HomeMy WebLinkAbout1998-010371 (tearoff/reroof) PERMIT
CITY OF ORONO PERMIT TYPE:
•'2750 Kelley Parkway- P.O. Box 66 ��;1��,�,j F t•��:
t Permit Number: �;��_,.�; , �
Crystal Bay, Minnesota 55323
(612) 473-7357 Date Issued: ��r,;�; c„��;;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - ���,==i i c a{-�t. - °=�T . +I�: .OWNER:
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APPLICANUP ITEE SIGNATURE ISSUED BY:SIGNATURE�j� -
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Total Fee: $ /o z. �-� Date Received:
, -Entered By: � Permit#: l� 3��
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CITY OF ORONO - BUII�DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all informat�on)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 3 . �, � � �
�\-� _� �� �, : �c.!1 I \ �' ZIP:
NAME OF OWNER: �0�� � y �`�Q� �c����r PHONE: (home -�- `.����
� (work)
MAILING ADDRESS: �� �� ��c:�..� �,�,,���: crrY:�'x ; �s :� ! z�:
CONT'RA.CTOR: �� � � C� : PHOivE: C�`� � �'`���3
COl�t'TACT PERSON: .� ;� � � � 1 - MOBILE/P�GER:
NIAII�ING ADDRESS: . o Z�.���f� l, CTi'Y: �\����-,��v� ZIP:_,3 ; ' '-y 1
STATE LICEI�TSE: #;��. � �S '-�� —�
A.RCHITECT/ENGINEER: PHO��:
I�IA.ILi�i TG ADDRESS: CITY: ZIP:
r,TA,ME; REGISTRATION#
TYPE OF tiVOR�i: New Addition Accessory Structure
Move � Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detain: \�r� .�, C.� '� ?S ��-�=-�. ���.���.
STORIES: SQ. FEET OF EACH FZ.00R: �
NO. OF BEDROOiVIS: GARAGE STALLS: ATT. DET.
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ESTI�VIA'I'ED CONSTRUCTION VALUATION (exclud.ing land): $ � �G� �—
I hereby apply for a buildino permit and I aclrnowledge 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 BuildinJ Code; that I understand this is not a permit and work is not to start without a
pernut; and that the work will be in accordance with the approved plan.
DATE:� - �-`���
APPLICANT'S SIGNATURE: � � �, �� ----_._ �
NOTE! Parade of H'omes events require separate permit approval by Police Department and
City Counci160 days przor to the event. Non permilted events wi11 not be allowed.
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Stc.13.04 RIGHTS OF SUBJECTS OF DaT?,
Subd. 1. Type oF data. The righes of individual on whom[he data is scored or to be stored shall be as set forrh in this secaoa.
Subd.2. Informatien reqirired to be given indiridual. An individual asked to supply priva[e or confidendal dara concerning h.imself shall
ba informed of: (a)the purpose and iacended use of the reques�data wichin the collecdng"state ageacy, polidcal subdivision,or statewide rystem;
(b)whe[her he may tefuse or is tegally rtquir.d to supply the requested data;(c)any lmown coasequeace arising from his supplving or refusing ro supply
privace or eonndenaai daca;and(d)[he idendry of orher pecsoas or enrides auchorized by stace or federal law to receive the data. This requiremeat shall
no[apply when an individual is asked�o supply invesrieadve daca, pursuant to secaon 13.82, subdivision 5, to a law enforcemeac ofrccer. -
The commissioner of revenue mav lace che noace r_auired under this subdivision in the individual ir.come tax or orovem taz refur.d
inscrucaons instead of on those forms.
Subd. 3. Access to data by iadi�iduai. tipon request to a responsible auchoriry,an individual shall be informed whe�her he is the subjecc
of s�ored dan on individuals,and whe�her ic is classified as public, private or conFidenrial. Upon his further request, an iadividual who is the subjec�
of scored privace or pubtic daca on individuals shall be shown che dara wi�hout any charge to him and;if he dzsires, shall be informed of the content
and meaning of chat data. Aher an individua!hu been shown[he priva�e data and informed of ics meaning, che dara need not be disclosed to him for
siz monchs chzrea[ur unless a dispuce or acaon pursuanc co chis secaon is pending or addidonai data on the individual has been collzcced or creaced.
The responsible authority shall provide copies of the privace or public data upon request by che individual subjecc of[he dara. Tne responsible authoriry
may require[he requesdng person to pay the accual costs of making,certifying, and compiling the copies.
The responsible au�horiry shall comply immediat�ly,if possible,wich any request made pursuant to[his subdivision, or wi�hin five days of
the dace of the requesc,exciuding Saturdays,Sundays and legal holidays,if immzdiate compliance is not possible. If he cannoc comply with the requesc
wi[hin chat time,he shall so inform che individual,and may have an addiaonal fivt days wichin which to comply wirh the request,eccluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest che accuracy or completeness of public orpriva�e
daca concerning himself. To execcise[his riehc,an individual shall noa"ry in wridng che responsible auchoriry dzscribing the nanire of the disagreemen[.
'fhe responsibie auchoriry shall within 30 days eicher: (a)correcc the data found to be inaccurate or incomplece and aaempe to nodfy past recipients of
inaccurate or incomplece data, including recipiencs named by [he individual; or(b)nodfy[he individual thac he believes che data to be coaect. Data
in dispute shall be disc(osed only if che individual's sc3temen[of disagreemenc is included wich the disclosed data.
The dz�erminarion of the responsible auchoriry may be appzaled pursuant to the provisions oF the administraavz procedure act relaang to
contesced cases.
DATA PRIVACY ADYISORY
In accordance with M.S. 13.04, Subd.2, "Riohts of subjects of data", we would like to inform you that your request
for a permi[ or license from the Ciry 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 fumish 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 perm.it or license.
3. The information may be shared with ocher 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 N1.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process chis application or permit.
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I understand my ri�hts as stated above.
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Signamre
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED —
PERMIT NO. COMPLETED
ADDRESS `� '7 S+2 ��" /���_ .�v��.��1
OWNER CONTR.
TELEPHONE NO. '
� DESCRIPTION G� �-- �t�
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04� 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 0 EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
D COMMENTS:
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d fJ WORKSATISFACTORY:PROCEED PROJECTCOMPLETE
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� [; CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
CJ CORRECTUNSAFECONDITIONWITHIN HOURS. �- pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspe ion 24 hours in advance.473-7357
Owner/Con acto o ite:
Inspecto .
White Copyllnspector's i Canary Copy/Site Notice