HomeMy WebLinkAbout1996-008267 - tearoff-reroof —
�� PERMIT
�'ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �;i��'�[;j���;
Crystal Bay, Minnesota 55323 Permit Number: �.}t y:Nt.;�,�
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(612)473-7357 Date Issued: {_k,_<<;��.j,��
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPUCANT%PERMITEE SIGNATURE c ISSUED BY:SIGNATURE �
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Total Fee: $ Date Received: � �� ��
Entered By: Permit#: ,`�'�(G, �
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle on OWNER OR CONTRACTOR
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JOB SITE ADDRESS: �-3C� �� k`�� G�: � ZIP: �J-�S�
NAME OF OWNER: �c�,;c,� �= _ �( � C—� PHONE: (home) �� 3-��3��
(work) ��.�� � ��7c:,
MAILING ADDRESS: ��Q �� +c�� G�1C:� �CITY: �j��r��; ZIP: ��__z�
CONTRACTOR: c_�C:N a �� �r 1�E�` PHONE: `-�� 3 �"( ��)�'
CONTACT PERSON: ��J �'t,�S MOBILE/PAGER:
MAILING ADDRESS: �f3LL S,��c-(i, ��� �.! CITY: �-v�_�:� ZIP: .j����.
STATE LICENSE: #
ARCHITECT/ENGINEER: �C:,i�.� � \ � t=`� PHONE: =� ?': "� 3�-�f
MAILING DRESS: CITY: ���:"��- r�-' ZIP: •� 3�=�,
NAME: �; t� �r t.�> REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_� Land Alteration
PROPOSED WORK(describe in detai�: ���- - ��� t��SC�
'���; �z�{ c�� l� �,1�_. ��c=:� ���'f'�-j t=C_� ;.�.t• ��t��
STORIES: ( SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. � DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ i���-��-
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 Ciry 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 e approved plan.
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APPLICANT'S SIGNATURE: � ��4-' � -- DAT'E: `� � ( ��{ c(P
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[1B.TECTS OF DAT?�
Subd. i. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himseif shall
be informed of: (a) the purpose and intended use of the requested data wichin the colleccing"state agency, political subdivision, or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any I:nown consequence arising from his supplying or refusing to supply
private or confidenrial data;and(d)the idenrity of o[her persons or enaries authorized by sta[e or federal law to receive the data. This requiremenc shall
not apply when an individual is asked to supply invesdeaave data, pursuant to section 13.82, subdivision�, to a law enforcement officer.
The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or propertv tax refund
instcuc[ions instead of on[hose forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subjecc
of stored data on individuais, and whecher it is ciassified as public, private or confidendal. Upon his further requesc, an 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 desires, shall be informed of ihe content
and meaning of[hat data. After an individual has been shown the private data and informed of its meaning,che data need not be disclosed to hun for
six months thereafter unless a dispute or acrion pursuan[to this section is pending or addiaonal data on the individual has been collected or crea[ed.
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 che requesting person to pay [he actual costs of makine, certifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of
the date of the reques�,excluding Sa�urdays,Sundays and leeal holidays,if immediate compliance is noc possible. If he cannoc comply with the request
within that time,he shall so inform the individual,and may have an additional 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 privare
data concerning himself. To exercise this rieht,an individual shall noafy in writing the responsible authoriry describing[he na[ure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipiencs of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the 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 administnrive procedure act reladn; to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�ts 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 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 pemut or license.
3, The information may be shared with other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council ac[ion 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.
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I understand my ri?hts as stared ab e.
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Signa[ure
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DATE TIME
CiTY OF ORONO CALLED W �� '
INSPECTION NO ICE SCHEDULED �
PERMIT NO. •�Z�"7 COMPLETED �_ �
ADDRESS �.c.���
OWNER CONTR.���
TELEPHONE NO. ��� -- `�/3�d'
� DESCRIPTION �-. .
� 01 FOOTINQ 17 MEC ICAL RI 18IXCAV/GRADINa/FIWNQ
�Q t AM j� 13 MECHANICAL FlNAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
�+ 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WOHK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITtON WITHIN HOURS. r pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR =�'CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnedContractor.ort—i�: �
Inspector. u
White Copylinspecto�'s File Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN I-/4
INSPECTION NOTICE SCHEDULED '� ` � r � � � <'
PERMIT NO. t��C �� COMPLETED �_
ADDRESS ���� C-�i k��< </"
OWNER /�:' �' :<� l.i' �` C��CONTR. `-`
TELEPHONE N0. / � � ' ' � �� 'y
� DESCRIPTION �� �" t .r-r-
� Ot FOOTING 11 MECHANICAL J� 18IXCAV/GRADINQ/FIWNd
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALI BD. 72 WATER HOOK-UP 17 SITE INSPECTION
Q A
_�0`5_FINAL ' 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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d ORK SATISFACTORY:PROCEED
W� ROJECT COMPLETE
W ORRECT WORK 8 PROCEED � SSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORAFY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. r- pHOTOTAKEN
INSPECTOFi WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �^ CITATION ISSUED
❑ INSPECTION HEQUIRED.CALL TO ARFiANGE ACCESS.
Call for the next ins ction 24 hours in advance.4T�73S7
OwnerlContra o site
Inspector.
White Copyllnspector's File Canary Copy/Site Notice