HomeMy WebLinkAbout1998-010475 (tearoff/reroof) PERMIT
��T'Y OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway - P.O. Box 66 =��-'��-!�=`��'
Crystal Bay, Minnesota 55323 Permit Number: ;s;t;�,?�
(612) 473-7357 Date Issued: ��;;�;��;_;;���;;_;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT! ERMITEE SIGNATURE ISSUED BY:SIGNATURE v'�"� 1
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` Tota� Fee: $ //�: / � Date Received: �
' Entered By: Permit#: /U�7�
CITY OF ORONO - BUII�DING PERMIT A7PPLICATION ;
All information must be submitted in full before plan review will be started.
(please print all information)
--------------------------------------- --- -- --------=----=� --
THE APPLICANT IS: (circle one) O�NER 4 _ CONTRACTOR ;
JOB SiTE ADDRESS: � �7 �CU �1�v�vc �� ZIP: �'.
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� NAME OF OWNER: � i m � '�"U S PHO�tE: (home) i
(work)
MAILING ADDRESS: 3��° �'�-,�1�' ,��- Il�� CITY: �►2,a r•.,�� ZIP: �
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CO�I'TRA.CTOR: � . `}� . SD�'1 ��} L�OY L$ � PHO��: ��� - (�-�� � i
COv�'ACT PERSON: � �c� MOBILE/PAGER: ��� - 3>> 7 � �
MATL .T�i tG ADDRESS: S% 7 S� ��`�/�'��-��>> l�Lv� CIT'Y: y�'1'�ti�Yti r� � ZIP: S S s(��� !
STATE LICENSE: # S 3 a �' i
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A�CHIT`ECT/Ei\'GINEER: PHO�tE: i
MA.ILTiti G ADDRESS: CITY: ZIP:
NAME: REGISTR.A.TION# i
TYPE OF tiVORb': New Addition Accessory Structure
Move � Remodel/Alteration Land Alteration ;
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PROPOSED tiVORK(describe in detai�: � �ft�'L G� � ���V�-���
�v n.��o r-- o� \�ti� � -e �- ��-�.a�a/r —
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STORIES: SQ.FEET OF EACH FLO�R: � -
NO. OF BEDROOiVIS: GARAGE STALLS: ATT. DET.
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ESTT�IATED CONSTRUCTION VALUATION (excluding land): $ �� � S
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 �Ciry and with
the State Buildin� Code; that I understand this is not a permit and work is not to start without a '�
permit; and that the work will be accordance wi th p roved plan. ,
APPLICANT'S SIGI\TAT'URE: DATE: � — � —� J
NOTE! Parade o 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 SUFi.TECTS OF DAT�
Subd. 1. Type ot'data. Tha riohcs of individual on whom the data is scored or to be scor•d shalI be as sec forch in this secdon.
Subd.2. Information reqirired to be given indir-idual. An iadividual asked to supply privace or confideaaal dara concemiag himseif shall
bz informed of: (a) [fie purpose aud inc:nded use of the requesc�dara wichin the eollecdng itat�agency, polidcal subdivisioo,or sntewide rynem;
(b)whe�her he may r.'use oi is legally requird to supply the r.quu�ed daca;(c)aay lrnown eoasequcnce arising from his supplying or refusing to supply
private oreonndenriai dara;and(d)th:idendry of a�herptrsoas or enaacs auchoriz:d by sc�te or federal law to teceive tha data. This requiremeat shall
not appty wh�n an individual is asked to suppiy invesri�aave data,pursuanc to secaon 13.82,subdivision 5, to a law enforcemen�ofricer. -
Tht commissioner of revenue mav olace tha nodce r_�uir_d und�r u4is subdivision in the individual income taz or orooem taz refurd
inscrucdor.s inscead of on chose forms.
Subd. 3. Access to data by indiridual. lipon request co a responsible au�horiry,an individual shall be informed whe�her he is the subject
of scnrd dat�on individuals,and whe�her ic is elassified as pubtic, privace or conFdendal. Upon his further reques�,an individual who is the subjec�
of s�ored privace or public daca on individuals shall ba shown the dat�wichout any charge to him and;if he desires, shall be informed of the concenc
and meaning of�hat data. Aher an individu�l has been shown the privacz data and informed of its meaaing, the dara need not be disclosed to him for
six moncns ct:ercatur uriless a dispute or acaon pucsuane co this secaon is pending or addidoaal data on the individua!has been cotlecced or creared.
Tht rsponsibta authoriry shall pcovide copies of the privaee orpublic data upon tequest by the individu�I subjece of[hz data. Tne responsible aucfioriry
may require the requesdng person to pay the accua!costs of rnaking,cerafying,and compiling[he copies.
The responsible auchoriry shall compiy immediately,if possibte, wi�h any request made pursuant to this subdivision,or wichin five days of
the da[e of[he request,ezciuding Sacurdays,Sundays and legal holidays,if immzdiate compliance is not possibte. If he cannot comply with the requesc
wichin that time,he shal!so inform the individual,and may have an addirionai five days within which to comply with the request,exciuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or comptete. An individual may contest the accuncy or completeness of pubiic or pri�ate
data concerning hir.iselF. To exercise chis ri¢ht,an individual shall noa"ry in wriang che responsible authoriry describing the nacure of the disagreemenG
The responsibte authoriry shail within 30 days eichec: (a)correcc[he data found to be inaccucate or incomplete ar.d attempt to nodfy past recipiencs of
inaccunte or incomplece data, including recipienes narr,ed by ebe individual;or(b)noafy the individual that he believes che data to be cocrecc Data
in dispute sfiali be disclosed only if the individual's sc3temenc of disagreement is inctuded with[he disclosed data.
The decerminadon of the responsible au�horiry may be appealed pursuant to [he provisions of thz adminisaarive procedure act re(aang to
cont_sted eases.
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 Ciry of Orono or any of its deparcments may require you to fumish certain private or
confidencial information.
You are notified that: •
i. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, buc refusal may require that the Ciry deny the permit or license.
3. The information may be shared with other local, sta[e or federal a�encies to the eztent necessary to process
' the permit or license.
4. If your requested permit or license requcres Council action 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 permic.
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Address�r� �� Y�� ��S� t�� Z� � I�_�c� --�n � ���.
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Signature
ATE TIME
CITY OF ORONO CALLED IN �p
INSPECTION NOTICE SCHEDULED '7 � � y%�
PERMIT N0. 5�75� COMPLETED �
ADDRESS �
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 F� 11 MEC AL RI 18 EXCAV/GRADING/FILLING
Q FRAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q O5 FINA� 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L PHOTO TAKEN
INSPECTOR WILL RETURN
�- CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance.473�73�J7
Owner/Contr n sit :
Inspector.
White Copyllnspector's File Canary CopylSite Notice