HomeMy WebLinkAbout1999-011568 - part tearoff/reroof PERMIT
�ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �-;'`I� L�T C���=�
Permit Number: �_;r � �r:�:
a Crystal Bay, Minnesota 55323 Date Issued: �' _
(612)473-7357 . - -
SITE ADDRESS: I
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DESCRIPTION: ------------------ —
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE I ED BY:SIGNATURE �i��
Tota1 Fee: $ Date Received:
F,ntered By: _ .C''�i-� Perm.it#: / � ,� . _
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review �-ill be started.
(please print all information)
THE APPLICAi�'T IS: (circle one) ONNER OR CONTRACTOR
JOB SITE ADDRESS: ��%� 5� �� 1 `j� � l� � ZIP:
NA1�iE OF Oti�'ER: PFiONE: (home)
(work)
I�iAII.Itii TG ADDhESS: CITY: ZIP:
C0��1'I'RACTOR [� ��1��,I� �6�-� ( °C�� ��h PHONE: �/l���i,'�
CONTACT PERSON: � GlC� NiOBILE/PAGER:
MAII�I�'G ADDRESS: � O � '^ �T'Y: ZIP:
STATE LICENSE: # �,� C/
ARCHITECTlEI\'GII�TEER: PHO�'E:
1�7.AII..I1i TG ADDRESS: CTTY: ZIP:
NAI1��: REGISTRA.TION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED'�VORK(describe in detai�: �1� �i ic��� � � '�--v�� ���
��`��--�-G�-'�.�-,E'-�� i�'7`_� �>�'� ? �-'��� ��}�f .D o G f��,�'
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STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GAR.AGE STALLS: ATT. DET.
ESTJI�IA.TED CONSTRUCTION VALUATION (excluding land): $ � �4/�� �
I hereby apply for a buildino pernut 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 permic and work is not to start without a
permit; and th�� the work will be in accor anc with the approved plan.
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APPLICAi��''S SIGNATURE: � ' ' � '? `,' DA'�E: � 1 �
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed. �
. �
Sec.13.04 RIGKTS OF SUBJECTS OF DaTA '
Sabd. 1. Type o[data. The righcs of individual oa whom the data is smred or co be swrcd shalI be u sec focch ia this secrion.
Subd.2. IntormaHon required to be givm tadi,•fdual. �1n iadividual uYed w suppty private or confideadal daa coacerniag himself sha21
be informed of: (a)the purposa aad iacended use of che requesred daa wirhia the eollecdng State ageary.poliacal subdivisioa.or sratewide rysum;
_ (b)whe�er he may cetuse oti is,legally requir:d to supply the requesud data:(cj any Idsawu caauqueace arisiag from his supptying or reftuing to suppiy
privace or confideaaa!data;and(d)the idendry o[o�her persoas or encdes auchacized by snce or federal law to trceive the data. 'Ihis requiremeac shall
not appiy when an indiv.iduaI is uked to supply invesdgzdve daa,pursuanc to secdoa 13.82,subdivisioa S.w a law enfoccemeat ofScec. .
The eer.imissioner of rcvenua mav otace che nodce r.auired undu chis subdivision in the individua! income tax or orooectv taz refund
insaucdons inscead of on those forms.
Subd.3. Aecess to data bv individuai. Upon rcquesc to a responsible authoriry,an iadividual shall be informed whether he is the subjecc
of stored dae ort individuats,and whecher ic is classiFied u pubGc,privace oc confidencal. Upan his further requesc,aa iadividual who is rhe subjeu
of stored privace or public daa on individuals shall be shown the dan wirhout any charge oo him and;if he desires,shalI be informed of the coatenc
and meaning of chat data. Afur an individual has been shown the priva�e dam and iaforaud ot ict meaning,the dara need not be disclosed oo hua for
siz mondu thereafur uniess a d'�spute or acdon pursuanc to this secdon is panding or addidona!dara on the individual has been coUeued or creared.
Zhe responsible auehoriry shall'pcovide copies of the private or public daca upon cequest by the individual subject of the dara. The raponsible authority
may require che requesdng person to pay the aceual cosu of making,cecdfying,and eomp'iling the eopia.
The cesponsible authoriry shall eomply immediatety.if possibte,wich any tequest made pursuanc to this subdivision,or within five days of
the date o[the cequesc.excluding Satutdays,Sundays and legal holidays,if immediace compliance is not possible. If he canaot eomply with the request
wirhin chat dme,he shatl so inform the individual,and may have an addidoaal five days withia which to compiy wich the request,excluding Saturdays,
Sundays and legal hotidays. �
Subd.4. Procedure when data ts not aeeurate or eomplete. M iadividual may contest che accuracy or completeness of public or private
dara conceming h'�msdf. To ezercise chis right,an individual shall aodfy ia wriciag the respoasible auchoriry describing che nature of the disagreemeac
The respotuible authoriry shall within 30 days either: (a)correct che dara faund w be inaccurate or incomplete and atumpt to nodfy past recipiencs of
inaceurate or incomptece data,including recipienct named by the individual:or(b)nadfy the individua!that he believes the data to be correcc Data
ia dispute shall be disclosed only it the individual's stacement of disagreement is included wi[h the d'uclosed data.
'It►e decemunaaon of[he responsible auchoriry may be appealed pursuanc to the provisioas of the administradve procedun aet relaang to
contesud cases. •
DATA PRIVACY ADYISORY
In accordance with M.S. 13.04,Subd.2, "Righcs of subjects of data"�we would like to inform you that your request
for a permit or license from the Ciry of Orono or any of its deputments may require you to furnish certain private or
confidential information.
You aze 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 shazed with other local.state or federal a�encies to the ettent 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 (availabte upon request) to review private.data onyouurself.
6. Your 11 n is re ired to process this application or permi[.
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Ciry Sate Zip Phoae
I understand ri;hts a�s stated above.
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Signamre
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE� � SCHEDULED —r '�
PERMIT NO.� �..( S � CO�pPLETED
�r� �f
ADDRESS�,��.� , « -�y ' G'• ---
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION (��G �� �z�� �
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 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 0 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL flEfURN
❑STOP ORDER POSTED.CALL INSPECTOR �7 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr n t .
Inspector.
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