HomeMy WebLinkAbout2007-P11495 - re-roof PERMIT
C1�=� OF ORONO
Z750 Kelley Parkway- PO Box 66 Permit Number: p11495
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
9/25/2007
SITE ADDRESS: 4325 Chippewa La Unit#
Maple Plain,MN 55359
P��� 31-118-23-42-0009
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Tear off&ReRoof
FEE SUMMARY: Permit Fee: $ 83.25 valuation: $ 3,000.00
State Surcharge Fee: $ 1.50
TOTAL FEE: $ 84.75
APPLICANT: Owner/Self OWNER: Daniel&Rebecca Schultz
MN 4325 Chippewa La
Maple Plain MN 55359
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 BUILD[NG CODE REQUIREMENTS.
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APPLICANT PER'viITEE SIGNATU ISSUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total 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 infornurtion)
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THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: `�C"'J�� W U D r}Q;1,(�(%�. LG( V�� ZIP: ?r� `�
Will this be a Parade of Homes,Remodelers Shawcase Home or other Display Home?
❑ YCS ��10 IJyes, a special ever�t perniit is r•eguired tivit{a Police Deparh�ient ancl City Courzcil approval
60 dav.r prior to the everzt. Slzz�ttle bzrs service x�ill be required uriless applicant demonstrates
scr fficient on-site parkrng is available. Non-pennittecl events will not be allowed.
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NAME OF OWNER: �qvt`'�}� �C{,Gl �(,��,,ti���_ PHONE: (home)�Sa-�� ��l1(��15
(work)�I�;���l�a-Ui�qS
MAILING ADDRESS: � ���� (i�y p��1��t,(�, CITY: (�W� ZIP: � 3
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CIT'Y: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �K yr;���
Any earth movement may require MCWD review and permits!
PROPOSED WORK(rleseribe in detai�: ��Pi.Z; ��v�
STORIES: � `/�'? SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED� DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �, Q(��
I hereby apply for a building pennit and I acknowledge that the infonnation above is complete and accnrate;
that tlle work will be in conforn�ance with the ordinances aiid codes of the City and with t11e State Building
Code;that I understand this is not a pennit a�id work is not to start without a permit;and that the work will be
in aecorda�ice with the approved plan.
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APPLICANT'S SIGNATURE: C DATE: L �JC U
31
Sec.13A4 RIGHTS OF SLIBJECTS Or DATA
Subd. 1. Type of da[a. The rights of individual on whom the data is slored or[o be stored shall be as set fo�th in this section.
SuUd.2. Informationrequu-edtoUegivenindi��idual. Anindividualaskedtosupplyprivateorconfidentialdataconceminghimselfshallbe
informed of: (�)the pu�pose�nd intended use of the requested data within the collec[ing state agency,political subdi��ision,or s[atewide sys[em;(b)
�vhether he may refuse or is legally required to supply the reques[ed da[a;(c)any known consequence ansing from his supplying o�refusing to supply
priv�te or confideniial da[a,and(d)the identity of o[her persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply wfien an individual is asked to supply investigative da[a,pursuant to section 13.82,subdivision 5,[o a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tAx or nronertV tas refund
insWc[ions instead of on those fo�ms.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infoaned whether he is the subject of
stored data on individuals,and whether it is classified as public,private or contidential. Upon his further request,an individual�vho is[he subject of
stored priv�te or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
meaning of that data. .After an indi�idual has been shown the private dat�and informed of its meaning,the data need not be disclosed to him for si�
monUis[hereaYter unless a dispute or action pu�suan[to[his sec[ion is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the pnvate or public da[a upon request by[he individual subject of the data. The responsible authonty
may require the reyuesting person to pay tlie�etual costs of making,ceRifying,and compiling the copies.
The responsible authorih�shall comply immediately.if possible,with am request made pursuant to[his subdivision,or within five days of
the date of the request,e�cluding Satardays,Sundays and legal holidays,if immediate compliance is not posaible. Ifhe c�nnot comply with the reyuest
wi[hin that time,lie shall so infonn the individual,and may have an additional five days within which to comply with the request,excluding Saturd�ys,
Sunda_ys and legal holidays.
SuUd.4. Procedure when data is not accura[e or complete. r1n individual may contest the accuracy or completeness of public or private data
concerning himself. To e�ercise this right,an individual shall no[ify in wri[ing the responsible authority describin�the nature ofthe disagreemenL The
responsible authority shall within 30 days either: (a)correct the data found to be inaocurate or incomplete and attempt to notiYy past recipien[s of
inaccurate or incomplete data,including reciPients named by the individual;or(b)notify the individual[ha[he believes[he data to be co�recL Da[a in
dispute sl�all be disclosed only if[he individual's st�tement of dis�greement is included wi[h[he disclosed data.
The dete�mina[ion of the responsible authorih m�y be�ppe�led pursuant to the provisions of the administrltive procedure act rela[ing[o
con[ested cases.
DATA PRIVACY ADVISORY
In aocordance with M S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a pemlit or license from the City of Orono or any of its departil�ents may require you to furnish certain private or
confidential infomlation.
You�re notified that
1. The information you furnish will be used to deteirriine your qualification for the permit or license
requested.
2. You mav refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the pernlit or license.
4. If your requested permit or license requires Counci] action to approve, some infonnation may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your fiill name is required to process this application or permit.
First Middle Last
Address
City State Zip Phone
I under tand my rights as stated above.
��'` � � 0
Signature
Res�t For7n 32
a3 �o� M .
CITY OF ORONO CALLED IN
INSPECTION NOTIC Q SCHEDULED ��`�7
PERMIT NO. !� / � COMPLETED
ADDRESS �.3aS ��
OWNER ��-���' CONTR.
TELEPHONE NO. 45 Z `fDSf O �gS.
� DESCRIPTION �eQ'� D�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW , ORK SATISFACTORY:PROCEED ROJECT COMPLETE�
WC CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN �_i CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
OwnerlContra n site:
Inspector.
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