HomeMy WebLinkAbout1997-009506 - tear-off/reroof � PERMIT
��` CITY OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 =�:.?�_�_�
Crystal Bay, Minnesota 55323 Permit Number: ;; ;:.���,;;_,
(612)473-7357 Date Issued: -
SITE ADDRESS:
..�__._ � ��� ���,�`_".� f��
s_.
DESCRIPTION:
`°, �j ? ;—ij `,�:.:7 b=,.-,��Fil;.'�'.. . ... . . . . .�.. , . .. . _ _ '�(;; :;�.�Y�#,Y.;^St:i
._._:_ _ __. � . ._. i �F�^.... _�i+ 'iR� . .'., —...._
. _�_��, _`._;���, 't� .`:�1:'F:. . ,� , ... }�s,,r_�.�'1��__��_�
f_�?;_�_l� i_"p�y-�+.;� di.-`�, l-�f._ � . `:�_�w�.0�.'•��t`�T'�rii,_
REMARKS:
FEE SUMMARY:
__._._ . ::•r� . .w'_'7 . ;_"•��
:=:s s.,...;...:;.��•�_.�:� �: :;t�;
i_3�._.�.� _ ���.��_'._ �3 �.�:V":
CONTRACTOR: OWNER: ' � �
_ .. ,.. J4F:=.L?_
_ i-;`,. �-
�_.....» _ . . . . . . _-Ft",; _ ' =
� , �,. _, ._ ,_ ; _
.
a , __ •.�ii'1I+.�1�.�"��w�s ..c.�t<`_._ ._.. ._.� __ � ,.. ...,�.'t''E � ':a.E f�1'v`� ��.I s_ 1"*";�:�':�..,_ . �'._ � .� .. _ -
, .
� M'� __»:1F1C.i:.! f"f�M� ^t{_.r.�v._. ,''_' ���� . _ '; �. . .. ��"�"'i'�l�S:+� t_I�:!"}.
. � _
k , *�F .
,. , ', �i�� .... .: :
� ����.1��.1 f��iQ��l=i�+'�.�i' _ 'f�i _ � k. , �.. _ `s�'•,�'.. � '=x��� �`����:#�'°�`��� t_ �4._'._ . . . , . . . . . . �
,
APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE '
�
' Total Fee: $ Date Received:
Entered By: Permit#: ��.�;��;;C;,..,
CITY OF ORONO - BUII.DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------- ------------- .,�_�
TfiE APPLICANT IS: (circle one) �Q$�VE��R CONTRACTOR
JOB SIT`E ADDRESS: _�:�.�s �� '-" •�"l-vr �' ZIP• _s s-3 s-1 �,
NAME OF OWNER• /11�,�`.� `',��--��.P�f � PHONE: (home) =�%'� - o s i.e'
(work) �'�l�� �- �r g�a �
MAILING ADDRESS: ��l ;_ � jF',,�z� �--' CI1'Y: ��-�: G��/ �� ZIP: s�.3.�C�
CONT'RACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STAT'E LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration�_ Land Alteration
PROPOSED WORK(describe in detai�: ��.�,�� � ".-��� ���������i�� �._-, _
-� � ,
�t:� r•; r _c �_
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�, ,
ESTI�i IAT'ED CONSTRUCTION VALUAI'ION(excluding land): $ ���� —
I hereby apply for a building permit and I ackaowledge 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.
� �� -`-��-�'ATE: �'!' C��--�' ;' 7
APPLICANT S SIGNATURE: �'��
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.
__ _ __ _ .M��
Sec.13.04 RIGHTS OF STJBJECTS OF DATA
Subd. 1. Type oF data. The righc�of iadividual on whom the data is stored or to be stnred shall be as set forth in this secdon.
Subd.2. Informaaon reqirired to be given individual. An individual asked to suppty private or confidendal data concerning himself shall
be informed of: (a)the purpose and inteoded use of the requesced dara within the collecang�tace agency,polirical subdivision,or sratewide rystem;
(b)whether he may refuse or is legally cequired to supply ehe requesud data;(c)any known consequence arising from his supplying or refusing to suppty
privace or conndendal data;and(d)the idenriry of other persons or enades authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve dam, pursuant to secdon 13.82,subdivision 5, to a law enforcemenc officer.
The commis5ioner of revenue mav place the nodce reouired under chis subdivision in the individual income rax or orooem raz refuad
instrucdoru instead of on chose forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject '
of stored data on individuals,and whether it is class�ed at public,private or conhdenaal. Upon his further reques�aa individual who is the subject
of stored private or public data on individuals shall be shown the data wi[hout any charge to him and,-if he dasues,shall be informed of the content
and meaning of that dara. Afrer an individual h�s been shown the private data and informed of iu meaniag,the data need not be disclosed ro him for
six mon[hs thereafter unless a dispute or acaon pursuant to this secdon is pendiag or addidonal daca on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesang person to pay the accual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible, with any request made pursuant to this subdivision,or wichin five days of
the date of the requesc,excluding Sacurdays,Sundays aad legal holidays,if immediate compliance is not possible. If he cannot comply wi[h the request
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply wirh 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 compieceness of public or private
data conceming himself. To exercise chis right,an individuai shall nodfy in wridng rhe responsible au[horiry dzscribing the nature of the disagreemenc.
The responsible authoriry shall within 30 days either: (a)cornct the data found to be inaccurate or incomplete and attempt to nodfy past recipientc of
inaccurate or incomplete data, inciuding recipients named by the individual;or(b)nodfy the individual that he believes the data to be correc4 Data
in dispute shall be disclosed only if the individual's stacemenc of disagreement is included with che disciosed dara.
The determinadon of the responsible authority may be appealed pursuant to the provisions of the administradve procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri;hts 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
confiden[ial information.
You are notified that:
1, The information you furnish will be used to detemvne 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 shared with other local, state or federal a;encies to the exten[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.
/1� "� � l,Cl/f� � �'�..�-'.<�'�� -
�Fint Middle I.asc
� -� S� � "``' �j � i
Address
�
��.�-�„ �. �].,� � S- j, �� ����� — G�S ��—,
Ciry State Zip Phone
I understand my rights as stated above. �l
_
� �. .
�'
--'' '.�i � �� �f��
Signature
�JO �AT��i� TIME
CITY OF ORONO CALLED IN ��� •� au�
INSPECTION NOTI E SCHEDULED -L`Z�J�
PERMIT NO. connP�ETE
ADDRESS ��. �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION �Z'e �o�
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 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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
D COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O /I�CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
o ( `sEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS.
INSPECTOR WILL RETURN ❑ PHOTOTAKEN
❑STOP ORDER POSTED.CALL iNSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrac or on '
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN /D
INSPECTION NOTICE SCHEDULED � io ��
PERMIT N0. C1S0� COMPLETED W-i c� •S'� �
ADDRESS s ' �.7�.
OWNER CONTR. .11.�./�/
TELEPHONE NO. �7(.� -f).S/2�
� DESCRIPTION
W 01 FOOTINO 11 ECHANICAL RI 18 D(CAV/GRADINO/F�WNa
y 0� 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMa—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINO FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
a� �
t s �� p ,4,.v.�nr� nrC.�..�
0 �V-=� fl�--�
�
�
O
�
W
�
Q
�
2
W
�
W
�
�
� WORK SATISFACTORY:PROCEED - PROJECT COMPLETE
W
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,` pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor sit .
Inspector.
White Copyllnspector's File Canary CopylSite NoCice