HomeMy WebLinkAbout2002-P05864 - re-roof � PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P05864
Crystal Bay, Minnesota 55323 Permit Type: Minor Aicerat�ons
(952) 249-4600 Date Issued: 11i22i2oo2
SITE ADDRESS: 445 Brown Rd S
I,ong Lake,MN 55356
P I D: 03-117-23-31-0001
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential c�
Census Code s ' �`� I
Permit Class: Building
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Permit Type: Minor Alterations Permit Sub-type(s): Building- oof �
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: � 111.25 Valuation: $ 4,850.00
State Surcharge Fee: $ 2.95
TOTAL FEE: $ 114.20
APPLICANT: Northrup Roofmg OWNER: Eric&Ivanette Smith
5015 Oakland Ave S 445 Brown Rd S
Minneapolis,MN 55417 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRIC'I'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APP ICANTPLRMITEESIGNATURE ISSUEDSYSIGNATURE
Copies: 1-File(SiQnitures Required), 1-Apvlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
�.
` Total Fee: $ Date Received:
Entered By: —� Permit#: ✓'C�s��' �,�
CITY OF ORONO - BUII,DING PERNIIT APPLICATIOleT
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 OR CONTRACTOR
JOB SITE ADDRESS: � �-(1 � � . ���_� �� ZIP: ��3� �
NAME OF OWNER: �, � a�,�� ����`�� PHONE: (home) �S�-. �1 l7 3�Co�C,�
(work)
MAII.ING ADDRESS: ��._� CITY: C�, ZIP:
CONTRACTOR: ti ����.s� ��'� �� PHONE: � \�-�a-�—3�J 3
CONTACT PERSON: ' � MOB E/PAGER: � � - � ��� �-
MAII.ING ADDRESS: ��S- �rt �t�,�,..� �����,CITY: � ZIP: ���(1-7
STATE LICENSE: # ac,�� g'���
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATIOl�#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration X Land Alteration
PROPOSED WORK(describe in detai�: �.u„ �� ;� ��-��� 5�, ,���� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �-(�'S�
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 �uilding Code; that I understand this is not a pernut and work is not to start without a
pernut; and that the work will be in accord nce with the approved plan.
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APPLICANT'S SIGNATURE: V DATE: i � c�^
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.
Sea13.04 RIGfiTS OF SCfBJECTS OF D�TA
Subd. 1. Type of data. The righcs of individual on whom che data is stored or to be stored shall be as set forth ia this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself sha11
be informed of: (a)-the purpose and inrended use of the requested data within the colleccing"state agency,political subdivision,or sratewide system;
(b)whether he may refuse oY is legaily required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idendry of other persons or enrides authorized by state or federal law to receive the data. 'Ihis requirement shall
not apply when an individual is asked to supply invesrigadve dara, pursuant to secrion 13.82,subdivision 5, to a law enforcement o�cer.
The commissioner of reeenue mav place che noace reouired under this subdivision in the individual income tax or propem raz refund
instrucaons instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public, private or confidenrial. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wi�hout any charge to him and,-if he desires, shall be informed of the content
and meaning of[hat 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 mon[hs thereafter unless a dispute or acaon pursuanc to [his secrion is pending or addidonal data on the individual has been coilected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individua]subject of che data. The responsible authoriry
may require the requesdng person to pay the actual costs of making, cerrifying, and compiling the copies.
The responsible aurhoriry shall compiy immediately, if possible,wi�h any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saeurdays,Sundays and legal holidays,if immediace 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 wluch 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 conceming himself. To exercise this right,an individual shall noafy in wriang the responsible authoriry describing�he nacure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy 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 disagreemenc is included with the disclosed data.
The decermination of the responsible authoriry may be appealed punuant to the provisions of the administradve procedure act relaang to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hts 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. 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. Your full name is required to process this application or permit.
First Middle Last
Address
City Smte Zip Phone
I understand my rights as stated above.
Signature
,�
DATE Tis
CITY OF ORONO CALLED IN //- Z Z -�'1 �
INSPECTION NOTICE SCHEDULED //-2z ��
PERMIT NO. PO��10� COMPLETED �r J'�
ADDRESS �'���� � � S�
OWNER .���� CONTR. ^
TELEPHONE N0. � l Z — 7G/ — `�� S'�7
� DESCRIPTION �� '
W O<� 11 MECHAN L RI 18 EXCAV/GRADING/FILLING
Q02 FRAMING � 13 MECHANI AL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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 FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAI 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTO�AMEET YOU:_YES_NO _ �
� COMMENTS: �-�°� — — ���� .¢..,��•..
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W� WORK R'►`.'PFl�D ❑ PROJECTCOMPLEfE
W �CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContract
Inspector
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