HomeMy WebLinkAbout1998-010538 - tearoff/reroof ,, PERMIT
�:�TY OF ORONO PERMIT TYPE:
2%50 Kelley Parkway- P.O. Box 66 _;�`I�,.�i�C'v��
Permit Number: :;���;_,;_;;
Crystal Bay, Minnesota 55323 _ -_ _
(612)473-7357 Date Issued: ;^,:;�y;;:�«;_;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ ��:�,� ;,—_��;�. _ _;�— . _;� OWNER:
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� rotal Fee: $ Date Received: �
Entered By: � - - �
��r`. Permit#: �: "?��� '
CITY OF ORONO - BUILDING PERNIIT A�PPLICATION
A.11 information must be submitted in full before plan review will be started.
(please print all information)
THE APPLTCANT IS: (circle one) O�'VNER OR CONTR.ACTOR � �
JOB SIT'E A.DDRESS: �Z(.�^;� �'/�—`"�SST ��/�: �� ZIP:
� NA11�IE OF OWNER: �,�,�%t/� /�-L�%(//=/T� PHO�tE: (home) �7� —/�/��
(work)
MAILIPtG ADDRESS: _ ���L--S��r'�'sT c�lL� CITY: a�r2��' ZIP:
/-�il- �
coti�.c�roR: �-��� � � � �r��, � � xo�: �c��-���' ��� I
CO�ITACT PERS ON: ,� �� r_�� MOBII.,E GER S�--�3 3 3 i
MA.II�T�i tG ADDRESS:�lf'��� G��G���.�c�`z ,, CITY: C.o�C�-.C/�-1� ZIP: S=3S"�� '
STATE LICENSE: # 2-�'G�.�v 3 L �
i
ARCHIT'ECT/ENGINEER: PHOivE:
NIAII�ING ADDRESS: CITY: ZIP:
1�,'AME; REGISTRATION#
TYPE OF ti�OR�i: New Addition Accessory Structure
Move ' Remodel/Alteration Land Alteration
PROPOSED'4VORK(describe in detai�: /� �G40��/�`!'?�Z �'L� � _
�rc�.�e�� ,��u��
STORIES: SQ.FEET OF EACH FLO�R: � -
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
,
O� .
ESTIi1�iA.TED CONSTRUCTION VALUATION (excluding land): $ ���� ' _
I hereby apply for a buildin�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 Buildin? Code; ihat I understand th.is 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: �� ATE: O�`��—'�.,��
NOTE! �arade o Homes events require separa e permit approval by Polzce Department and
� City Counci160 days prior to the event. Non permiited events wi11 not be allowed.
�_ � �.
M �
Sec.13.01 RIGHTS OF SLJBJECTS OF D:�TA
Subd. 1. Type of data. The righcs of individual oa whom che data is stored or to be scord sha[I be as se�forch in this secaon.
Subd.2. Information reqirired to be given indi�idual. An individual asked to supply privare or confideaaal dara concerning himsetf shall
be informed of: (a)the purpose and in�.nded use of cho rcquu�dara wichia the eollecdng Yuce ageacy,polirical subdivision,or sntewide ryr.em;
(b)whethcr he may rfuse or is le3ally requir_d co supply th�rquested data;(c)any lmown coasequeace arising from his supplying or refusing to supply
privace or conndendal dara;and(d)the ide¢dry of ocher persoas or endaes a��:oriz=d by sc�te or federdl law to teceive the dam. This requiremenc shall
no�apply wh:n an individu�l is asked co supply invesdgadve daca, parsuant to secaon 13.82,subdivision 5, to a law enforcemeac of�ccer. -
TF.a eommissioner of re�•enue mav p(ace the noace r_ouird und=r this subdi�ision in the individual income tax or orooem tax refund
inscructions instead oF on chase forms.
