HomeMy WebLinkAbout2003-P06578 - re-roof .�.. . 1�
PERMIT
CITY OF ORONO Permit Number:
27�0 Kelley Parkway- PO Box 66 P06578
Crystal Bay, Minnesota 55323 Permit Type: MinorAiteranons
(952) 249-4600 Date Issued: ��23�2003
SITE ADDRESS: 445 Spring Hill Rd
WAYZATA,MN 55391
PID: 25-118-23-34-0003
DESCRIPTION:
Proposed Use: Residential
Pernrit Class: Building Census Code O/S-Building
Pernut Type: Minor Alterarions Pernut Sub-type(s): B�lding-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 209.25 Valuation: $ 12,000.00
State Surcharge Fee: $ 6.50
TOTAL F'EE: $ 215.75
APPLICANT: All Weather Roofmg OWNER: R J NIGON&M E IVIGON
2101 East 26th. St. 445 SPRING HILL RD
Minneapolis,MN 55404 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required). 1-Auulicant,1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
�� � " �Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUIIrDING PERMIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: `r�Y S� � /� �`�s �.' // i2c� ZIP: S-S 3,� �
NAME OF OWNER:_ 2 ��� �� N�'� v � PHONE: (home) 9 SZ Y�G� p� 6�
� (work)
MAILING ADDRESS: S�y S- .S P -•'nf N,'/l��CTT'y o P-� •,o ZIP:�.s 3 9 �
CONTRACTOR: � r� (�(�-�c��e � t�oo.� I'r, PHONE: ��Z� �2 i - 2 S'Y.S`
CONTACT PERSON: I •-, c � t- MO ILE/PAGER: �/ 2 2 ('o �o(a 3
MAILING ADDRESSi Z /a l L-'c S� 2 6'`�Sf' CITY: �/l f� ZIP: S'S"uoY
STATE LICENSE: # S`Q 3 Sr �
ARCHITECT/ENGINEER: PH���
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move � RemodeUAlteration� Land Alteration
PROPOSED WORK(describe in detai�: 'Te�.- o��'� F��� 1��v� a0o�,.h �`� � c �
� ,,
l�Lt 7��o h. �'+ �o S� h /D�. �o.o � 1/2 n e i l�C��i e r �o f�'n r O /'!� l i.� Poly/so C/'c�J�C
` h � �� ��Y a, s�e �yS`m;� � � 7 e>r�ic. ! �l�S�� � r�o aresr,�rrP
STORIES: 1 SQ.FEET OF EACH FLOOR: � �C Z o
NO. OF BEDROOMS: . GARAGE STALLS: ATT. DET.
o a
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � j�� ��°'
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 pernut and work is not to start without a
permit; and that the work will be in accordance with the a proved plan.
APPLICANT'S SIGNATURE: ��— DATE: 7 Z � a
NOTE! Parade of Homes events require separate permit approval by Police Deparlment 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[JB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be sto�ed shall be as set forth in this secdon.
Subd.2. Information reqirired to be givea individual. An individual asked W supply private or confidential data conceraing himself shall
be informed of: (a)the purpose and intended use of rhe requested data within the collectiag rtate agency,political subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requesud data;(c)any known consequence arising from his supplying or refusing to supply
privau or confidendal data;and(d)the identiry of other penons or enriues authorized by state or federal law to receive the data. This requirement shall
not apply when an individual u asked to supply invesdgadve da[a,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or pronertv taz refund
insnvedons inscead of on those focros.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individuai who is the subject
of stored private or public data on individuals shall be shown the data wirhout any charge to him and,-if he desires,shall be informed of the content
and meaning of chat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
siz months thereaher unless a dispute or action pursuant to this section is pending or addidonal data on the iadividual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesdng person to pay the actual costs of making,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 dau of the roquest,exciuding Sarurdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal 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 individua!may conust the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall nodfy in wri[ing the responsible authority describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomptete and aaempt to nodfy past recipients of
inaccurate or incomplete data,including recipients named by rhe individual;or(b)noafy the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the adminisnarive 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 permit or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential infomzation.
You aze notified that:
1. The information you fumish 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 shared 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.
First Middle Last
Address ,
City State Zip Phone
I understand my rights as state above.
a.
signacure
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DATE TIME
CITY OF ORONO CALLED IN s���
INSPECTION N E SCHEDULED '7-28-03 �
PERMR NO. COMPLETED
ADDRESS y�-� �/�i"f� f-��lI /��'
OWNER CONTR. ��� �-�� /Ur�l
TELEPHONE NO. L�/��a �� ���0�
� DESCRIPTION ��L[_�" !3� '���
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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 FOUNDATIOWREMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OHDER POSTED.CALL INSPECTOH
O CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
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Inspector.
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