HomeMy WebLinkAbout1997-009183 - re-roof � - PERMIT
` CITY OF ORONO PERMIT TYPE: -..- . :.
2750 Kelley Parkway- P.O. Box 66 -'��-=:��.'`v=�
Crystal Bay, Minnesota 55323 Permit Number: _ :;;T�;__;
(612) 473-7357 Date Issued: _ — �-�—
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SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNAT ISSUED BY:SIGNATURE ��'-'� 'C'�
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan revie�v will be started.
(please print all information)
--------------------------------------------------------- ---� - - -----------------------------------------------
THE �.PPLICANT IS: (circle one) OWNER�OR CONTRACTOR
JOB SITE ADDRESS: /,� �� �';�- :�tY ��'-� ZIP: S�S.j .�- 3
NAME OF OWNER: �P U i �� �G �—l �° PHONE: (home) �{�G' Y ��
---- (work)
MAILING ADDRESS: �a� y� CITY: �r '� a ZIP: _5 5�.� 3
�
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: Z�:
STATE LICENSE: �#
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
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PROPOSED WORK(describe in detain: / �=�-�.- �'� ��J(� 1`"- �`' �'���
STORIES: SQ. �EET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ -���?C%
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 that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � �� DATE: � '�/ � l �
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.
� � �
Sec.13.04 RIGHTS OF SiJB.TECTS OF DATA
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 secaon.
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 aod 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 supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidenrial data;and(d)the identity of other persons or endries authorized by state or federal law ro receive the data. This requirement shall
not apply when an individual is asked to supply invesrieauve data, pursuant to section 13.82,subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the nocice reauired under this subdivision in the individual income tax or propertv tax refund
instructions inscead of on chose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whecher it is classified as public, private or confidenaal. Upon his further request,an individual who is the subjecc
of stored private or public data on individuals shall be shown the data wichout any charge to hirn and,�if he desires, shall be informed of the content
and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hicn for
six months thereafter unless a dispute or acrion pursuanc to this secrion is pending or addidonal data on the individual has been collected or creaced.
The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual cosu 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 the 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 addirional 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 compleceness of public or private
data conceming himself. To exercise this right,an individual shall noafy in wridng the responsible authoriry describing the nature of the disagreement.
The responsible authority 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, including recipienu named by the individual; or(b)noafy the individual that he believes the data to be correct. Data
in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed data.
The de[ermination of the responsible auchority may be appealed pursuant to the provisions of the administrarive procedure act relaang to
conrested 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 that:
1, The information you furnish will be used to deternune 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 a�encies 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.
/`1 f' (// U /1/�''�l � 1 ��c r/-( t-' [�
First / Middie Last
� 7 `/ / �Y �G7G� S)� �
Address � � r�'-� " � �� � /
l'/` /.(�i 7 Gi / � � �l /LL v� J � �- �r _ �� .�
Ciry "---- State Zip Phone
I understand my rights as ted above.
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Signacure
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO � SCHEDULED
PERMIT NO COMPLETED
ADDRESS � 2 r�
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL R 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
D. 12 WATER HOOK-UP 17 SITE INSPECTION
5 FINA 14 SEWER HOOK-UP 06 PROGRESS
� MO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d ❑WORK SATISFACTORY:PROCEED OJECT COMPLETE
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� C;CORRECT WORK&PROCEED i ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDiTIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 2a hours in advanc . 3-7357
OwnerlContr r o site,
Inspector
White Copyllnspector's File Canary CopylSite Notice