HomeMy WebLinkAbout2001-P04120 (building: re-roof) PERMIT
CIT�s' OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po4�2o
Crystal Bay, Minnesota 55323 Per'mit Type: Minor Alterations
(952) 249-4600 Date Issued: �i2si2oot
SITE ADDRESS: 3245 Carman Rd
Excelsior,MN 55331
PID: 20-117-23-14-0010
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Buildin Census Code O/S-Building
Permit Class: g
Permit Type: Minor Alterations Permit Sub-type(s): Building- Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 223•25 Valuation: $ 13,000.00
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 229.75
APPLICANT: Skyline Exteriors OWNER: Jon& Kirsten Nielsen
6491 Arthur St NE 3245 Carman Rd
Fridley, MN 55432 Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE � ISSUEDi3Y SIGNATURG
Cooies: l-File lSi�nitures Reauired), 1-Applicant, 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1
�'otal Fee: $ Date Received:
• Entered By: Pernut#:
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 OR CONTRACTOR
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JOB SITE ADDRESS: ����S (,' '�-�'�?-�� ��5� ZIP:
NAME OF OWNER: ��'1 �'� ��S�> � PAONE: (home) `�s� -j.� s-�f!��.
(work)
MAILING ADDRESS: ���`/� �Z.�n��-,-, �C� CITY: r�;'��� �, ZIP:
CONTRACTOR �S�f �;1 ��C��m�� PHONE: ��-,.S-�S`--%.l`3 / 1
CONTACT PERSON: n;_1 �•�/s�,-�VIOBILE/PAGER: S�-�,� 1�
MAILINGADDRESS: LFy�/ �lf �.-�,�,}f i2��- CITY: �,;�,C�/� 7 ZIP: s.sy3.�
STATE LICENSE: # �a��ry�� �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: '�e �r;�� /��'='� "'� r���-�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � •3-�'"� �
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 not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATLd��"�-.� ��-- DATE: ��-��- ���
NOTE! Parade of 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 RIGHTS OF SUBJECTS OF DaTA
Subd. 1. Type of data. The rights of individual on whom che data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to suppty private or confidential data concerning himself shall
be informed of: (a)the purpose and iatended use of che requested dara within[he collecang"state agency, poliacal subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply rhe requested data;(c)any known consequence arising fmm his supplying or refusing to supply
priva�e or confidential data;and(d)the iden�icy of ocher persons or enndes authorized by state or federal law to receive the data. This requirement shall
not apply when an individuat is asked to suppty invesrieadve dara, pursuant ro secdon 13.82, subdivision 5, to a law enforcement ofFicer.
The commissioner of re�•enue mav place the ❑oace reouired under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms. �
Subd. 3. Access to data by indi��dual. Upon requesc to a responsibfe 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 funher request,an individual who is the subject
of scored private or public data on individuals shall be shown che data wiehout any charge to hun and, if he desires, shall be informed of the content
and meaning of[hat data. Afrzr an individual has been shown[he private data and informed of its meaning, the data need not be disclosed to him for
six mon[hs thereafter unless a dispute or acrion pursuant to [his secaon is pending or additional data on the individuai has been collected or created.
The responsible aurhoriry shall provide copies of the privace or public data upon request by the individual subject of che data. The responsible authoriry
may require [he requesting person to pay the actual costs of making, cenifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,o�within five days of
the date of the request,exduding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within�hat 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 accuncy or completeness of public or private
dara conceming himself. To exercise chis rieht,an individual shall nodfy in writing the responsible authori[y describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, induding recipiencs named by [he individual; or(b)notify the individual that he believes the data to be correct. Data
in dispute shali be disclosed only if the individual's statement of disagreemen[is included with the disclosed data.
Tt�e determination of the rtsponsible authoriry may be appealed pursuant to the provisions of the administra[ive procedure act reladng to
contested cases.
DAT� 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 reauest
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:
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 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 pernut or license requires Council action to approve, some information may become
public.
�. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
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Address
�,�r�� l��7 �.��i �5 J" ,� 3 � �C=�`.S� � �'�ll 3 /
Ci� State Zip Phone
I understand my ri?hts as stated above.
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Signature
DATE TIME
CITY OF ORONO CALLED IN 7 -�5 l� `�C.,
INSPECTION NOTI E SCHEDULED
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PERMIT NO. /�� COMPIETED 7=� =/S`'
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ADDRESS �a����� �C�// J"��,/'��(�
OWNER CONTR. � �
TELEPHONE NO. �7 - �j�/
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� DESCRIPTION C��� • � �-'� G` ! ��
� 01 FOOTING ` 11 MECHANICAL RI 18 EXCA %GRADING/FILL NG
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANOS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REM6VAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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�W Xr tvORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContr or on site:
Inspecto�� � �
White Copylinspector's File Canary Copy/Sfte Notice
DATE TIME
CITY OF ORONO CALLED IN � ��-�
INSPECTION NO CE SCHEDULED 7�.��7 �1������
PERMIT N0. �U ���� connP��Eo /�-2�'� -
ADDRESS �.-�� S �C`�-- 1 i`Y1Cc/�? �--�-�
OWNER CONTR. J/G���� �c fv-�
TELEPHONE NO. �� �� � - �5..�
� DESCRIPTION ���-�� ° � � `-��� ` ��
� 01 FOOTING 11 MECHANICAL RI 1 E AV/GRADING/FIL ING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARC COVER FiEMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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�� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WlLL FETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContrac on site:
Inspector.�/�������
White Copyllnspector's File Canary Copy/Site Notice
�AJE TIME
CITY OF ORONO CALLED IN /
INSPECTION NO� E SCHEDULED -�3c: '� �
PERMIT N0. COMPLETED /` la
ADDRESS ��� y�� C�-��/� .�:'-E-rl
OWNER CONTR. �S //1s-. � •
TELEPHONE NO. � �� ~� �r�j�r
� DESCRIPTION ��-C��� { �/�C�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
� 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/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFURE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTOARRANGEACCESS.
Cali forthe next inspection 24 hours in advance. �95Z� 24Q-Q6QQ
OwnerlConVact it •
Inspector.
White Copy(Inspector's File Canary CopylSite Notice