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Home My WebLink About2004 - P07994 - re-roof PERMIT �.IT�' OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P07994 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 9/28/2004 SITE ADDRESS: 210 Willow Dr N LONG LAKE,MN 55356 PID: 34-118-23-32-0004 DESCRIPTION: Proposed Use: Residential BuildingCensus Code 0/S-Building Permit Class: Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 5,000.00 State Surcharge Fee: $ 3.00 TOTAL FEE: $ 114.25 APPLICANT: Roen Roofing and Remodeling OWNER: RONALD E MILLER 1022 Meadow St. 260 WILLOW DR N Cologne,MN 55322 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. Xf .40 // �A • / APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE Copies: 1-File(Siinitures Required), 1-Applicant, 1-Monthly Reports. 1-Assessin2, 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) THE APPLICANT IS: (circle one) OWNER OI�CONTRACTOZ JOB SITE ADDRESS: -270 w I 1 ` got ZIP: 55-35-a Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? n Yes [ No If yes, a special event permit is required with Police Department and City Council approval 60 clays prior to the event. Non permitted events will not be allowed.,,�j NAME OF OWNER: (2---° / ' ' I PHONE: (home) 5-z- y 73-/ 2-6 c 1,.)r i/0 gef (work) MAILING ADDRESS: 2 7 " 7.0 f'tCITY: O, )O ZIP: tk CONTRACTOR: / 1,6-1"-) Peery `� P j^,+ e �� PHONE: 73-.Z - /C6 "-2. 7 2-S{ CONTACT PERSON: e-3;e MOBILE/PAGER: 6/2 -S 7 - 7 7-/ MAILING ADDRESS: /d 2 z 4E'4 P" - CITY: �'o�f S ZIP: 5-Ic] 2 2- STATE STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detail): J / STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 0-0 ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 5; 44° 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: DATE: 2 �� / • 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 himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement 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 refund 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 subject of stored data on individuals,and whether it is classified 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 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 authority 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 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 private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients 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 the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 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 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 stated above. Signature Ve 9 TFry TIME \/ CITY OF ORONO CALLED IN /� �•6 INSPECTION NO Q SCHEDULED 7'0?8 0cf PERMIT NO. • .9 Y COMPLETEDnnt.. ADDRESS a 70 Gvi// � Al OWNER CONTR. / /2-0012-46-1 TELEPHONE NO. 9'S2- WQ47 Z728' DESCRIPTION / ea-t_ net- 6.. tAj L.L. 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS C1) 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP CC LLI 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 o COMMENTS: ccLu C cc 0 CC 0 U- W ct Q 2 W Z LU CC d LU WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED E ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN E CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952) 249-4600 la Owner/Co• . ite: Inspector. 4S White Copy/Inspector's File Canary Copy/Site Notice