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Home My WebLink About2002-P05227 (re-roof) � PERMIT C�TY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Pos22� Crystal Bay, Minnesota 55323 Permit Type: Minor atterat�ons (952) 249-4600 Date Issued: si2si2oo2 SITE ADDRESS: 4045 Bayside Rd MAPLE PLAIN,MN 55359 PID: 06-117-23-14-0022 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S -Building Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 209.25 Valuation: $ 11,500.00 State Surcharge Fee: $ 6.25 TOTAL FEE: $ 215.50 APPLICANT: YEAR RourrD xooF�rrG irrc OWNER: x&L BooN 1507 PULASKI ROAD 4045 BAYSIDE RD BUFFALO,MN 55313 MAPLE PLAIN MN 55359 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �C6� , � ^ � � � � ` �� -t �'�'1��s,�_ ��-- APPL CANT PERMITEE SIGNAT E ISSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Reoorts, 1-Assessing, 1-Finance Page 1 � Total Fee: $ �/5_ S�C� Date Received: 5-�� 'U Z Entezed By: �%--- Permit#: ��JS Z 2 � CITY OF ORONO - BUII.,DING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------------�-----�-------------------------- THE APPLICANT IS: (circle one) OWNER OR ONTRACTO&� JOB SITE ADDRESS: �L'y.� �9f/�Si��' /t-� ZIP: S.S-3S� NAME OF OWNER: �--� -�r �oc�.� PHONE• (home) �s2 � %y�--�'�°z7 � (work) 1�ZAILING ADDRESS: ��S /-�� S�G,�/��/,CITY: Oi��sQ ZIP: �S3S9 CONTRACTOR: ��f�/ �CDUw� od � � PHONE: ��3"�Z7�"��Z-- CONTACT PERSON: � �v�. OBILE/PAGER: �/z �-.�z� - �d� MAILING ADDRESS: /�v �. �� -� ��CITY: a � ZIP: _�S^�/� STATE LICENSE: # Z�� /a/S� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NA1�IE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: ��G/� —�� l/('�-d�o� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ %��a o. � I hereby apply for a building pernut 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 work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: `�'�'�' � � DATE: -S �� 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. ti Sec.13.04 RIGHTS OF SUB.TECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secrion. Subd.2. Informatioo reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself sha11 be informed of: (a)the purpose and intended use of the requested data within the collecang'state agency, poliacal subdivision,or sratewide sysum; (b)whe[her he may refuse oY is legally required to supply the requested data;(c)any Irnow�coasequence arising from his supplying or refusing to supply privace or confidenaal data;and(d)the idendry of o[her persocLs or enrides authorized by state or federal law to receive the data. This requirement shall not apply when an individuai is asked to supply invesrigadve dara, pursuant to seccion 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place the norice reauired under this subdivision in the individual income tax oc oropem raz refund instructions instead of on chose forms. Subd. 3. Access to data by indi��dual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is ciassified as public, private or confidenoal. Upon his further request,an individual who is the subject of stored private or public dara on individuals shall be shown che data wichout any charge to hun and,�if he des'ues, shall be informed of the contenc and meaning of chat data. Afrer an individual has been shown the private data and informed of its meaning,the dara need not be disclosed to him for six months thereafter unless a dispute or acrion pursuanc to [his secdon is oending or addiao�al data on the individual has been collected or created. The responsible auehoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making,cerrifying,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 the request,exctuding Sarurdays,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 additional five days wichin which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individuai may contest the accuracy or completeness of public or pri�•ate data conceming himself. To exercise chis rieht,an individual shall noafy in wridng the responsible authoriry describing�he nature of the disagreement. The responsible authoriry shail wichin 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy pasc recipients of inaccurate or incomplete data, inctuding recipients named by [he individual;,or(b)norify the individual thac he believes the data to be correct. Data in dispu�e shall be disclosed only if[he individual's stacemenc of disagreement is included with the disclosed data. The de[erminaaon of the respensible authoriry may be appealed pursuant to the provisions of the administradve procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts of subjects of data", we would like to inform you that your request for a pemut 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 that: 1. The information you furnish will be used to determine your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require tha[ the City deny the permit or license. 3. The information may be shared with ocher local, state 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 perm.it. First �tiddle Last Address Ciry State Zip Phone I understan � rights as stated abo . , �� G� { Signa re DATE TIME CITY OF ORONO CALLED IN INSPECTION N �E - SCHEDULED � �— PERMIT N0. � � COMPLETED '� ADDRESS r�� S �- ' � OWNER CONTR. ' TELEPHONE NO� '-�� "f �� ' P UC;F � � DESCRIPTION � l� 01 FOOTING 11 MECH NICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS 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 � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU�YES_NO � COMMENTS: � W a � J O �. � O � W � Q � Z W � W � � �ORK SATISFACTORY:PROCEED ^�,�OJECT COMPLETE O CORRECT WORK&PROCEED �❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHfN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnedContra o on sit Inspector. G�� White Copyflnspector's File Canary CopylSite NoUce % DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE �7 SCHEDULED -� ,� PERMIT NO. pO S� / COMPLETED �"-^ Z'" �� ADDRESS ��-� ��S�C�- �C'�" 4 OWNER �c�ON CONTR. �� Q� �«'d�'�"`i TELEPHONE NO. -U4� - L�o/� �lr�C� �UO 3 � DESCRIPTION �/l 4�7'I� � 01 FOOTING 11 MECHANIC L RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAI 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 � C ENTS: � �� , � � � s a o (:�S� c�s iGt � � 0 W � Q � z W � W � � d W �1NORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 4� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContra t r on site: 1�� l f inspector� White Copyllnspector's File Canary CopylSite NoNce