HomeMy WebLinkAbout1997-008886 - tear-off/re-roof � .. PERMIT
CITY.OF ORONO PERMIT TYPE:
?�50 Kelley Parkway- P.O. Box 66 ;=;!} :: :�',-;:.�;_
Crystal Bay, Minnesota 55323 Permit Number: - ' °..'=_:"=`
(612) 473-7357 Date Issued: _ _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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AP ICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE
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�'otal Fee: $ Date Received:
' Entered By: Permit#:
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 QR CONTR.ACTOR �'
JOB SITE ADDRESS: ���'l_��� '�'�'r�''� r������ r� F�.L� ZIP: �����i I
NAME OF OWNER: '���-i�'�-'L>��,_- � �_t,�,_� >v�-��,<-�r' PHONE: (home) '-��%� --7%?�
(work)
MAILING ADDRESS: :'�-�� ��_ t_��;i.�� r��nvT �<.tl CITY: ��KUn.i(1, ZIP: `�>;?�'i I
CONTRACTOR: �1,� � -,'�`��>�.� �'�n1�t��C.���►�l PHONE: ���-�'�; � "
CONTACTPERSON: ���;�It�C '�c���-r-�;'T MOBILE/PAGER: (�:/�=, -�'�,� :�
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MAILING ADDRESS: 1.'� :`i r j1, `�� .. :r�f ;���;'. CITY: �!r'r°�r?t'; ,�i�..' ZIP -_;r ,�.
STATE LICENSE: # �1` ;�:7
ARCHITECT/ENGINEER: �1��1{- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: i�� ��A=' � �r?�t�c�`�'-l= _
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. �_ DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��L'-f;�' < �{'; _
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 Ciry 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 accordanc,� with the approved plan.
. _`
� .-� DATE: t�,�;���i�
APPLICANT'S SIGNATURE; :: �= ,.
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NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
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Sec.13.04 RIGHTS OF SLJB.TECTS OF D�Ta
Subd. 1. Type of data. The righcs 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 concerning himself shall
be informed of: (a)the purpose and intended use of the requested dara within the collecting"state agency, poliricai subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)[he idenriry of other penons or enddes authorized by state or federal law to receive the data. This requirement shall
noc apply when an individual is asked to supply invesrieadve dara, pursuan[to secaon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav piace the nodce required 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 individual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject
of stored data on individuals,and whether it is classified as public, private or confidential. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data without 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 him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addiUonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The respon$ible authority
may require the requesting person to pay the actual costs of makine, certifying,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 Saturdays,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 addiaonal five days within which to comply with the request,exciuding 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 right,an individual shall notify in writing the responsible authoriry describing the namre of the disagreement.
The responsible auchoriry shall within 30 days eicher. (a)correct the data found ro be inaccurate or incomplete and attempt ro noufy past recipients of
inaccurate or incomplete data, inciuding recipients named by the individuai; or(b)notify the individual that he believes the data to be correct. Data
in dispute shali be disciosed 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 relaang to
contested cases.
DATA 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 determine 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 pernut or license.
4. If your requested permit or license requires Council action to approve, some information may become
pubiic.
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.
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I understand my rights as stated above.
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Signacure /
DATE TIME
CITY OF ORONO CALLED IN '���� /
INSPECTION NOT SCHEDULED <�� �-� �r� : / - �' ��
PERMIT N0. ���� COMPLETED �_ �
ADDRESS �'������ C :a - �- 1 ��1_�� _��"�
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OW N ER����''�ft:����.� CONTR.
TELEPHONENO. /J%� 7 _ � � �' �
� DESCRIPTION �i'/_c� % tz���- ���r�l'-�i��
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� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
QZ-� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TFEE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �ORK SATISFACTORY:PROCEED : PROJECT COMPLETE
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Q C' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ^ CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73rJ7
OwnerlContract `�s�te:
Inspector. v
White Copylinspecior's F e Canary CopylSite Notice
D.� TIME
CITY OF ORONO CALLED IN
INSPECTION NO ICE SCHEDULED / 7 _1'r��
PERMIT N0. ���'' COMPLETED 5
ADDRESS �-�'S:�� `d ( _`��_�; (�_/` , ���'
OWNER �����,� CONTR.
TELEPHONE NO. ��Z7 - '7`17�''
> DESCRIPTION �['�,��-�
� 01 F�OTING 11 MEC ANICAL RI 18 EXCAV/GRADING/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 tAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 VVALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
� INAL � 14 SEWER HOOK-UP 06 PROGRESS
�
J DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PIUMBING FINAL 28 CEDAR SHINGLES� 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES��NO
� COMMENTS:
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O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -. pHOTO TAKEN
INSPECTOR WILL RETURN
C;STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance.473-7357
OwnerlCont act n site:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice