HomeMy WebLinkAbout1998-010689 (Remodel) PERMIT
' CI'TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 '=:`:����`'`.}�"�`
Crystal Bay, Minnesota 55323 Permit Number: :::�i_+;�,;�°=�
(612)473-7357 Date Issued: i�;r.,i��:�.�'��:�:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE l4I
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_Tota�-Fee: � Date Received: 8 /ZS/5a' ;
Entered By: �^� Permit#: ;y�r�9
CITY OF ORONO - BITII.,DING PERNIIT A�PPLXCATION
A.11 information must be subm.itted in full before plan revieiv will be started.
(please print at1 information) .
THE APPLICANT' IS: (circle one) OtiVNER OR CONTRACTOR� � � . �
JOB SITE ADDRESS: %�'I�L� ��������� �Zl� �l�/'�� ��' ZIP:
� NAME OF Oti�IVER: �3/c'�r c� �/��./c�l < ,-.� PH0�1E: (home)
� (work) L,c" 1/ ,lC'�/� �`/`l�'
�r�,nvG�n��ss: ���a ��; /���Tra�-�;,;������. zze:
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CO�TTRACTOR: PHOivE: � ;
CO��'ACT PERSON: MOBILE/PAGER: � � '
1��TATLI�i tG ADDRESS: CIT'Y: ZIP:
STATE LICENSE: #
A.RCHITECTlEI�'GINEER: PHOYE:
��IA.IL .1�i tG ADDRESS: CITY: ZIP:
I�,TAME: REGISTRATION#
TYPE OF tiVORb': I�Tew Addition Accessory Structure
Move � Remodel/Alteration ri Land Alteration
P�tOPOSED'�YORK(describe in detai�: f E=ci� ��.l� �,�,;� ; �` , �� �= � ;% �� �;c _
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STORIES: SQ.k'EET OF EACH FLOOR: � -
NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET.
. �
EST�IAT'ED CONSTRUCTION VALUATION (excluding land): $'�>��'�" �
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 tha[ the work will be i.n accordance wich the approved plan.
APPLICANT'S SIGNATURE: �j,�cr�l <i/%llE"/ �c-�j DAT'E:j��`;�`l:�
NOTE! Parade o H'ome� 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.13.0:RIGHTS OF SCfBJECTS OF DATA
Subd. 1. Type of da[a. The rizfi�s oF ir.divid�l on whom the data is stored or co be s;oced shafl be as set focth in this secaon. -
Subd.2. Information required to be�ven indi�idval. An icdividual asked to supply private or coaE.denaal dara concern�g himsetf shall
be iaformed oF: (a) t�e purpose and inc:aded use of the teques�daa within the eollecdag�tate ageacy,polidca!subdivision,oc satewide rys.em;
(b)whe�`�er he may r`use or is legally tequiced to supply the rquesud dac�:(c)any Imown coasequence arising from his suppiying or refusing to supply
private oreor�dendaI da¢;ar.d(d)che ide¢dry of otherpeaoas orendd:s z�chori:ed by Sc��a orfederal law to r:ceive tha da�. "Ihis r:quiremeatshall
r.oc apply when an ir:dividu_I is as4;ed co supply invesd�adve da�, pursuant to s:cdon 13.82,subdivision 5, to a law enforcemenc oEiicer. -
Tne eomm.issioner of revenue mav oiace che nodce r_auird under chis su�division in the individual ir;come tax or oreoam mz r=fued
ins:tucdor.s insc_ad of on chose forms.
Subd. 3. Access to data by indir1dual. lipon requesc tD a rsponsible au�horiry,an iadividual shall be inFor,aed whecF.e;Ce is che subject �
of scord dati on individuals,ar:d wh=ther ic is elass�:d�s public, priva:e or co�dendal. Upon his fucther cequest,an i.^.dividual who is the subjea
of seored privac_-ar public daca on individuals shall be shovm che dac;wi�houc any char3e to him aad;if he desires,shall be infoccned of the eontene
ar.d meaning of�hat data. Ahcr an individual h�s 6een shown the privam data and inforsied of iss meaning,the data need not be disclased to him foc
siz monchs d:areai�-.c u;iless a dispute or acdon pur�uznc to this sccdon is pend�ng or addidooal dati on the individual�u beea collec�d oc eraced.
The rspons;ble authoriry shall pcovide copi:s of the privace or public data upon requ:st by�he individual subjec[of tha da�. 'Iht responsible authoriry
may rzquire �he requesang pecson to pay che accual cosu of m.aking,eerdfying,and compiling tfie copies.
The responsibte auchoriry shall eo�piy immedia�ely,if possible, wich any rcques�mada pursuant to[his subdivision, or wichin five days of
the da�e of che request,exdudir;g Sacurdays.Sundays and legal holidays,if immediace compliar.ce is not possibla If hc caanot comply with the requesc
wi�hin[hat dr.ie,he shall so inform the individual,and may have an addiaonaI fivt days wichin which to comply wi[h the requesc,excluding Satutdays,
Sundays and legal holidays.
Subd.4. Pcacedure vchea data is not accurate or eomplete. An individual may contest tl:e accuracy or completeness of public orpri�•ate
daca cor.ceming hir.:self. To exe:cise chis ri¢ht,an individual shall nod'ry in wridng eh:responsible auchoriry describing the nacure of che disagreemenc.
'Ihe responsible auchoriry shali within 30 days eicher: (a)correct thc data found to be inaccurata or incomple�e az:d attempt to nodfy past recipienu of
inaccurate or incomplece daca, inciuding recipienes nam:d by the u:divid�al; or(b)nodfy the individual that he believes che data to be eocrece. Data
in dispuce shalt be disclosed only if the individual's sca�em�nc of disagreemen�is includzd wich the disclosed da�.
The decerminadon of the responsibla auchoriry may be appealed pursuant to 4�e provisions of chz adminiscrarive pcocedure act relaang to
contesced eases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjects of data",we would like to inform you thac your request
for a permit or license from the Ciry of Orono or any of its deparcments may require you to fumish cenain private or
confidential information. J
You are notif ed that:-
1. The informa[ion you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to suppIy data, but refusal may require that the Ciry deny the perm.it or license.
3. The information may be shared with ocher local, sta�e or federal a�encies to t�e extent necessary to process
' the permit or licease.
4. If your reques[ed pernut or license requires Council acttbn to approve, some informa[ion may become
public.
5, You have certain ri?hts 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 permi�.
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Ciry Snt� Zip Phaae
I understand my ri�hcs as stated above.
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION� TIC SCHEDULED "J
PERMIT N0. c MPL TED
ADDRESS Z-d
OWNER � CONTR.
TELEPHONE NO.
� DESCRIPTION � � O
� O1 FOOTING 11 MECHANICAL 18 EXCAV/GRADWG/FILLING
Q �RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
05 IN 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d C]WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
Ownerl ntrac r n te:
Inspe t
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