HomeMy WebLinkAbout2009-00743 - doors CITY OF ORONO PERMIT NO.: 2009-00743
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 10/21/2009
952 249-4600 FAX: 952 249-4616
ADDRESS 1340 VINE PL
PIN 07-117-23-42-0031
LEGAL DESC SAGA HILL REVISED
LOT 000 BLOCK 017
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,915.00
NOTE: REPLACE(2)PATIO DOORS-NO CHANGE TO ROUGH OPENING
APPLICANT PERMIT FEE SCHEDULE 132.75
HARMONY HOMES INC. STATE SURCHARGE(VALUATION) 2.96
1120 WINTER ST.NE
MINNEAPOLIS,MN 55413- MAIL-IN FEE 2.00
(763)413-1100 TOTAL 137.71
Minnesota State License#:20501883 PAID WITH CC# 6201
OWNER
CHERBA,RICHARD
1340 VINE PL
MOUND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due use.
lel 9/
Applicant Permitee Signature Date
fs6kd By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
10/20/2009 13:41 7634344933 HARMONY HOMES INC PAGE 04
Total Fee: S �' �! Date Received: 10/2j/O
Entered By: Permit#: —O
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 ONTRACTOR UU
JOB SITE ADDRESS: 13 VO &E. PIVV- � TZIP: 0
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑Yes M No Ifyes, a special event permit is required with Police Department and Ciry Council approval
60 days prior io the event. Shuttle bus service will he required unless applicant demonstrates
uicient on-site parking is available. Non permirted events will not be allowed.
NAME OF OWNER. CIL- g PHONE: (ktome) 7rZ 177-51
P
n (work)
MAILING ADDRESS: 3 l f- CITY: kM ZIP: f 5 q(a
CONTRACTOR: eok L PHONE: 174 S-O�Z
CONTACT PERS 14 MOBILE/PAGER: 11 Z� -d5z L
MAILING ADDRESS: t 7-N m CITY: 1 ZIP- SLI0 3
STATE LICENSE: #� ��s '� EXPIRATION DATE: 3 t
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGIS'T'RATION: #
TYPE OF WORK: New Home Addition Accessory tore
Move Home Remodel/Alteration(ie: Siding, indow5 �A� g
Any earth mov t may require MCWD re ' ew and rmats!
PROPOSED WORK(describe in Wall): I mo,*1 Z N-Ma Qp IZ S
P T'b --
S ORIES: SQ.FEET OF EACH FLOOR:
.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): S ( 5
II iereby apply for a building permit and I acknowledge that the information above is complete and accurate;
th it the work will be in conformance with the ordinances and codes of the City and with the State Building
C dc;that 1 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 approv
f4APPLICANT'S SIGNATURE• DATE: Lo—1-6 -
3l
10/20/2009 13:41 7634344933 HARMONY HOMES INC PAGE 03
Sec.11.04 RIGFPrS OF SUBJECTS OF DATA
Subd. I. Type ofdam. The rights ofindividual on whom the data is stored or to be stored shall be a.4 vet forth in this sactiorm,
Subd.I. information required to be given individual, An individual asked to supply privyte orcenftdential dam conecming himicirshall be
infirrmed or (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statowide system;(b)
wlethcr he may refuse or is legally required to supply the requested data:(c)any known consequence arising from his supplying or refu4ing to supply
privntc or confidential data;and(d)the identity of other persons or entities aurhorizcd by wire or fcdenl law to receive the data,This requirement x1311
not apply whet+an individual is asked to supply investigative data,pursuant to section 13.8,,subdivision 5,m a law enforcement Officer.
1bgcommisgioner f vcn a notice req>Lrra undeLrh"it visin.1n the individual income ._�.
iasttuctions�gstcad of nn those form`, �x.+•��tar iefuLrd
Subd 3. Access to data by individual, Upon request to a responsible authority,an individual shall he informal whether lie is the subject of
stared data on individuals.and whether it is elassifled as public,private or confidential. Upon his further request,an individual who is the subject 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 content 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 him for silt
months thereafter unless a dispute or action pursuant to this section is pending or additional date 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 authority
may require the requesting person to pay the actual costs of making.certifying,and compiling the copies.
The responsible authority shall comply immediately,ifpossiblc,with any request made pursuant to this subdivision,orwithin five days of
The date of The request,cxcluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannotcomply with the request
within that time,he shall so inform the individual,and may have an additional five days within which ro comply with the request,excluding Saturdays.
Sundays and legal holidays.
Subd.4, procedure when data is not accurate oreomilicte,An individual may contact die accuracy orcompleteness of public or private dam
concerning himself, To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the diangreement.The
responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notifyt pearecipiof
ents
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 the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedurc act relating to
contested cases.
i
DATA IVACY 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 famish certain private or
confidential information.
You are 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 liccnse,
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.
61 Your hull name is required to p ss this application or permit.
First INiddre
Last
Address
al �5 / i Z.Z3 -C)52 L
carr
State Zip Phone
1 understand rights as stn above.
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DAT TAME
CITY OF ORONO CALLED IN 1d-�b
INSPECTION NOTICE / SCHEDULED
PERMIT NO. 06�74T 5 COMPLETED
ADDRESS 1344 VIA-f- PI
OWNER CONTR. k�n&Te'!j
TELEPHONE NO. _NO3 `ft3 110D
r
DESCRIPTION pah'0 Na_t
❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q El FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
41 ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
ztj
v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
vOi COMMENTS:
W
Q.
O
O
W
W
W
Q
Z
W
W
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W ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ IS E CERTIFICATE OF OCCUPANCY
QO ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj 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 site:
Inspector. I r !l
White Copyllnspectoes File Canary Copy/Site Notice