HomeMy WebLinkAbout2004-P07387 - re-roof � -w ♦
�IT'� OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po�3s�
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: aii3i2ooa
SITE ADDRESS: 3045 Sixth Ave N
I.ong Lake,MN 55356
PID: 28-118-23-32-0008
DESCRIPTION:
Proposed Use: Residential �
Permit Class: Building Census Code �'"� C I �
Pernut Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 125.25 Valuation: $ 5,500.00
State Surcharge Fee: $ 3.25
TOTAL FEE: $ 128.50
APPLICANT: Maintenance Free MN,Inc. OWNER: 7ohn&Barbara Ryder
4216 83rd.Ave.N. 3045 Sixth Ave N
Brooklyn Park,MN 55443 Long Lake MN 55356
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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APPLIC T ITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Re4uired), 1-Atmlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ (��'� Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �D l .S� (�� G�JL � ZIP: ��S� 3 S �
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No If yes, a special event permit is reqteired with Police Department and City
Council approval 60 days prior to the event. Non permitted events will not
be allowed.
NAME OF OWNER: �� I1 �"� '�'� PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
!' y� � � �/� �� PHONE-C�63J ���a �lY/
CONTRACTOR: �n Q�li..�-�C ,
CONTACT PERSON: /'����G� MOBILE/PA ER:
MAILING ADDRESS: ��( 8,3�' �vt�� CITY: �� �n . ZIP: ss'Yy3
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeVAlteration_� Land Alteration
PROPOSED WORK(describe in detai�: T.Co✓ � �- �,�--�od�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�IATED CONSTRUCTION VALUATION (excluding land): $ �;7 �� .
I hereby apply for a building permit and I aclrnowledge 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 tart without a permit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE: DATE• �3�U�
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type o[data. The rIghts oC(ndividual on w6om the data ls stored or to be stored shall be as set forth tn this sectlon.
Subd.2. InformaUon required to be gtven individual. .�1n individual asl•ed to sapply p�(vate or contidentlal data coocerning himseltshall be
[ntormed of: (a)the purpose and inte�ded use ot t6e requested data within the co0ectiag state age�cy,political subdivision,or statewide system;(b)
whether he may retuse or is legally required to suppiy the requested data;(c)an�•laowa consequence arising from hIs supplying or retusiag to supply
private or conttdential data;and(d)the identity otot6er persons or eaHNes authoraed 6�state or federal law to recelve t6e data.This requlrement shall
not apply when an Indivldual is asl:ed to supply(nvesNgaUve data,pursuant to section 13.82,subd(vlslon 5,to a law enforcement ofticer.
The rnmmissioner o!revenue mav�lace the notice reoaired under this subdi�ision in the ind[vidual income taz or orooertv tax refund
instructions�nstead of on those(orms.
Subd.3. Access to data by indivldual. Upon request to a responsible aothorit�-,an Individual shall be informed r►�hether he 1s the subject ot
atored data o�individuals,and whether it Is clsssiRed as public,pm•ate or rnntideatia4 L'pon his further request,an(ndl�idual who is t6e subJect of
stored private or public data on indlviduals shall be shown the data without any charge m 6im and,if he des(res,shail be informed o[the content and
meaning of that data. After an individual has been shown the pricate data and informed of its meaning,the data need aot be disclosed to him forsix
months thereafter unless a dispute or act(on pursua�t to thls section is pending or add[tional data on the individual has beeo collected or created. The
responsible suthority shall provide copies otthe private or public data upoo request by the individual subject of the data The responsible authority may
require t6e requesting person to pay the aMual costs of making,certitying,and compiling the rnpies.
The responsible authority shail comply immediately,if possible,with an.-requtu made pursuant to thls subdivislon,orwithlo[ive days of the
date o[the request,ezcluding Saturdays,Sundays and legal holida�-s itimmediate camplia.oce Is not possible.Ithe cannot comply with the request wtthin
that time,he shall so inform the(ndividusl,and may have an add(dooa!five days w-hhla whic6 to comply wlth the request,eacluding Saturdays,Suadays
and legal holldays.
Subd.4. Procedure when data is aot accurate or rnmplete.An Individual mar contest the accuracy or completeness of public orprivate data
concerning himself.To exercise this rlght,eo individual shall notih-in writiag the responstble authority describing the nature of the dlsagreemenG The
responsible authortty shall within 30 days either: (a)correct the data[ound to be inaccnnte or tncomplete and attempt to nodfy past reclpients o[
Inaccurate or iarnmpiete data,including rectpients named by t6e individusl;or(b)nodf�the individual that he believes the data to be correcG Data in
dispute shall be disclosed only If the individual's statement oi disa,.reement is Indaded with the disclosed dsta.
The determination ot the responslble suthoriry may be appealed pursaant to the provistons of the adminlstrsti�•e procedure sM 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�ou that your request
for a permit or license from the City of Orono or an��of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The iaformation you furnish will be used to determine yoar quaGScation for the permit or license requested.
2. You may refuse to supply data,but refusal may reqaire that the City deny the permit or license.
3. The information may be shared with other local,state or federal agencies to the estent 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.13.0-3(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle
Last
Address
City State Zip Phone
I understan rights as stated ab e. .
Sig re
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��- �'��..� State of Minnesota Department of Commerce Licensing Division'
�� Department of Commerce Telephone: (651)296-6319
�. 85-7th Place East,Suite 600 E-mail address: licensing.commerce�state.mn.us
«�� � St. Paul,MN 55101-3165 Website address: commerce.state.mn.us
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�eya�►�arne Mk{�(VTE�IA�1�� FI�'�� A�N�NNESOTA IN� eus�n�ss structure
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Address: 42>`E�.Q3l�b AVE N '
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BROOKLYN PARK, MN 55443 "" "
License Identification Number: BC- 2O2CG�7 Qnaliiying Persam_ DANIEL LEE ENGEBRETS�N JR
License Expiration Dafe: 3/�'�/20�5 Contirwing.Education: 7 MTs CE due by 3I31/2005
DATE TIME �
CITY OF ORONO CALLED IN -�3
INSPECTION NO,T�CE SCHEDULED LI-//o -n�/ �°�'
PERMIT NO. /"C7 �3�7 COMPLETED
ADDRESS 3 U�S �i� �t/�
OWNER CONTR. �%�`�_ �i.cc /VI�
TELEPHONE NO. �� 3 S�� � ��I
� DESCRIPTION __ t�e�r o� � � �oa�
� O7 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/fILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPUUNT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FI 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL � 36 FOUNDATIOWREMOVAL
� OWNER/CONTRACTOR TO MEET YOU: ���YES_NO
y COMMENTS:
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W ORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WtLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next i spection 24 hours in advance. (g52) 249-4600
OwnerlContra i
Inspector.
White Copyllnspector'a FI Canary Copy/Sfte Notice