Subd. 3. Access to data by individual. lipon request co a responsible auchoriry,an individual shall be informed whether�e is the subject �
of s�ord data on individuals,and whz�hzr it is elassified as pubiic, private or conFdenaal. Upon fiis furcher requesc,an individual who is the sabjecc
of scored privace or public dam on individuais shall be shown che dac�wichouc any charge to tiim and,-if he desires, shall be informed of the concent
and meaning of chat data. Aher an individual has been shown che privac:data and informed of iu meaning,[he daca need not be disclosed to hi.ra for
siz monchs[f:ereafter unless a dispuce or acaon pursuan�co this secaon is pending or addiuonal data oa the individual has beaa collzcc�d or created.
The r:sponsibi�authoriry shall provide copies of[he privace or public data upon request by the individuaI subjecc of the data. The responsible au�oriry
may require the requesdng pe�son to pay the actual costs of making,cetrifying,and compiling tfie copies.
The responsible auchoriry shall comply immediatzly, if possible,wich any tzquest made pursuant to this subdivision,or wichin five days of
the date of che request,excluding Sacurdays,Sundays and legal holidays,iF immcdiate compliance is not possible. If he canno�comply with the requesc
wi[hin that dme,he shail so infocm che individual,and may have an addidonai Five days wichin which to comply wi[h the request,exctuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest che accuracy or compieteness of public orpri�•ace
data conceming hir:self. To ezeccise�his ri¢h�,an individual shail nod"ry in wridng che responsible authoriry describing the nanire of the disagreemen�.
The responsible authoriry shall wichin.i0 days either: (a)corrcc the data found to be inaccurate oc incomplece and attempc to nodfy past recipiencs of
inaccurd;e or incomplece data, inctuding re:ipiena named by the individual; or(b)notify the individual that he bzlieves[he dara to be coaecc Data
in dispu�e shall be disclosed only if the indi�•idual's sc3t�menc of disagr:emenc is includtd with the disclosed data.
Th�de�erminadon of the responsibte au�horiry may be appealed pursuant to the provisions of che administrarive procedure act relaang to
contesced eases.
DATA PRIVACY ADVISORY
In accordance wi�h 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 Ciry of Orono or any of its departments may require you to fumish certain private or
confidencial information.
You are nocified thar.-
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, bu� refusal may require that the City deny the permit or license.
3. The information may be shared with ocher local, state or federal a�eocies to the extent necessary to process
' the permi[ or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have cercain riQhts under M.S. I3.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First tiSiddls Last
Address .
Ciry Srate Zip Phoae
I understand my ri;hcs stated above.
Signan.re
D TE + TIME
CITY OF ORONO CALLED IN / ,''S�'�I� �
INSPECTION NOTICE SCHEDULED /.�-2 �=`l� /� 3 a
PERMIT NO.����'rJ" � `� COMPLETED � �
ADDRESS �;�(�,S �'O �� S 'f � R �Ctd � k'r ✓�'�
c:OW�N�R`�4( � ��� 7L CONTR. ,�� 7L2 c ��t.g�✓►�aq
TELEPHONE N0. � � �� �fl3 y
� DESCRIPTION
lL 01 FOO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMING � 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�Qc
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED f 1 ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t n 24 hours in advance.473-7357
OwnerlContractor on s'
inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN '��i���`�
INSPECTION NOTICE SCHEDULED i/.%l��y"�' y
PERMIT NO. /"C>� 3�' COMPLETED �
ADDRESS�(F��i'1 L.^ � �z��. .lr � � •
OWNER � o-Y�L'�.ti� CONTR.`-1�.e��
TELEPHONE NO. '4�C%'r�`�Z%�^1�" r
� DESCRIPTION ��.�r__��
lu 01 FOOTING 11 CHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 F�p�' ' 13 MECHANICAL FINAL 19 �AKESHORE/WETLANDS
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TRE�❑�nnn�q L
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPE� � CT��
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS: ���� �.���
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W� WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
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'nspection 24 hours in advance.473-73rJ7
OwnerlContrac it :
Inspector. -
White Copyllnspector's File Canary CopylSite Notice