HomeMy WebLinkAbout2003-P06581 (re-roof) � . PERMIT '
CITY OF ORONO Permit ►vumb r:
2750 Kelley Parkway- PO Box 66 Po6ssi
Crystal Bay, Minnesota 55323 Pet-mit Type: Minor Alterations
(952) 249-4600 Date Issued: �i2s�2oo3
SITE ADDRESS: 4080 Bayside Rd
MAPLE PLAIN,MN 55359
PID: 06-117-23-14-0014
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building ensus Code O/S-Building
Permit Type: Minor Alterations ermit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ g3•25 Valuation: $ 3,000.00
State Surcharge Fee: $ 2.00
TOTAL FEE: $ 85.25
APPLICANT: 7udd Interiors Inc. OWNE : M.T&M M HARRINGTON
3825 Virginia Ave. 4080 BAYSIDE RD
Deephaven,MN 55391 MAPLE PLAIN MN 55359
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE AL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL C TY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANTPERMITEE G ATURE ISSUEDBYSIGNATURE
Conies: 1-File(SiQni[ures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin , 1-Finance Page 1
. , �
Total Fee: $ Date Received: -��'-� `d-�
Entered By: 2— Permit#: TT/>/s S'frl
�CITY OF ORONO — BUILDING PE T A.PPLICATIOl�
All information must be submitted in full befo e plan review will be started.
(please print all info tion)
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THE APPLICANT IS: (circle one) OWNER O �ONTRACTOR j
JOB SI
TE ADDRESS: 0�0 � � � � Z�� �)
NAME OF OWNER: �I PHONE: (home)
(work)
MAILING ADDRESS: 0 � �� / - ITY: 01ro►no ZIP: Lj 5
CONTRACTOR: J 1n�I to� PHONE: ��Z- ��S�b
CONTACT PERSON: � �. IL AGER: {1 _3�6����1-S�
MAlLINGADDRESS: 2 V iv�a R� CITY� ��= �������^ Z�� SS3�1
STATE LICENSE: #�.,o�$3',�
ARCHITECT/ENGINEER:
PHONE:
1VIAILING ADDRESS: CITY: Z�:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
.__
Move Rem �rafio Land Alteration
PROPOSED WORK(describe in detain: �-o� ' iY� �- � - ' � '��-
STORIES: SQ.FEET OF EACH OOR:
NO. OF BEDROOMS: GARAGE ST LS: ATT. DET.
EST�IATED CONSTRUCTION VALUATION ( xcluding land): $ � poo-`—
I hereby apply for a building pemiit and I acknowled e that the information above is complete and
accurate; that the work will be in conformance with e ordinances and codes of the City and with
the State Building Code; that I understand this is n a permit and work is not to start without a
permit; and that the work will be ' accordance wi the approved plan.
' � ` � - 23��� 2�3
APPLICANT'S SIGNATURE: � � DATE: �1�
NOTE! Parade of Homes events require separat permit approval by Police Department and
City Council 60 days prior to the event. Non pe itted events will not be allowed.
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Sec.13.04 RIGF3TS OF SUSJECTS OF D�1TA
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 section.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenual data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency,polidcal subdivision,or statewide system;
(b)whether he may refuse oY is legally required to suppiy the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the identity of other penons or endties authorized by state or federai law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�•enue mav place the nodce required under this subdivision in the individual income tax or proper[y tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuais,and whecher it is class�ed as public, private or confidennal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data without any charge to hun and,if he desires, shall be informed of the content
and meaning of that data. Aftzc an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereaher unless a dispute or acrion pursuant to this secrion 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 actual costs of making,cerafying,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 ihe request,excluding Saturdays,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 private
data concerning himself. To exercise this right,an individual shall notify in wridng the responsible authoriry describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to noufy past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The decermination of the responsible authoriry may be appealed pursuant to the provisions of the administradve 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 infor�.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 that:
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 pemut or license.
3. The information may be shared with other 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 permit.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature
STATE OF MN DEPT. OF COMMERCE
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DAT TIME
CITY OF ORONO CALLED IN , '� �
INSPECTION NOT E SCHEDULED '�'� � t " '�'�
PERMITN0. �� ' COMPLETED �� `
ADDRESS � -� ��
OWNER CONTR.✓�- r .�'���OrZs' ��re-
TELEPHONE NO. - ���
� DESCRIPTION � ��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FI ING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WET DS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECT�ON
Q 05 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 REM VAL
J 10 PLUMBING FINAL 36 FOUNDATION/REM VAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OC PANCY
� ❑CORRECT WORK,CALL FOA REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUTAED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249 4600
Owner/Contrac I,�'.e�r�ite-
Inspector. '�= �
White Copyllnspector's File Canary CopylSite Notice