HomeMy WebLinkAbout2003-P06263 - re-roof PERMIT
CITY OF ORONO Permit Number:
2750�elley Parkway- PO Box 66 P06263
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 5/2/2003
SITE ADDRESS: 1065 Tamarack Dr
Long Lake,MN 55356
PID: 26-118-23-31-0018
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 331.75
APPLICANT: Perkins Construction Inc. OWNER: Mr.&Mrs.Graham
2745 Mediling Ridge Rd 1065 Tamarack Dr
Plymouth,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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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Siznitures Required), 1-Avolicant, 1-Monthly Reports, 1-Assessim. 1-Finance Page 1
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)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTO
JOB SITE ADDRESS: U 5 T ' �' L A k ZIP: <-r
NAME OF OWNER: T l vim"15 � �C'�H�GYI PHONE: (home) 2- y'13- -5 5-
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(work) _5't0-^6
MAILING ADDRESS: 6 '> �% CITY: 6 4o
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CONTRACTOR: �,ef�iv5 <<'ti'�� PHONE: 7 6 IS ` 2-8o3 s—
CONTACTPERSON: L � L-Arf�.,.,S MO�UE/PAGER: 763 - y`�'Z' Y03<-
MAILING ADDRESS: 2 ?`�� qtr G.9rc;�v�f /`� CITY: ZIP: yY .
STATE LICENSE: # ��`
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail):
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.__
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ or `vo
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 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.
APPLICANT'S SIGNATURE: 6G��-�-.'C4 � DATE:
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himsel shall
be informed of: (a)the purpose and intended use of the requested data within the collecting State agency,political subdivision,or statewide tem;
(b)whether he may refuse of is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to pply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requiremen shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5,to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax fund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the ject
of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the s ject
of stored private or public data on individuals shall be shown the data without any charge to him and;if he desires,shall be informed of the co tent
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to h' for
six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual 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 auth wity
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with thereest
within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturc ays,
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 pri ate
data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagree nt.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipien of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. ata
in dispute shall be disclosed only if the individual'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 administrative procedure act relatin 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 requ st
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 request
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 proc s
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may beco e
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.
AL
First Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature
V
DATE TIME
CITY OF ORONO CALLED IN ✓ Z
INSPECTION NO-TIC NO-TICSCHEDULED Co
PERMIT NO. 2 3 COMPLETED
ADDRESS E>
OWNER CONTR. PC V--A hS
TELEPHONE NO. 3 ' 4 4 Z- - b SS
DESCRIPTION
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
2 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
ti COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W CORRECT WORK&PROCEED 11ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on
Inspector.
White Copy/Inspector's File Canary Copy/site Notice
F"— 5 DATE TIME
CITY OF ORONO CALLED IN /
INSPECTION NL T,JCF��� 3 SCHEDULED
PERMIT NO. tt''((�� COMPLETED
ADDRESS O _T 2 mar--V-
OWNER CONTR.
TELEPHONE NO. 4�L r ��
DESCRIPTION (� r L�la
1 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
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 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
v 10 PLUMBING FINAL YNO 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU: YES
COMMENTS:
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W� A RK SATISFACTORY:PROCEED El COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on lte:
Inspector.
White Copyllnspeclo File Canary Copy/Site Notice