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Home My WebLink About2007-P10963 - re-roof PERMIT CITY OF ORONO t750 Kel�ey Parkway- PO Box 66 Permit Number: P10963 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/3/2007 SITE ADDRESS: 4360 Chippewa La [lnit# Maple Plain, MN 55359 PID: 31-118-23-42-0015 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 perresolution#: Separate permits required: NOTICES/REMARKS: Tear off and reroof house/garage FEE SUMMARY: Permit Fee: $ 125.25 Valuatioo: $ 5,443.00 State Surcharge Fee: $ 2.75 TOTAL FEE: $ 128.00 APPLICANT: Midwest Roofing OWNER: Dana&Theresa LeMoine 313 Jefferson Hwy 4360 Chippewa La Champlin,MN 55316 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 BUILDING CODE REQUIREMENTS. _ . C�}r� APPLICANT PERMITEE SIGNATURE UED BY SIGNATURE Copies: 1-File(SignaturesReguired), l-Applicant, l-MonthlyReports, 1-Assessing,(IfSeptic, l-Septic) Page l � ' 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 a!1 information) ------------------------------------------------------------------------------------------------------------------------ -- -_-�--� THE APPLICANT IS: (circle one) OWNER O CONTRACTOR� JOB SITE ADDRESS: �3 �d C��;ppe� �w e ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a specia/event permit is rec�zrired i��ith Police Department and City Cotrncil approvnl 60 clays prior to the event. Sharttle bus ser•vice ivill be reqc�ir�ed x�nfess applicant clei��onstr•ates su�cient on-site parking is avarlab/e. Non-permitted eve��ts ivill not be a!/owed. NAMEOF OWNER �q� Le w�oi he PHONE: (home)gSZ�25'� �o�ao (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �j,�es� ,Qoa��ht , Src�i'ht. `�ne. PHONE: Z63 •y2�•`j�o9,6 CONTACT PERSON: p�,�,.��t Mt,,�l,�,,. MOBILE/PAGER: MAILINGADDRESS: 3J3 ,Tr�•�, h�v CITY: C�«p/�� ZIP:SS'�/6 STATE LICENSE: # Zoo 1 a2'�� EXPIRATION DATE: 3-3/-O g ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: � - ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure . Move Home Remodel/Alteration (ie: Siding, Windows) � Any earth movement may require MCWD review and permits ! PROPOSED WORK(describe in detai : ��,- .�' �} Bof �a se ,.c — �o s STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ S' yy3 � 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 City and with the State Building Code; that( understand this is not a permit and�vork is not to start without a pennit;and that the work��•ill be in accordance with tl�e approved plan. APPLICANT'S SIGNATURE: �G��Q DATE: ��o�— ;1 . � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private orcontidential data concerning himselfshall be informed of: (a)die purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is le�ally requimd to supply d�e requested data;(c)any kno�vn consequence arising from his supplying or reFusing to supply private or confidentiai data;and(d)the identiry ofother persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individuat is asked to suppiy investigative data,pursuant to section I 3.82,subdivision 5,to a la��enforcement officer. The commissioner of revenue ma�place the notice rec�red under this subdivision in the individual income tax or�rooertv tax refund insvuctions instead of on those fonns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and��hether it is dassitied as public,private or confldentiaL Upon his further request,an individual who is the subject of stored private or public data on individuals shal I Ue shown the data without any charge to him and,if he desires,shall be infonned of the content and meaning of tliat data. Atter 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 action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or pub�ic data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made purs�ant to this subdivision,or within tive days of the date ofN�e request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request �vithin d�at time,he shall so inform the individual,and may have an additional tive days within�vhich to comply with the request,e�cluding Saturdays, Sundays and legal holidays. S ubd.4. Procedure when data is not accura[e or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise chis ri�ht,an individual shall notiiy in writing the responsible authority describing the nature of die disagreement The responsible authorit��shall within 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual N�at he believes the data to be correct. Data in dispute shall be disclosed only ifthe individual's sta[ement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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: l. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may 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 permit 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(availabfe upon request)to review private data on yourself. 6. Your full name is required to process this application or pern�it. First N[iddlc Last Address C��- St:�te Zip Phone I understand m�� rights as stated above. . ��n;irurc Reset Form �' � �� 'DA�� rn � TIME � {' J ITY OF ORONO CALLED W 5-�p�,�� /y] �'� INSPECTION NOTIC SCHEDULED _-�'[�� PERMIT NO. � COMPLETED _�_ ADDRESS � � �-- OWNER CONTR. � l t ��Q�'�" TELEPHONE N0.� �+F� �oZ � — / � � � � DESCRIPTION �Yl C� �� ty 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADI /FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINA 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATfON/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W a � � O >. � O � W � Q � Z W � W � j d W WORK SATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETUFN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the ne inspection 24 hours in advance. (952� 249-4600 OwnerlContr r on ite: Inspector. White Copyllnspector's File Canary CopylSite Notice