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Home My WebLink About2008-00403 - re-roof , . CITY OF ORONO PERMIT NO.: 200&00403 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSVE�: 1U19/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 15 BROWN RD S PIN : 34-118-23-34-0010 LEGAL DESC : UNPLATTED 34 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILD[NG-UNDEFINED VALUATION : $ 4,200.00 NOTE: TEAR OFF REROOF GARAGE ONLY — '��-S� �� S�"F"s�KE� APPLICAIYT PERMIT FEE SCHEDULE 118.00 TODAYS EXTERIORS INC. STATE SURCHARGE(VALUATION) 2.10 l 1308 70TH PLACE N MAPLE GROVE,MN 55369- TOTAL 120.10 (763)425-0803 Minnesota State License#: 20387451 OWNER EISS, JOHN& BONNIE 15 BROWN RD S LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifica[ions,applicable City approvals,and the State Building Code. This permit is for only the work described and does no[gran[permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construetion is suspended for a period of 180 days at any time after work has commenced. The applicant is responsibl suring all require ctions are requested in con nc�e the State Bui ' g e.This permit may be revoked y time fr�due cause. /� / /°l / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. Total Fee: $ �o��•lG DateReceived: � Entered By: Permit#: p�Q —b D D CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �S S J��+� ,�� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �1� If yes, a special event pe��mit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed NAME OF OWNER: �oNn1��=��o�� PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: ��y( S � !r'o�S -�c� PHONE: 7(3 �l2,�'- G b o 3 CONTACT PERSON: A e a�.1 MOBILE/PAGER: ��Z 6 ti y� o Z3 6 MAILING ADDRESS: �130 � 7c� K �� N CITY: �.q�,� 6�.o,.r ZIP: ,S�',�6 g STATE LICENSE: # Zo3 d 7K� � EXPIRATION DATE: 3�,�/ o� ARCffiTECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) ��,c,;�� Cqra�� Any earth movement may require MCWD review and permits ! a�� PROPOSED WORK(describe in detuin: %',qf- o� �,� a,J q q�,¢4 r-' 2� • rov� , STORIES: �_ SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ L1ZB� .�, 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 n start without a permit; d that the work will be in accordance with the approved plan. — '----„-- APPLICANT'S SIGNATURE: �� DATE: �� d � 3t . , , Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself shal l be informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice reauired under this subdivision in[he individual income tax or property tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. 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 him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning the data need not be disdosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shal I 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. [f he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is no[accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify 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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested 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: L 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 permit 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. our full name is required to process this application or permit. �� s� First Middle Last �( 3� v 70� ►,oL r� Address 1�� tit •s S:S�C� � �� z 6��r • 0 2��, City State Zip Phone I understand m s as stated abo . Signature �� Resel Form 32 � �� n DATE TIME i `CITY OF ORONO CALLED IN (��I INSPECTION�N�'O^�T C.�'°�(.� SCHEDULED j a� � PERMIT NO.=�-^'� w L�� COMPLETED ADDRESS �� 'u�� V� OWNER CONTR. ' � TELEPHONE NO. � � � -ba � DESCRIPTION F� �a I �f '— � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PIUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES�L NO � COMMENTS: � � - a t t�� J�.?��L ,��i-�.G'� �Q�- o +r � ' � ��,uL� r�l '-P� - m ��1�ZI�i�8 0 � w a Q � z W � W � � � � ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED �SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIOfV REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-Q6QQ OwnerlContractor on site: Inspector. r . 1/ �' � < � � White Copyllnspector's File Canary CopylSite Notice