HomeMy WebLinkAbout1999-011731 (re-roof) PERMIT
CITY OF ORONO PERMIT TYPE: :;,_,,.��;,;���
, 27� Kelley Parkway- P.O. Box 66 Permit Number. '�=''_ � .'���f
Crystal Bay, Minnesota 55323 ..-�
(612)473-7357 Date Issued: �:,_=r`��.�=.��_�:-.
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPUCANTrPERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ ���- � '� Date Received: - �-- �
Ente;ed�3y: !�"��'� Permit#: // � �� �
CI7'�Y OF ORONO - BITII�DTNG PERMIT APPLICA'I`tON ` � �
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All informafi3on must be submitted in full before plan re�ie�v �-ill be started. . �
� (please print all information) . . � ,
. . . -_— . - _� ,
T`HE APPLICA2rTT IS: � (circle one) . OSVNER OR CONTR.ACTOR � . . . .
;
�oB s1� �u�x�ss: � ��i> '�,�'�'�� _s"T zrn: �s � ,
NA.I�i� OF O�'Y�'ER: �U��� G-�c%��f�� PHONE: (home) ��7%-� �-'
. (work) � %�`�' _ <,--�-�-�
IYIA1LItiTG A3�D�'•ESS: � _S F� CTTY: .
ZIP: _�:�'.-?�/
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COv'I'RACTOR: �n C�� � �` �� b,� �-j��, PHONE: f 7�-y\� -
CONT'A.CT PERSON: >>, � MOBILE�PAGER: _S , -9y�7 �
N1ALC,ING ADDRESS: ,-��;��� �a,;2� ,i>%��� .h� CITY: S��r���, ZIP: I�--33�
STATE LICE�'SE: # �/�` �' '3/ �
A.RCHITECTlENGTtii'EER:� � PHO�'E: ��
1�'TAILI�i 7G ADD�tESS: CTI'Y: ZIP:
. ��ME; REGISTRATION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration _
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PROPOSED ti'STORK(describe in detai�: '
STORIES: SQ.F'EET OF EACH FLOOR: DET. � � �
�►0. OF BEDROOMS: GAR.AGE STALIS: ATT. . . �
. . . � a :� �� .
EST�IATED CONSTRUCTION VALUATION (excludinb 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 ihe ordinances and codes of the City and with
the State Buildi.n� Code; that I understand this is noc a pennit and work is not to starc without a
permit; and thac the work will be ' ac ' dance w�th , e a proved plan.
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APPLZCA���'I' S SYGNATURE.
NOTE! �'arade of Homes events require separate permit approval by Police Department and
� Cily Counci160 days prior to tke event. Non permitted events wi11 not be allowed.
Sec.I3.Q4 RIGFTTS OF SUB,TECTS OF DATA � �
Sutd. i. Tyg:of data. The rights af iadividual on wham the data is scored or ro be smr.d shalI be u set for�h ia this secrioa
Sutd.2. Iatormation reqtv.rrd to be given iadiridual. �ln individuaF ask:d w suPPtY Pri'��or confideadaI daa concerning hiasetf shaIl
be in,°o�::d o°: (a)the pargose acd inc:nded use of the cequ�daa wichia�e eoIIecting 3��e agenty.polirical suMivision,or sram,vide rys;:�•
(b)wh:c..e:ho;..ay r_Ficse o;is_IegalIy rrqui._d to st:PPlY.che r_quesmd daca:(e)aay lcnov�eoasequcece arisin3 from his supolying or refuing tr�supply
privace or co:i:;d:r.��!daa;ar.d(d)t}e ideadry of oLer�Zoas oce�ddes aucuorized by sc��.or fcac^.'!��:;:; r_ceive co da�. This r.qui.;ccceac s�a!I
noc a�pty wuca an ir.dividuaI is asked W supply iavesagadve daa,pursuanc to s<cdoa 13.82,subdivuioa 5, w a law enfactementoEncer. . -
't�e eenrnissioner of tevenue mav piaca.the nodc- rauird und-r this subdivision in the individual ircome caz or orooectv taz refund
inscrucaons L*�scead of on those forstu. .
Subd.3. Access to data by indiridual. Upon request to a�espansible authodry,an individual shali be informed wht�herhe is the subjecc
eE stnr.d daa on individuaIs,aad whecher it is ct�u�ed as public,private or eonFdenaal. Upoa his fuccher r_quest,an iadividaal who is th:subje:c
of stor.d priva:e or public dam an iudividuals shall be shown che daa wichaut any eharge to him and;if ha duues,shall be infocmed oE rhe eoatenc
ar.d meaning of chat dara. Aher an individual has been shown the priva�e daca ar.d informed o[ict meaaing,the dara aerd not be disclased to him for
siz mondu�her.afur unless a dispute or acaon purruanc to chis se:don is pending or addiaoaal da�on[h:individuaI has been callec�d or ereac�d.
Tae respoatible authoriry shaIl�provida eapies of the priva�oc pubiic dara upon rcquesc by the individual subject o!che daca. The resporssible autfiociry
may requir_ �he rsquesdng person to pay the accual cosc�oi making,eertitying,aad eomp'iling the eapia.
'Ihe respansihle auchoriry shalt eomply immediacefy,if possible,wich aay request made pursuant cn�his subdivision,ar wichin five days of
the dac:of�he reques�.exciuding Sacurdays,Sundays ar.d leg�l holidays,if immediace eompliance is notpossible. If he eanaot comply with tho request
wi�hin dsat atne,he shalI so inform che individual,and may have an addidonal fiv:days witfiin which to comply wich the request,ezcludiag Sacurdays,
Sundays and ItgaI holidays. , . .
Subd.4. Procedure when data is not accurate or eomplete. An individval may eonc�st che accurdcy oc eompiet�aess oFpublic orprivate
dara conceming himself. To ezetcise diis right,an individual shall noaFy in wridng the respoasible auchoriry descdbing the naaira oE[he disagreemeac
The tespoasible authoriry shall wichin 30 days either: (a)corract ehe daca found to be inaccu�ac,or incomplec�aad atc.:mpc to norify past«cipiencs of
inaccucace or incomptae data,including recipieaes narned by the individual;or(b}notify the individual thac he betieves the dati to be correct Daa
in dispuce shail be disclosed onIy if the individuai's sca�erzenc of disagreement is induded wi�h th�disclosed dara.
. The daterminaaon of the responsible auchoriry may be appealed purnsanc to the provisions of the admuusa-arive procedure act reianng to
eonces:r.d cases. � . •
DATA PRIVACY ADVISORY �
In accordance with M.S. 13.04, Subd.2, "R.igbts of subjecu of data", we would like to inform you that your request
for a pemut or Iicense from the Ciry 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 refusaI may require that the Ciry deny the permit or license. �
3. The information may be shared with other local,stace or federal a�encies to the etcent necessary to process
the permit or license. �
4. If your requested permic or license requires Council action to approve, some information may become
. public, . . . . . . . � .
�5. You have certain ri�hts under M.S. 13.04�(available upon request) to review privace data on.yourself.
6. Your full name is required to process this application or permit.
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I understand my righcs as stated ve. II
Signacure
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION N�IC SCHEDULED �
PERMIT NO. COMPLETED
�
ADDRESS �- `
OWNER I.rl. �l�`e�ONTR. '�`� �'��=-
TELEPHONE NO. " �L
� DESCRIPTION l�
�
Ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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
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= 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 COMMENTS:
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d ❑ ORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR C CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 3-73rJ7
OwnerlContra n ' e:
Inspector.
White Copyllnspecto ile Ca ry opylSite Noti