HomeMy WebLinkAbout1991-003956 - re-roof/over-lay �S�F_,IZ1�II
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1335 Brown Rd. South • P.O. Box 66 Permit Number: �-��-�'-�-'t'�-Z3�'
Crystal Bay, Minnesota 55323 Date Issued: '-'t�`'.=�}`-''��='`
(612) 473-7357
SITE ADDRESS: ,._,_. _ _ _
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APPLIC /PERMITEE SIGNAT E ISSUED BY:SIGNATURE � ����
CITY OF ORONO -`BIIILDING PERMIT APPLICATION �
Total Fee: $ Date Received:
Date-Approved: �
---
Entered By:
Permit�:
ALL INFORMATION MIIST BE SIIBMITTED IN FIJLL BEFORE PLAN RSVIB�W i�lILL BE STARTED
(See Check-off List Enclosed) _
-------------------------
THE APpZIGANT IS: (circle one� OWNER o CONTRACTOR �
�
JOB SITE ADDRESS: � � � � �O � � ��D ZIP: �j � ��
(work)
NA1�SE OF OWNER: �u �.� ����t� r PHONE: (home)¢7�`7a��
MAII,ING ADDRESS: tJUX I� 7 CITY CQY�T�}'l- .U/7� ZIP: ����
CONTRACTOR: ^Q�� � � ����"' PHONE: ���" �� ��
MAILING ADDRESS : �� � ���- � CITY' ��N � ZIP'
TYP$ OF WORR: New Addition Accessory/Structure Move
Demo Remodel/Alteration Renovate �r� Land Alteration
PROPOSED WORR (describe in detail) : +' � � w��- � ��� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF B$DROOMS: GARAGE ST�LS: ATT. DET. _
) Q�
BSTIMATED CONSTRIICTION VALIIATION (egcluding land) : $ I �� -
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 Ci d with the State Building Code; that I
understand this is not a permit and wo is not to start without a permit; and
that the work will be in accorda ce with the approved plan.
' IGNATQRE: ���'�� DATE:�
APPLICANT S S
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. Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
'
• - e � On the Narth Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
Iicense 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 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 extant necessary to process the permit or
license.
4. If your requested permit or I.icense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�ate
data on yourself.
6. Your full name is required to process this applicatian or
permit.
�c�f�� l� � Q �(� �
First Middle Last
�� 1 a�? C 22 � �'o �� �o�i
Address
����"T�L ��� �� �� � �
City State Zlp
�� � ��� ��J
Phone �
I underst d my righ s as st ed above.
. �-
Signature
BUILDING&ZONING-473•7357 • AD�tINISTRATION&FINANCE-473-7358 • PUBLIC WORKS -473-7359
ASSESSIN G -
� . , • " �
�.04 RIGHTS OF SIIBJECTS OF DATA � �
Subdivision L Type ef data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
. Subd. 2. Information required to be giv� ����L An.individuel asked to
� � su 1 rivate or confidentiel c3ata concerning �m�sit�h�in the collecting state agency,
�P y P uested data
purpose and intended use of the re9 tem; (b) whether he ma� refuse or is legally
political subdivision, or statewide sys �oWn consequence arising from his
required to supply the requested date; (�) anY
su 1 ing or refusing to supply private or confidential data; and (d) the identity of
PP Y
other persons or entities authorized by Svidual iseeskedlto supplyein est gat ve da 8
requirement shall not apply when en indi
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma lert t8X re�und instQuct ons�insteadhoi
subdivision in the individual income tax or r•
on those orms. . � --- - -- - .
Subd. 3. Access to �ata bp in��i�- IIPon request to e responsible
authority, an individusl shall be informeda h bli� hPr vateeor confident a1.� IIPon �
individuels, and whether it is classlfled P ' ublic data on
further request, an individuel who is the subject of se tr�e�mri�ae if he desires, shell
individuels shall be shown the data withou fan�y��tg. �ter an individual h�s been
6e informed of the content end meaning the data need not be �sclosed to
shown the privste data and informed of its u���action pursuant to this section is
him for six months thereafter unless e �SP
� ending or additional data on the individu e h�gteQor public dataruponarequest by
p reauire the
� responsible authority sha1l provide cop1esThe res onsible authority may
the individual subjec�yf the d��• p �Qrtif n and compiling the
requesting person to the actual costs of making, Yi 6'
copies. if possible, with any request
The responsible authority shall comQly immediately,
made pursuant to this subdivision, or with lida e- if Simmediateg compliancs eisu not
excluding Saturdays, Sundays and 1Qga1 Y�'
ossible. If he cannot comply with the requ et �thin�i��n w��h tohcornplYnw�h the
p have an additional � Y5
individual, and maY �d le al holidays-
request, excluding Saturdavs, SundeYS g
Subd. 4. Pmced�e when data is not accs�ate or complete. An indi�i�� may
- ublic or private data conesrning himself. To
contest the accuracy or completeness ef P in ryrjting the responsible authority
exercise this right, an ind�ndu�1 s� notify �ible euthoritq shall within 30
describing the nature of the disagreemen� The respa
days either. (a) correct the data found to be lete dataeincluding rec pie ts namedt by
notify past recipients of inaccurate or incomp
the individual; or (b) notify the individuel in�v dual'slstatementof disagreement is
Data in dispute shall be disclosed only if the
• included with the disclosed data• e�e� p�suant to the
' The determination of the responsible authority tp�ontested cases. • '
provisions of the administrative procedure act relating
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT SCHEDUIED ' �
PERMIT NO. -� COMPLETED
ADDRESS -'� �/� � � ,�
OWNE CONTR.
TELEPHONE NO.
� DESCRIPTION
lL 01 FOOTING 11 MECHANIC RI 18 E AV/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
r�BD. 12 WATER HOOK-UP 17 SITE INSPECTION
O5 F 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 P�UMBING 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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� COMMENTS:
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d C�WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED ��i ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP OROER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next s 'on 24 hours in advance 473-7357
OwnerlC ra t r on si :
Inspect
White Copyllnspector's File Canary Copy/Site Notice