HomeMy WebLinkAbout1997-008861 - re-roof � � PERMIT
CI�i'� O'F' ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 _ __ ; .
Crystal Bay, Minnesota 55323 Permit Number: _ _ 4:;�,:s'"
(612) 473-7357 Date Issued: . —
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT�PERMITEE SI E � ISSUED BY:SIGNATURE
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•Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OI3,CONTRACTOR
JOB SITE ADDRESS: � �� �,(;-�'1 �����!U ��0�� ZIP:
NAME OF OWNER: �0(,l, Q„S l�f,� (' �l'� PHONE: (home) �7,'- 7���
r (work)
MAILING ADDRESS: l`7 D ��� �(�'�� l�ITY: �� � ZIP:
CONTRACTOR: ��"` Y��.�-� QO �I� �� PHONE: �7-� �.S�3 ( 7
CONTACT PERSON: � S e MOBILE/PAGER: ��'/�-��s
MAILING ADDRESS: i 1�5 �. ��C� c��/ CITY: �'/�� ZIP: �.5 ��f 7
STATE LICENSE: # :�3 S� `
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: Z��
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPO$�ED WORK(describe in detai�: � �1 i'
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $��
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 e it nd work is not to start without a
permit; and that the work will b in acc ar}�e ith e l pr v�d plan. ,
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APPLIC
ANT'S SIGNATURE: .����� � _ �� DATE:
NOTE! Parade�Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[JBJECTS 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 reqtrired to be given individual. An individual asked ro supply private or confidenrial data concerning himself shall
be informed of: (a)the purpose and iatended use of the requesced data within the collecdng'state agency,polirical subdivision,or sratewide system;
(b)whether he may refuse or is legally required ro supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or enddes authorized by state or fedecal law to receive the data. T'his requirement shall
not apply when an individual is asked to supply invesdearive data, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav place the ❑otice reauired under this subdivision in the individual income tax oc properN tax refund
instructions instead of on those forms.
Subd. 3. Access to data by indiridual. 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 classified as public, private or confidenaal. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown[he data wichout any charge to hun and, if he desires, shall be informed of the conten[
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual has been collected or crea[ed.
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 costs of making, certifying,and compiling the copies.
The responsible auchoriry shal(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 leeal 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 within which to comply with the request,excluding Saturdays,
5undays 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 conceming himself. To exercise[his rieht,an individual shall norify in writing the responsible authoriry describing the nature of[he disagreement.
The responsible authoricy shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, inciuding 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 de[erminarion of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified that:
1. T'he 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 pernut 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 pemut.
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C�ty State \ Zip Phone
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Signature
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI e��. SCHEDULED —
PERMIT NO. � COMPLETED
ADDRESS �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION �.- d � �G� L�
L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
0 O-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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 ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED C: I SUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. �- pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7357
OwnerlCont c r site:
Inspector -
White Copyllnspector's File Canary Copy/Site Notice