HomeMy WebLinkAbout1996-007840 - tear-off/re-roof � � P�RMIT
CITY OF ORONO PERMIT TYPE:
?750 Kelley Parkway- P.O. Box 66 F��1�.3=��!��li: .
�rystal Bay, Minnesota 55323 Permit Number: i ii:;;;_��i}
612) 473-7357 Date Issued: =Y��:;�-,�,Y��,
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APPLICANTiPERMI SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ i��� � DateReceived:
Date Approved:
Entered Bv: Permit#: -
CITY OF ORONO - BUII�DING PERMIT APPLICATION
ALL IYFORiVIATION�1UST BE SLB1-1ITTED IN FULL BEFORE PLAN REVIEW WII.L
BESTARTED
----------------- ---------------------------------
THE APPLIC�'�tT IS: (circle one) O`VNER Ol�CONTRACTOR�`;
JOB SITE ADDRESS: �(�/t l-����t �-� I�s����z ZIP: S��S 3 � �/
NAME OF O�V�TER: �,��,v z �` ��e ti'Z-e_ L--- PHONE: (home) y%� - �/Z 7
(work) -
MAILINGADDRESS: �f a l �' �nr��6sf �-+-/� D�2-_CITY: (� ;�c� �.% c� ZIP: -S_ C•�
CONTRACTOR �,�.���y' �c�N s�,-.� --���,�•j t�.�,�-���' __PHOiVE: � /� -�)� -3 i j ��
NIOBILE PHONE/PAGER �� �'�� - .j Sc �—
1��AILING ADDRESS: �0 ���, ,� 3 S�/ CITY: ��-I,�.. � yLL�,�--. ZIP:. ��.�r3 � �
STATE LICENSE: # 2 3 3 L__
ARCHTI'ECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZII'.
NAi'�1E: REGISTRATION #
TYPE OF WORK: New Addition Accessory S�ucture
Move RemodeUAlteration �_ L.uxi Alterauon
PROPOSED WORK(describe indetail): y- t ;,�- ��' - �''��''J
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STORIES: �_ SQ• ' 'ET OF EACH FLOOR: / 2�r-c� -�-� � —
NO. OF BEDROO�iS: ' GARAGE STALLS: ATT. � � DET.
s,4
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ESTli1�IATED CONSTRUCTION VALUATION(excludingland): $ � � , ��
I hereby apply for a building permit and I acknowled�e 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 w' 1 be in accordance with the approved plan.
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APPLICANT'S SIGNA � ��--- DATE: ,� - /
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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.
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Sec.13.04 RIGHTS OF SLTBJECTS OF DATA
Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given indiridual. An individual asked to supply private or confiden[ial data concerning hunself shall
be informed of: (a)the purpose and intended use of the requested data within the collecdng'state agency, poliacal 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 idennry of other persons or endries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to suppiy investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue may place the notice required under this subdivision in the individual income tax or prooertv 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,priva[e or confidential. Upon his further request,an individual who is the subject
of stored private or pubiic 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 priva[e 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 addirional data on the individual has been collected or created.
The responsible auchority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesring person to pay the actual cosu of making, certifying, and compiling the copies.
The responsible authoriry shall comply immediacely, 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 comp(iance is not possible. If he cannot comply with the request
within that time,he shall so infornt the individual,and may have an additionai 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 priva[e
data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nocify past recipienu 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 sha11 be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administradve 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 detemune 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 pemut 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.
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First �Middle Last
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Address _
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I understand �rights as stated above.
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Signature !/
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DATE TIME
CITY OF ORONO CALLED IN .1�- �
INSPECTION NOTI SCHEDULED � -� ,�/ '� O �
PERMIT N0. � ��� COMPLETED � +ti
ADDRESS �
OWNER CONTR. •--
TELEPHONE NO. ��C� ' .�5��
� DESCRIPTION _�/ ��
� Ot FOOTING 11 M CHANICAL RI 18IXCAV/GRADINCi/FIWNO
y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSUTATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINC3 FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YQU:_YES_NO
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN �
❑STOP ORDER POSTED.CALL INSPECTOR r'CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next spection 24 hours in advance.473-7357
OwnerlContract n si :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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DAZE TIME
CITY OF ORONO CALLED IN �. �� `k"
INSPECTION NOTICE SCHEDULED �� �'� '"���
PERMIT N0. '�' ? -'� COMPLETED M �_
ADDRESS ,�r, ., �, - r" ,:�/_-- :c
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OWNER ;=i� � _ CONTR. -�- 'r�.. .�
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TELEPHONE NO..��S f� - .��C�-� ����
� DESCRIPTION � �����
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� 01 FOOTINO 11 MECHANICAL RI 18IXCAV/aRADINQ/FIWN(3
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAi�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
OS FI� 14 SEWER HOOK-UO O6 PROdRESS
� EM�SITE 27 SEPTIC MAINT. 21 COMPIAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBINC3 Fil 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUEO
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlCon a o ite:
Inspector. � -
White Copyllnspector's Fi Canary CopylSlte Notice