HomeMy WebLinkAbout1990-002805 - re-roof/tearing off PERMIT
CITY OF ORONO PERMIT TYPE: L;�����;l�,��
1335 Brown Rd. South • P.O. Box 66 Permit Number: �?t�:��__�s�
Crystal Bay, Minnesota 55323 Date Issued: C;:i/�F,!vji3
(612) 473-7357
SITE ADDRESS:
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REMARKS:
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APPLICAN �f+�1ITFE SIGNATURF ISSUED BY SIGNATURE
^ . . CITY OF ORONO - BIIILDING PSRMIT APPLICATION
. �.
Total Fee: $ f �,-,Z , �S Date Received:
Date Approved:
Entered By: �
Permit#: � t) � �
AT•T• INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN REVIE'W WII,L BE STARTED
(See Check-off List Enclosed)
-----------------------------------------�------�-------------------------
THE APPZICANT IS: (circle one ) OWNER or�CONTRACTOR
JOB SITS ADDRESS: I �a �../')e � ��.C.��, ZIP:
(work)
x� oF owx�z: iu I(�.�-wt 125, L;�S (�-��L L pHorrz: (home)�73'y�J 7I�
MAILING ADDRESS: j �O�.l�►eUu�ha,s� Dr�� � CITY: �ZIP:
CONTRACTOR: YYIO�J'� r PHONE: �7�3 3� /
MAILING ADDRESS: �.�2Sl�e� C�( c� CITY: rLy/�nc�l�.,�� ZIP: SS �y /
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
..� �Sf � .
PROPOSED WORK (describe in detail) : {�'r C��
�v� - ' � � ��r'�e� �e �o� o�s�rt�� re��� a Y� s�l�'sfac s�� n�.
�I �v s �.(I ���`s `r'a.(,L e�l s � S C W e r .�-f��6cr.
STORIES: I SQ. FEET OF EACH FLOOR:
NO. OF BSDROOMS: GARAGE STALLS: ATT. DET.
. � �Q �
ESTIMATED CONSTRDCTION VALIIATION (egcluding land) : $ � �
2 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 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 b in � cc ance wit h a p ved plan.
APPLICANT'S SIGNATDRE: DATE: �� �d
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
9
,� - � � On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike 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 wil.l be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to suppl.y data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other Iocal, state or
federal. agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review privat�
data on yourselfe -
6. Your full name is required to process this application or
permit.
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First iddle Last
1 �7 s � � ��c��-�� DZc� � ��
Address
/�-uu�, l(� /`� s .S�y�/ 7
City State Zip
� �� � 3 � �
Phone
--under ta�ad my rights as st d bove.
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Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
` - .
�.p,4 RIGHTS OF SIIBJECTS OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
gubd, 2, Information required
to be given in�v��' An.individual asked to
� su 1 private or confidentiel data concernina �BmW hin the collect g state gency,
PP Y uested
purpose and intended use of the req
olitical subdivision, or statewide system; (b) whether he may refuse or is leg y
p the requested datg; (c) anY kn°Wn consequence arising from his
required to supply rivate or confidentiel data; and (d) the identity of
supplying or refusing to supply P state or federal law to receive the data. This.
other persons or entities authorized by 1 �nvestigative data,
requirement shall not apply when an individual is asked to supp y
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue mav pla�� taX re°und instructi nsunsteadhos
subdivision in the individual income tax or r��e
on those orms. . --- - .
Subd. 3. Access to �ata bp indivi�u81• Upon request to a responsible
authority, an individuel shall be informed wh ublic h r vateeor confident al.e Upon his
individuals, and whether it is classified es p � P ublic data on
e to him and, if he desires, shall
further request, an individusl who is the subject of stored private orVi�u� � been
individuals shall be shown the data withou�fan�y ��g. After an indi
6e i n formed of the content and meaning t he data need not be �isclosed to
shown the private data and informed of its meaning, ��uant to this section is
him for six months thereafter unless a dispute or action p
� rivate or public data upon request by
ending or additional data on the individ�h hss been collected or created. e
• p require the
responsible authority shall provide copies o P �in the
the individual subject of te gc��•�o� of mak ng,l�QBt f3'ingy s�d �omp g
requesting person to pay th _
copies. y if ssible, with any request
The responsible authority shall comply immediatel , Po
maae pursuant to this subdivision, or withinlag e �f Slmme�gteatcomplisnce eisu not
excluding Saturdays, Sundays and legal hol ys,
ossible. If he cannot comply with the request within that time, he shall sp inforth the
p within which to com ly
individu excluding Saturdays, Sundays ar►d legel�ho1i�Ys'
request,
te or complete. An individuel maY
. Subd. 4. Procsdiu'e �►hen data � ublic o�p ivate data concerning himself. To
contest the accuracy or completeness of P in writing the responsible authority
exercise this right, an individuel shall notify �ible authority shall within 30
describing the nature of the disagreement. The respe lete and attempt to
days either: (a) corre of inaccurate ordincomplete datae including recipients named by
notify past recipients
the individuel; or (b) notify the individual that he believes the data to b eementcis
Data in dispute shall be disclosed only if the individual's statement of disagr
• included with the �isclosed data• � aQpealed pursuant to the
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
DATE TIME
CITY OF ORONO ca��Eo-w
INSPECTION NOTICE SCHEDULED ���
PERMIT NO. coMP�ETEo � - �-( • �s�/ �����
ADDRESS ` � �h�•�y C�I<kS E
OWNER _ U�c���--� CONTR. _ _
TELEPHONE NO.
❑ FOOTING ❑ PLUMBING RI `�� ❑ SITE INSPECTION
❑ FRAMING �MECHANICAL �,� C.�.✓+(.* . ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ WATER HOOKUP ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING
W �"FINAL ❑ SEWER HOOKUP ❑ COMPLAINT
� ❑ PROGRESS ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
� ❑ DEMO�. O SEPTIC MAINT. ❑ SEPTIC FINAL
� ❑ FIRE PREV. ❑ WELL TEST PUMP ❑ FIREPLACE/WOOD BURNER
Z O
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W ❑ WORK SATISFACTORY: PROCEED ❑PHOTO TAKEN
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Q ❑ CORRECT WORK&PROCEED
V ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED. CALL INSPECTOR.
p INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
I nspector , 473'7351
White Copy/Inspector's File Gold Copy/Site Notice