1=—HDG��iEi•1���EL
���.�� l.=�i.�-�� W�w���k: Ty��=}� �;E—�;i:j��E�
�•H1lSt,tS [..!_�t��+ �.•'�- r��T . �t�•_�I C'Ei`1 I I t-�L.
REMARKS:
FEE SUMMARY:
`z!f—�`iE_E fi���1_Il1� �',�`j L�.�_,{_7
Ls�=�'n 7—F_Y �b�'f:4 . f� .
•w����sr��C�} �...'�r�' __�..-_....__ �a�sdr�
! i_.s�,ri,� ��F_ ^�j�i , `:`-i
CONTRACTOR: — H����i i c L�-�t. — '�;�1' . L I C: OWNER:
�1�_i(���:�_i� t'arit�'=:TR�f�.:TIi��h� Il��: ���:°��:,:��;=,� ��.:=.�_, f_��:r��►�� �tii����iL�ru�) k+�i{��
�.i;�,�,�°iy 1i;�7H t�'JE t�l ��li}t� �,TH Ai�E C�i
���'L� C��;i:fVE !*it.� �;�:�;�,�� t_��;�:i�i� t�"� ��:=:��.
(h � ;) —F�':=',=�-` i i= '�i. 7:?—i i:=��.:_'
��.� �+�.,:'.� _.� . .��.�_. � _ . _
-�'�-!c ,_.�ai)�`;'.;?I.t"�r-I�} I-i F=��i"� �;;-,r��i i-,:-�I '.- I'"�t'".i�'�''I t � = I=_1 t'� �:.»� 3 r,��y_ j i_ �;:�^;� �;¢?'"`�.3��'w'-.�'I� �! �-
_.t-.= _ _.�i__ . ._....,__� . !�r••.�... t��_ ('
'=�i=`�=_�1����' fll�� f-��7•=`?��`=� �3_� =11.�� f-�t._� �}.��_'•�''.�'��. ii'a `,�1�?1:.�� �_!_��'��"`E.._�f�=`��.�`::_ ','? �.Ys"� r il....�_ �-..,,1. ; '7'� !..it'
�iE-�`�ii+�!i .�i �}T r� i!!4�r '—' 1} —:�;�':': '- #i`' �:':�'�ii Ut-'—�l�;�� �-��� �3 i �,i z �['I!ii- t;= i! t .�'-�
L _ _. _. _�_ J.�.�E. •i•_� �'i�� _. . . _... �.i . . . . .. .. �� ... _ �.�_. i'.� �..�_ _.. . _.. �.., ... . I
�
� �
APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
, �
. Total Fee: $ DateReceived:
DateApproved:
Entered By: ���C� Permit#: ��'� 7
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL IVFOR1titATION�NST BE SUBl�1IT'TED P1 FULL BEFORE PL��T REVIEtiV tiVII..L
BE STARTED
----------------- ----�-------
THE APPLICr��tT IS: (circle one OWivER CONTR.ACTOR I
JOB SITE ADDRESS: �OD ZIP:
NANIE OF O`VNER: �,/L-�-�> (,���v'mz. PHO�tE: (home)��73 —��'S�
(work)
MAILINGADDRESS: s�( �n,-�- CITY: ZIP'
�
CONTRACTOR:`Yl ohson o h S''�r �l�� PHONE: �a-S� � �� 2- (
I�IOBILE PHOiVE/PAGER: �
MAILINGADDRESS: /U6�v— lOS a�-�'Go__CITY�� ZIP: SS3b 9 I
STATE LICENSE: # S f 3 � �
i
�
ARCHI'TECT/ENGINEER: PHOivE:
i1�IAILINGADDRESS: CITY: Z�:
NAiV1E:
REGISTRATION # '
TYPE OF WORK' New Addition Accessory Structure �
Move RemodellAlteration Land Alteration
PROPOSEDWORK(describeindetail): r�� I���� -
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET.
ESTIMATED CONST'RUCTION VALUATION(escluding land): $_��g� ^
I hereby apply for a building permit and I acknowled�e 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 permit 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: � —3( — � 6
NOTE! Parade of Homes e uire separczte permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
'� �
:
Sec.13.04 RIGHTS OF SLJBJECTS OF DATA
Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stor�d or to be stored shall be as set forth in this secdon.
Subd.2. Iaformation req�red to be given individual. An individual asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and intended use of che requested dara wi[hin the collecdng§rate agency,polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or co�dendal data;and(d)the idendry of other persons or enudes authorized by state or federal law to receive the dara. This requirement shal!
not apply when an individuat is asked to supply investigaave daca,pursuanc to secdon 13.82,subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv taz refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible au[horiry,an individual shall be informed whether he is the subject
of stored dara on individuals,and whecher it is classified as public,private or confidendal. Upon his furrher request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wid►ouc any charge to him and, if he desires, shall be informed of the content
and meaning of that data. Aher an individual has been shown[he private dara and informed of ics meaning,the data aeed noc be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to chis section is pending or addidonal data on che individual has been collected or creaud.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting penon to pay che accual cosu of making,cectifying, and compIling the copies.
The rosponsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exctuding Satutdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidonal five days within 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 private
data conceming himself. To exercise chis right,an individual shall notify in wriang the responsible authoriry describing the nature of the disagreement.
The rosponsible authority shall within 30 days either: (a)correcc the dara found to be inaccurate or incompleu and aaempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be cornct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is inctuded wich the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the adminisuadve procedure act relating to
contested 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 pernut or license from the Ciry 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 license.
3. The information may be shued 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.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�
p�nt Mid Last
.�062� � 105�' �- ��
Address //
� %�^ ��3 61 7 c�-�6oZ8'2'
Cih, State Zip Phone
I un erstand y righu as stated above.
Signatu
�
DAT '�/ TIM�
CITY OF ORONO CALLED IN n � %
INSPECTION NOTI SCHEDULED
PERMIT NO. 4 a COMPLET
ADDRESS /DO .- ��� (JE
OWNER �rCb(�i�DC.�4�V� CONTR.
TELEPHONE NO. �`a�
� DESCRIPTION f J^ �C?A-L ��601�
� 01 FOOTiNO 11 MECHANICAI.RI 18D(CAW(iRADiNGUFlWN�
�Q 02 FRAMINO 13 MECHANIGIL FlNAL 19 LAI�SHORFJWETLANDS
Q 03 INSULATION 24/2S WOpD BURNER/FlREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FlNAL 14 SEWER HOOK-UO O6 PROORESS
Z
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
W 07 DEMO—FlNAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= OB PLUMBINO RI 23 SEPTIC FlNAL 35 HARD COVER FiEMOVAL
v 10 PLUMBINO FlNAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YE8_NO
y COMMENTS:
�
W
a
J
O
a
o�
0
�
W
�
Q
�
2
W
Zi
W
�
�
d WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-7357
OwnerlContra o s
Inspector.
White Copyllnspector's File Canary Copy/Site Notics