HomeMy WebLinkAbout1998-010937 (Re Roof) PERMIT
. � G�TY OF ORONO PERMIT TYPE: �:;f_�;�;:;�4�w;�
2750 Kelley Parkway- P.O. Box 66 � �, - -
� Crystal Bay, Minnesota 55323 Permit Number: i�,i ;.'��:r;
(612) 473-7357 Date Issued: �i a.I:�ii::'�;�:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: — }�_°��1 t i r:'�r. —
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APPLICA EFMITEE SIGNATURE ISSUED BY:SIGNATURE
� ! Total Fee: $ Date Received:
Entered By: ��� Permit#: /� �-7�,"7
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
--------------------------------------------------------- ------------------------------------------------------
THE APPLICANT IS: (circle one OWNER R CONTRACTOR
JOB SITE ADDRESS: ��v?O L`�r�i�Lrr �a�� '�d�T�F' ZIP: s�3`� �
`�r� �-
NAME OF OWNER: C�d2cLy 62Tc�o��Q�� PHONE: (home) ��7/ -�'���
-� (work) �7/ _ C���7
MAII.ING ADDRESS: ���� ��� �a'�I�CITY: ��J�uy�-�_ ZIP: .S'�" ��
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CONTRACTOR: ��P�� PHONE: �f 7�-:�5� S�
CONTACT PERSON: MOBILE/PAGER:
MAII.ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detai�: �� - YO� �Gi'�7�r%'s � `/o�l-5e
STORIES: Z SQ. FEET OF EACH FLOOR: ����
NO. OF BEDROOMS: 2-- GARAGE STALLS: ATT. DET. �'
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��G�Q
I hereby apply for a building pemut 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 pernut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: (�%ll�"� ������lZGC��I DATE: /�' .._ � ��
NOTE! Parade qf'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 D�TA
Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd.2. Information req�rired to be given individual. r1n individual asked to supply privace or confideooal dara concerning himself shall
be informed of: (a)the purpose and intended use of the requesced data wi[hin the collecang'state agency,polidcal subdivision,or sratewide rystem;
(b)whe[her he may refuse oi is legaily required to supply the requesced data;(c)any Irnown coasequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idenary of other persoas or endaes au[horized by state or federnl law to receive che data. This requiremenc shali
not app(y when an individual is asked to supply invesdgadve da[a,pursuant to secaon 13.82, subdivision 5, to a Iaw enforcement officer.
The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or�rovem taz refund
instructions inscead of on[hose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible auchoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is class�ed as public, Private or confidenaal. Upon his further request, an individual who is the subjecc
of stored private or public dara 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[hat data. After an individual has been shown the privare data and informed of its meaning,the dara need not be disclosed to him for
six monrhs thereafter unless a dispute or acdon pursuanc to [his secaon is pending or addidonal data on the individual has been collected or created.
The responsible authoriry 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 accual cosu of makin¢,certifying,and compiling the copies.
The responsible au[horiry shall comply immedia[ely, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and(egal holidays,if immedia[e compliance is not possible. If he cannot comply with the request
wi[hin that dme,he shall so inform[he individual,and may have an addidonal five days wi�hin which to comply wi[h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuncy or completeness of public or private
data concerning himsetf. To exercise this right,an individual shall noafy in wridng che responsible authoriry describing[he nature of the disagreemeat.
The responsibie authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipiencs named by the individual; or(b)nodfy the individual thac he betieves the data to be coaect. Data
in dispute shall be disclosed only if the individual's sta[emenc of disagreement is included wi[h the disclosed data.
The determinadon of the responsible authority may be appealed pursuant to the provisions of che administrative procedure act relaring to
contested cases.
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri.u,,hts of subjects of data", we would like to inform you that your request
for a pernut or license from the Ciry 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 perm.it 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 wich ocher local, scate 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 �tiddle Last
Address
Ciry Stare Zip Phone
I understand my rights as stated above.
j� /
���G�
Signantre
DATE TIME
CITY OF ORONO CALLED IN / �/'+���
INSPECTION NOTICE SCHEDULED 6 �
PERMIT N0. � 9.3 7 COMPLETED �l 9 �''
ADDRESS `7�� 4P"^
OWNER CONT .
TELEPHONE NO.
� DESCRIPTION �'t/1�r�
� 01 FO�T�NG 11 ECHANICAL RI 18 EXCAV/GRADWG/FILLING
Q <B� r�ulw.� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 D. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
D COMMENTS:
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d�ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
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� ❑ CORRECT WORK R PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ,`, pHOTO TAKEN
�NSPECTOR WIL�REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contrac
Inspector.
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