HomeMy WebLinkAbout1997-009586 (re-roofing) � PERMIT
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CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �.
Crystal Bay, Minnesota 55323 Permit Number: - .
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(612) 473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPUCANTrPERMI EE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ Date Received: i c - ;� ��. �� �
Entered By: � .li�' Permit#: �f� �"(��
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 o �OWNE CONTRACTOR
JOB SITE ADDRESS�•.�r �+�/ ��� � ZIP:
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NAME OF OWNER: PHONE: (ho e � ���
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MAILING ADDRESS: CITY: ZIP: �
CONTRACTOR� C� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CIT • 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�: ��Ili/V1.� ��
STORIES: � SQ. FEET OF EACH FLOOR: ���
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DE .
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ESTIMATED 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 Ciry 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 w ill in acc da c w' the approved plan.
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CANT'S SIGNATURE: DATE: �� ��
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 SUBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the dara is stored or to be stored shall be as set for[h in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and incended use of the requested data wichin the collecting"state agency, political subdivisio�,or statewide system;
(b)whether he may refuse oY is legaily required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
� private or confidential data;and(d)the idenrity of other persons or endries auchorized by state or federal law to receive the data. This requ'uement shall
not apply when an individual is asked to supply invesrieaave data, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or property tax refund
instructions instead of on chose forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stbred data on individuals, and whe[her it is classified as public, private or confidenrial. Upon his funher request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to hun and, if he desires, shall be informed of the content
and meaning of chat data. After an individual has been shown the private data and informed of its meaning,che data need not be disclosed to hun for
six months thereafter unless a dispute or acrion pursuanc to this 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 reques[by the individual subject of the data. The responsible authority
may require[he requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of
the date of[he request,exctuding Sacurdays,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 addidonal 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 pri��ate
data concerning himself. To exercise[his right,an individual shall noafy in wriang the responsible authoriry describing the nature of the disagreement.
The responsibie authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, inciuding recipients named by the individual; or(b)notify the individual that he believes rhe data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
Ttte determination of the responsible au[horiry may be appealed pursuant to the provisions of the administraRve procedure act reladng 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 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, 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.
��?�` �- �1/
First �� �dd Last
Address �� � ��
��n, State Zip Phone
I unders y rig ts as state above.
•
Signa[ure
DATE TIME
CITY OF ORONO CALLED IN i�- �- � %
INSPECTION NOTICE SCHEDULED i� ' S �`>=� � -
PERMIT N0. �5� �� COMPLETED T—
ADDRESS S ��/� ,C�,�z �.�;i::--c�: l�cz
OWNER �=-�`t�-i CONTR. �
TELEPHON E NO. �1 �3� � ����� �"��- 4���-�� 7��C'
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� DESCRIPTION /��-i �< t J
� 01 FOOTWG 11 MECHANICAL " 18 EXCAV/GRADING/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREJWETLANDS
p 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 VV/4�tED. 72 WATER HOOK-UP 17 SITE INSPECTION
Q
_`OS FINAL_- 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEM�SITE 27 SEPTiC MAINT. 21 COMPLAINT
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Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER HEMOVAL
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v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O i� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
OCORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CAIL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance.473-7357
Owner/Contrac r n it :
Inspector.
White Copyllnspector's File ' Canary Copy/Site Notice
DATE TIME
CITY OF ORONO cA��Eo iN /�` =�� �� �
INSPECTION NOTICE scHE�u�Eo /�' -� `� s�t%�r"'
PERMIT N0. �15��Y k COMPLETED
ADDRESS ;3_3�7�L t�i���-.1� -��-- !{CJC/
OWNER /���� '� CONTR. —
TELEPHONE NO. Lf � � � -3� ���
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� DESCRIPTION I k�t,� z. c �� `Z.-. - .-�<: c�
� 01 FOOTING 11 MECHANICALRI � 18IXCAV/GRAOING/FIWNG
02 FRAMING . 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEM4—SITE 27 SEPTIC MAINT. 21 COMPLAINT
�
�Q 07 DEM�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
� COMMENTS:
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� C� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContracto si e
Inspector. �'
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN '� ` I Z -�l]� �'��
INSPECTION NOTICE / SCHEDULED - J�I ' �
PERMIT N0. �� ��� COMPLETED
ADDRESS �' � �' �
OWNER CONTR -(� C�C�i=-�`�.
TELEPHONE NO. `1��J' � l QI ��C.f 7 a - 3 S 2� 1
� DESCRIPTION _„�;1�-,��
� 01 FOOTING 11 ME(�ANICAL RI 18 EXCAV/GRADINGJFILLING
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHOREJWETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
v
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL Z$CEDAR SHINGLES 36 FOUNDATION REMOVAL
� NE ONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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� [,CORRECT WORK&PROCEED �. ISSUE CERTIFICATE OF OCCUPANCY
W
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING 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 inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice