HomeMy WebLinkAbout1999-011865 - tear off/re roof _ __ !—
�� .� . PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 _ -
Crystal Bay, Minnesota 55323 Permit Number: ._ �.`°���v��
(612) 249-4600 Date Issued: _ ._ ... -. ._ _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ ;�t;;:� ; :_:?,,�, _— ;_;� EV�:: OWNER:
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APPLICANTPEFMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ J � � s Date Received: _��/.sl ���
Entered By: _.,�,-� Permit#: 1 i S�'i��� �
CITY OF OR.ONO - BU]I,DING PERMIT APPLICA.TIOi�I � �
A1I iaforma�ion must be submitted in full before plan revie�v �-ill be started. .
� (please print all information) . .
i"HE APpLICAir'T IS: � (circle one) O�VNER OR CONTR.ACTOR � .
aos sz� AnnxEss: � °Il-s '��s �� � �i- �� z�: -�"� 9/ ;
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i�tA,I1�IE OF Oti��R: ��,�''� ,�a,'� PHONE: (�iome) �l?� - 7 y/..s'
(work)
I1�IAILI�'G ADDRFSS: ��»^Q. _CTTY: ZIP: _
—' �- �n � _ pxorrE: y 1/- 90 6�
CONT'R.ACTOR: �-►'�,�Y1Q- G ✓' l��
CONT'ACTPERSON: �i`1� Sc�i n�'e-I MOBILE/PAG R: S �-�'% 7
TG ADDRESS: oZ�/�S R �If CITY: .��c1!`Q ZIP: �
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STATE LICEI�'SE: # �Ol 6�,� �
ARCHIT�CT�ENGItii TEER: . . PHO�'E:. �
iV1.A.II�Itii'G ADA�tESS: _ CTTY: ZIP:
� NAME: REGIS'I'RATIO�t#
TYPE OF tiYORh: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration _
ED'4'�ORK describe in detai�: �� �� `�� d
?R�T�S (
ST'ORIES: SQ.FEET OF EACH FLOOR:
NO. OF BElJROOiVSS: GARAGE STALLS: ATT'• _____ DET. � � - . . �
EST .T1-i TAZ'ED CONSTRUCTION VALUATION (excluding land): $ � � � �
I hereby apply for a buildino permit and I acknowledge that the information above is complete and
accurace; that th�work will be in conformance with the ordinances and codes of the City and with
the State Buildi.*�� Code; that I understand this is not a permit and work is not to start without a
permit; and thac the work will be in acc rdance wi the appr ved plan.
A.PPLICAi�"T'S SIGNA'TLT�E: D�'�: 9'! �/�
NO�'E! Parade o,�Hornes events require separate permit approval by Police Department and
� City Council 60 days prior to the event. Non permitted events will not be allowed.
. * l
Sec.13.04 RIGFiTS OF SLJB,TECT'S OF DAT.+► • �
Satd. 1. Tyge of data. The righcs af individual on whom the dara is s�ored or ro be stcr:d shall be as sec forch ia this secrioa
5ubd.2. Iatormation reqinrrd to be givm indlriduaI. An individual asted to supQly privam or confidecdal dam conceraing hiauelf shall
be ia.°oc.�:ed o,`: (a)Ihe purpase and incendcd use of the requcs�data wichin the eotIecdng��ce ageaty.poGacal suL+divisioa,or sramwide rys�m•
(b)whecLe:he;..ay r_�us:or is.legally tequir:d to suPPiY.�e r_ques�d daa:(e)aay Icsawn eaas:quccce arisia3 fmm his suppiyiag or reFusing w suppiy
privace or co;i:;der.csI daa;ar.d(d)�e iCeaary of ocherpersoas orecd3es au�oriz:d by snce ar f:ac^.':c::.o r_ceive�o d33. This r_qu'uc�eat s��.�l
noc a�ply waea aa ir:dividual is asked to supply iavesriganve daca,pursuaac to s<cdon 13.82,subdivision 5,w a law enfarcement ofncer. . -
T�e eenrnissiorter of tevenue mav otace the nodc- r�!ird und-r this subdivision in the individual income eiz or orooertv tiz refund
instrucdons Lnsu_d of on those larms. .
Subd.3. Access to data by iadiridual. Upon requesc to a respansibie auchodry,an iadividual sha11 be informed whe�her he is the subjecc
ef sto�d dsn on individuaLs,and whe�her it is elass�ed as pubiic,privato ar eonF.dend�l. Upan hu furcher r_ques�,an iedividual who is[he subjc�c
o[s;or.d priva;e or public data on iadividuaIs shalI be showa ehe daa wirhaut any eharge ta him and;if 6e desira,shali be infocmed of the eaacenc
and meaning of that daa. Aher an individual his beea shown the pcivatY dae ar.d iafo�med of iu meaaing,the daca need not be d'uclosed oo him for
siz monchs ther_afur unl:ss a dispuce or acdon pursuanc ta this se;don is p<nding or addidoaal dara on tfie individuaI has been colIecc:d or ereac:d.
The tesponsibie autl:oRry shaIl'provida eopies of che privac:orpubiic daa upon request by ehe individual subjecc of che daa. The respocuible aucfioriry
may rcquir_ �he cequesdng pecson to pay the acntal eostc ai making,eecdfying,and eompiling the eaQies.
The cesponsible au�horiry shali eompfy imrtsediataty,if possibie,wich aay requat made pursuant to this subdivision,or wi�Fun five days of
the dace o![he rcques4 ezciuding Saturdays,Sundays ar,d leg�l hotidays,if ir,unediace compliance is not possibte. ff he eaaaot compiy with the requesc I'�
wichin that ame,he shalI so inform che individuaI,and may have an addidonal fiv:days wichin which to eomply wich the requat,ezduding Sacurdays, !
Sundays and legal hotidays. . , . �
Subd.4. Procedure when data is not accuraeo or eomplete. An icdividual may eont�st the accuracy a�eomplet�neu olpablic orprivace
data conceming tiimsetf. To exercise[his righ�,an individual shall naafy in wridn,�he responsibie au�horiry desrn'biag the nanire of the disagreemeac.
The ccspoasible authoriry shall wichin 30 days ei�:er: (a)eorrect�he dara found to be inaccucat�or incompiete and atc:mp�to nodfy past racipiencs of
inaccucate or incompiae daca,inctuding recipien�s narrsed by the individua.l;or(b}aoafy che individual thac he believes�he daa to be correcc Daa
in dispuce shall be disclosed only if the individual's scater,senc of disagreem:nt is included wi�h th:d'udosed daa.
. The decerminadon of the responsib(a aurhoriry may be appaaled purnsanc to the provi;ions of tha adminisaadve procedure act reladng to
conc:s::d cases. � . •
DATA PRIVACY ADVISORY �
In accordance wich M.S. 13.04,Subd.2, "Rights of subjecu of data", we would like to inform you that your request
for a permic or license from the Ciry of Orono or any of its departments may require you to furnish ceRain private or
confidential information.
You are notified thar.
1. The information you furnish will be used to determine your qualification for che permit or license requested.
2. You may refuse to suppty data, buc refusal may require that the City deny the permit or license. �
3. The information may be shared with ocher local, state or federal a�encies to the ettent necessary to process
the permit or license. �
4. If your requested permit or license requires Council action to approve, sorne information may become
. public, � � . . . . . ,
�5. You ha�e certain ri�hts under M.S. 13.04 (availabie upon request) to review private data on.yourself. . .
6. Your full name is required to process this application or permit.
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Ciry Sate Zip Phone
I understand my ri�hcs a,��ated ve.
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signacur�
PAT TIME
CITY OF ORONO CALLED W z �-�
INSPECTION NOTIC ��S' SCHEDULED �� ��
PERMIT NO. � COMPLETED �3 �`� Z• �C'
ADDRESS �a�15 �-u5C0 �c,�r� �- j��
OWNER I��� I CONTR. ���C��h�. ���'�Pr� ��
TELEPHONE N0. y~1� - `�C�(��
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� DESCRIPTIO��'1-'
Ly� 01 F OTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 IN ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
v 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
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
D COMMENTS:
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d �ORKSATISFACTORY:PROCEED G PROJECTCOMPLETE
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� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �. pHOTOTAKEN
INSPECTOR WtLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR i-CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector.��� � fiX'�-�I�
White Copyllnspector's File Canary Copy/Site Notice