HomeMy WebLinkAbout1998-010401 - storm dmg repair PERMIT
CITY Of,�ORONO PERMIT TYPE: -
2750 K�IIe Parkwa P.O. Box 66 �-'`��'{�"`'
y y Permit Number: �-� ��=�.
Crystal Bay, Minnesota 55323 -��f;d � -
(612)473-7357 Date Issued: :ir�:�';�:4;:'�_i_:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY: _ _
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APPUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: � $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
A.11 information must be submitted in full before plan re�iew will be started.
(please print all information) .
Trf� A.PPLICANT IS: (circle one) O��NER OR CONTRACTOR �
JOB SITE A.DDRESS: � �c� �U��� �.��� ��� z�: SS-���
� NAME OF OWNER: /��F.I f%1'Z PIIOi�tE: (home) 7�j ' �0 7C�
(work)
MAII�ING ADDRESS: ��U � UPji,�.:,,t �.�CTTY: �rc�ti..v ZIP: �C�
CO�t'I`RA.CTOR � v�.�. �- PHONE: 53-7�� C���
CO�I'ACT PERSO� : (.���,��,n �'�,,,^,�� MOBILE/PAGER: �1�t - /c�`7 7
MATLING ADDRESS: �G'l� �.��;;.5�,��.-,,o �14J�CITY: �,.���'-�-4 ZIP:��
STATE LICEI�TSE: # �c��a�r3�
A1�CHITECT�ENGINEER: — PHO\TE:
MAII�ING ADDRESS: --- CITY: ZIP: __._
T,*�,ME: �-- REGISTRA.TIOti'# ---
TYPE OF tiVOR�i: New Addition Accessory Structure
Move � Remodel/Alteration�_ Land Alteration
PROPOSED`VORK(describe in detai�: K t&�p�t✓� I�.�� ���sc�
STORIES: SQ.FEET OF EACH F`LOOR: '
NO. OF BEDROOMS: GARA.GE STALLS: ATT. DET.
ESTlil�A1'ED CONSTRUCTION VALUATION (excluding land): $ _(, �c7O' �
I hereby apply for a building pemnit 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 Buildin� Code; that I understand this is not a perm.it and work is not to start without a
pemut; and that the work will be in a rdance �ith the approved plan.
APPLICANT'S SIGNA�CTRE: DATE: ��/ �
NOTE! �'arade o Flomes events require separate permit approval by Police Deparhnent and
� City Counci160 days prior to the event. Non permitted events will not be allowed.
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Scc.13.0:RIGHTS OF SUBJECTS OF DATa
Subd. 1. Type oF data. The righcs oF individual on whom the data is stored or to be s�or:d sba11 be as se[forth ia this secdon. "
Subd.2. Informatioa reqirired to be givea individual. An iadividual asked to supply private or confid�ndal data concerning fiimsetf shall
ba info�med of: (a)the purposo and inr:nded use of[he rtquess�dara wi[hin the collecdng§tat�a;eacy,poliacal subdivisioo,or sacewide ry�m;
(b)whe[her he may rfuse or is legally requir.d to supply[he rquesced data;(c)any Fmown coasequence arisin3 from his supplying or refusing to supply
private or confidenrial data;and(d)th_idendry of ocher pacsoas or enades au�horized by se�ee or federal law to r:ceive the dara. This requucmenc shall
not apply when an individual is asked to svpply invesdgadve data,pursuant to secaon 13.82,subdivision 5, to a law enforcemznt ofricer. -
Tha commissioner of rever.uo mav place tha noace r_auir.d under this subdivision in the individual ir.come �x or orooem tax refued
inscrucrions inscead of on chose forms. '
Subd. 3. Access to data by individual. tipon requesc to a responsible au�horiry,an individual shall be informed whe�her he is the subjecc �
of scored dact on individuals,and whechtr it is ciassified as pubtic, privace or confidenrial. Upon his furcher request,an individual who is the subjecc
of scored private or public dara on individuals shall be Shown che data wi�hout any charge to tiim and;if he desires, shall be informed of the eontent
and meaning of that dara. Afcer an individu�!has been shown[ho privac�data and informed of ics meaaing, the dara need noc be diseiosed to him for
siz monrhs thereaiter unless a dispute or acdon pursuanc to chis secdon is ptnding or addidoaai dat�on the ir.dividual has been collected or crearr.d.
The responsibie authoriry shall provid�copies of the priva[�or pubiic data upon reques�by the individual subje:c of che data. Tne responsible auchoriry
may requir the requesring person to pay the accual coscs of making,cerafying,and compiling tfie copies.
The responsibla au[horiry shall comply immediately,if possibfe, with any request madz pursuant to[his subdivision,or wichin five days of
the dace of tht request,excluding Sacurdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he canaot comply with the requasc
wirhin that time,he shall so inform che individual,and may have an addiaonal Five days wichin which to comply with the requesc,excluding Saturdays,
Sundays and legal hotidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest cha accuracy or completeness of public orprivate
dan concerning himself. To exercise chis ri¢hc,an individual shall noa'ry in wriang che responsibie auchoriry d:scribing the nantre of the disagreemeac.
The responsible authoriry shall wi�hin 30 days eicher: (a)corrcc che data found to be inaccurate or incomplece and aaempt to nodfy past recipiencs of
inaccurate or incomplete data, including recipien�s named by che individual;or(b)nodfy the individual thac he believes che data to be correcc. Data
in dispum shall be disclosed only if the u:dividual's s��emenc of disagreement is included wich che d'uclosed da�.
The decerminarion of the rzsponsible auchoriry may be appealed pursuant to the provisions of che 2dmirus[radve procedure act reladn� to
contesced cases.
DATA PRiVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Riohts of subjects of data", we would like to inform you that your request
for a pernut or license from the Ciry of Orono or any of its departments may require you to fumish certain;private or
confidential information.
You are notified tha[:�
1. The information you furnish will be used to determine your qualification fo:the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permi[ or license.
3. The informatioa may be shared wich ocher local, state or federal a�encies to the excent necessary to process
' the permi[ or license.
4. If your requested permit or license requcres Council action to approve, some informa[ion may become
public.
�. You have certain rights under M.S. 13.04 (available upon request) to review private data onyouurself.
6. Your full name is required to process this application or permic.
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Addcess
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Ciry _� Sate Zip Phone
I understand my rights as stated above.
Signa�ur
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE,, , ; � SCHEDULED ta 2�-5�J �'e'�
PERMIT NO. � COMPLETED G -L3 -4`� `T'��
ADDRESS ��7� lL�t� ;i�w�) �.�5�''► (�
OWNER CONTR.�"�NL
TELEPHONE NO. �1 ��i - IU 17
� DESCRIPTION "7UF?Ji�Y\ �As'Vlr4(��� �C��' (-�•.►s.Q
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED i=: PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ,_ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ,- pHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor si :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �-�y-!� / � � �>
INSPECTION NOTICE /,( SCHEDULED io-��--yd� , ' a
PERMIT NO. �, � / �/ 'COMPLETED T �_
ADDRESS � /�'G • �-�'��� �
OWNER ,'��--<-�ti' CONTR. ��
TELEPHONE NO. � .3 S �� CYJ�
� DESCRIPTION .'j,r�. �� �� f-GC.y2_...--
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04.yUA�6-�II� 12 WATER HOOK-UP 17 SITE INSPECTION
�05 FINAL � 14 SEWER HOOK-UP 06 PROGRESS
� OZ DEMO-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
� OWNER/CONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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� [7 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORREC7 WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next i spection 24 hours in advance.473�73�J7
OwnerlContr t n s te�
a�%��
Inspector. ��'
White Copyllnspector's File Canary CopylSite Notice