HomeMy WebLinkAbout1997 - 009121 - repair & re-roof PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number: 0Q9121
Crystal Bay, Minnesota 55323 Date Issued:
(612)473-7357
SITE ADDRESS:
NO.:LAMER LA.
DESCRIPTION:
REPAIR RE-ROOF
Ting Permit Type SF-ADD/REMODEL
,..7);_nA61n9 Work lype
4S4 T . RESIDENTIAL
REMARKS:
FEE SUMMARY:
VALUATION SS : S00
Base Fee $112 . 25
CONTRACTOR: - - OWNER:
CitN1HY 1474. 41 .
,SCI
MN SS317
THE UNDERSIGNFD HEREBY REQUESTS PERMISSION TO MAIO: THE REAL IMPROVEMFNTS
SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REOUIREMENTS .
7
APPLICANT/PERMITEE SIGNATURE /9"--. ISSUED BY:SIGNATURE
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 CONTRACTOR
JOB SITE ADDRESS: 8 3 S / N Ft-Al WCL L ZIP:
NAME OF OWNER: I4 v C<C B I D U-)6-1-L- PHONE: (home)`17 2 -"I CLQ 3
(work)
MAILING ADDRESS: 8 S i' N D 5 kivtrV\C-71_1--'1/4thY: ZIP:
CONTRACTOR: BL A l SC W T<SoA.1 Lo PHO : 7q- sci 4 I
CONTACT PERSON: B L/k t S& t.J 4-r.SO nJ MOBILE ' • t S)-(o-5-`10 4 -- bre,-rrA
MAILING ADDRESS: Iso t}) tJC r2 .)r2 CITY:CkArs if kS S& ZIP: .S'S 3 i 7
STATE LICENSE: # '-/Z ,3
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X. Land Alteration
PROPOSED WORK(describe in detail): Mo Vt DCS K stow F /Loo F )QgPA-►2
R.vr, NE-LJ R ocs eZ--g_ Ill 6741 AA-ns NE P c K
STORIES: SQ.FEET OF EACH FLOOR: I
NO. OF BEDROOMS: 3 GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 5DQQ — (000
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 cordance with the approved plan.
d
APPLICANT'S SIGNATURE: DATE: 6 - Z 3-`1�I
NOTE! Parade of 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 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 of 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.
B LA t s e R. cjJ T3o,J
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I understand my rights as stated above.
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Signature
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CERTIFICATE OF SURVEY
for Chuck Bidwell
• of Lot 4 , Block 1 , Pirates Cove ORONO COPY
• Hennepin County , Minnesota
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I hereby certify that this is a true and correct
representation of a survey of the boundaries of
...) Lot 4 , Block 1 , Pirates Cove , and of all existing
.....) buildings and hardcover thereon . It does not purport
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.
COFFIN & GRONBER"G , INC .
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Mark S . Gronberg Mn . 'tic . No. 12/55 1116
# -
Engineers , Land Surveyors , Planners
Long Lake , Minnesota •(.5 F'
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V, Scale : 1 '' = 30 '
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SYFE: ELAN CinAiji'. :,?i Pi...Ais- -. Date : 7-28-88 1
ICK'iPPEOVED o : Iron Marker
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DATE / TIME
CITY OF ORONO CALLED IN -/-; '7 `4 'Jt -D A,
INSPECTION NOTICESCHEDULED f '/, �i 7 ��
PERMIT NO. /" x/ COMPLETED t�
ADDRESS (�`�� .�� r .
OWNER � �r �� 6:11---7-PL
CONTR. 4.2c:- LLJete/& -
TELEPHONE NO. q7 V -,3-951/
DESCRIPTION de 04
(01 FOOTIyA 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 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
tQ 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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0
cc
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CC
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CC
d ORK SATISFACTORY:PROCEED PROJECT COMPLETE
CC ❑ CORRECT WORK&PROCEED E ISSUE CERTIFICATE OF OCCUPANCY
• ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
Cl 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.473-7357
OwnerlContracto it :
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATE > „TIME
CITY OF ORONO CALLED IN (o- 23-97 IV 44/
INSPECTION NOTICE , SCHEDULED (P 'Q 97 3:3o
PERMIT NO. 77/ / COMPLETED
ADDRESS 13 o
OWNER ` /� CONTR.�� o GCJ �i�
TELEPHONE NO. 7 7 1 —
DESCRIPTION
L 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
p 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
I` 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
10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
C) COMMENTS:
cc
cc
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cc
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W
CC
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WORK SATISFACTORY:PROCEED
PROJECT COMPLETE
CC L CORRECT WORK&PROCEED r- ISSUE CERTIFICATE OF OCCUPANCY
C) L' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Op BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwneriContr o o ite:
Inspector.
White Copyllnspector's F e Canary Copy/Site Notice