HomeMy WebLinkAbout2002-P05058 (chimney repair) PERMIT
C I TY O F O RO N O Permit Number:
275� Kelley Parkway - PO Box 66 Pososg
Crystal Bay, Minnesota 55323 Permit Type: ada�t�o�xemodevRepair
(952) 249-4600 Date Issued: 4�lgi2oo2
SITE ADDRESS: 3237 Casco Cir
Wayzata,MN 55391
PID: 20-117-23-43-0013
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Pernut Class: Building Census Code 434
Pernut Type: Addition/Remodel/Repair Pernut Sub-type(s): Chimney Repair
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 181.25 Valuation: $ 9,375.00
State Surcharge Fee: $ 4.70
TOTAL FEE: $ 185.95
APPLICANT: SingerConstruction OWNER: 7effBrower
6576 Nathan Lane N 3237 Casco Cir
Maple Grove,MN 55369 Wayzata MN 55391
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 PGRM SIGNATURE SUED BY SIGNATURE
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Conies: 1-File(Si�raitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�. 1-Finance Page 1
Total Fee: $ Date Received:
.
� Entered By: Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATIOle1
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: _�� �7- �ys�� �,��i� zrn: 5�3 �� i
NAME OF OWNER: ,�-�%/= ;3 /'�GJ e l� PHONE: (home)
(work)
MAILING ADDRESS: S�- CITY: ZIP:
CONTRACTOR: ���/ Gl.��' ,a,h/�� -�f-{C- PHONE: ,��j__j'3� �/�� c�
CONTACT PERSON: T,>or� MOBILE�f��= li�Z- 3 y� ��f•(
MAILING ADDRESS: �v �7 6 �.�,r�T� q ,� CITY:/'�� �'�-v�-� ZIP: S S�6�7
STATE LICENSE: # 13 C J y 3 7
ARCHITECT/ENGINEER: PHONE:
VIAILItiG ADDRESS: CITY: ZIP:
NAl�IE: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: �y �,.,.,��� �-- � ,(�/� c:`
�c?�s� (� � � i��� �i� �� -� FiY� /�s �. r ��
STORIES: �-- SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�.'��
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� 7�
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 ardinances 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 SIGNATURE: �� DATE: �-- ��r� Z
NOTE! Parade Qf Homes events require eparate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGH'TS OF SUBJECTS OF D�1Ta `
Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concecning himself shall
be ie.'ormed of: (a)the purpose and intended use of the requested data within the collecting"state agency,poliacal subdivisiou,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising fmm his supplying or refusing to supply
privare or confidendal data;and(d)the idendry of ocher penons or enrides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrieadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or proper[v tax refund
instructions instead of on those forms.
Subd. 3. Access to data by indi��dual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals, and whecher it is classified as public, priva[e or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to hirn and, if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hirn for
six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority
may require the requesting person ro pay the actual costs of makine, cerdfying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate 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 which 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 concerning himself. To exercise this rieht,an individual shall nodfy in wriang the responsible authoriry 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, including recipients named by the individual; ot(b)notify[he individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to
contesced cases.
DAT� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights 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 furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to deternune your qualification for the pemut 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 pemut 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.
(. Your full name is required to process this application or permit.
First �fiddle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
��� `
Signantce
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION TICE SCHEDULED '�Z-'�Z . 3�
PERMIT N0. G Q�� COMPLETED �� �
ADDRESS_ .�.�3 � C��� ��
OWNER CONTR. S� �� �'%' C �S�
TELEPHONE NO. � �� � �S� � • `��
,
� DESCRIPTION � �-�-'�-
� Ot FOOTING 11 MECH L RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECH ICAL 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 OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 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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W� WORKSATISFACTORY:PROCEED E COMPLETE ���..�
W ❑C O R R E C T W O RK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �952� Z49-4600
OwnerlContractor si e:
Inspector.
White pyfl�spector's File Canary CopylSite Notice