HomeMy WebLinkAbout1996-007957 - re-roof � n PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �.!;T l I��;��lt;
Crystal Bay, Minnesota 55323 Permit Number: _ _ �,,� �
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(612) 473-7357 Date Issued:
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SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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A LI ANT/P RMITEE SIGNATURE , ISSUED BY:SIGNATUR C�( .
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Total Fee: � DateReceived:
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Date Approved:
Entered By: �.�, . Permit�: �i 9_'�`�
CITY OF ORONO - BUILDING PERII�IIT APPLICATION
ALL �NFOR1vIATION�IUST BE SL�BI�ITTT'ED IP1 FI�Z.L BEFORE PL��REV�tiV ti�L
BESTARTED
----------------- --------- -----------------__-_-_---------------------------
THE APPLIC��tT' IS: (circle one) O�VNER OR��T�CTOR��-
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JOB SITE ADDRESS:
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NAl�IE OF O`VNER: ti� �-�r�� L Sc�i�e�,l� PHO��E: (home) �7/ >l�/_�
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MAILINGADDRESS: ���- 1 D ����i, ��; �(ucc� CITY: I�i�c��u�-�� ZIP: s-5' 3 �l
CON'TRACTOR: ��S���' �fi SS c>< <'�- �r°�
PHO�IE: �l �_S`- 5���� Z
. l-IOBIL.E PHOiYE/PAGER:
�y� ,-��2�c d��- s�. CITY: i'i-�� ,/S ZIP: ss���� �>
MAILINGADDRESS: -' �_ ' ,
STATE LICENSE: #
ARCHTI'ECT/ENGINEER: PHO�tE:
I�IAII.�1G ADDRESS: CITY: ZIP:
NAitiIE: REGISTRAT'ION #
TYPE OF WORK: New Addition Accessory S�ucture
Move RemodeUAlteration Land Alterarion
PROPOSEDWORK(describe indetail}; �'� `i'�'�'-�
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOtiIS: > GARAGE STALLS: ATT. h DET.
ESTII�i IATEDCONSTRUCTIONVALUATION(excludingland): � �Z c-���
I hereby apply for a buildin� permit and I acknowled;e that the information above is complete
and accurate; that the work will be in`conformance with [he 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 be in accordance with the approved plan.
APPLICANT'S SIGNAZ'URE= ;
������ DATE: ��.��6
Np�! parade of Homes event require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
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Sec.13.04 RIGHTS OF SUB.TECTS OF Da.T?,
Subd. I. Type of data. The righrs of individual on whom the data is stored or to be scored s6all be as set for[h in this secdon.
Subd.2. Information required to be�ven individual. ?.n individual asked to supply priva[e or confideaaal data conceming himself shall
be informed of: (a) the purpose and inceoded use of the requested da[a wichin the collecting'stace ageocy, polidcal subdivision,or stacewide system;
(b)whe�her he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
privace or confidendal data;and(d)[he idenary of ocher persons or enrides auchorized by state or federal law to receive the data. This requirement shall
no�appty when an individual is asked �o supply invesagaave dara, pursuanc to secdon 13.82, subdivision 5, to a law enforcemeo[o�cer.
"Ihe commissioner of revenue mav place the notice required under this subdivision in the individual income taz or prooercv taz refund
instcucaons instead of on[hose forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed wherher he is the subject
of stored data on individuals, and whed�er i[is classified as public, privace or confidenoal. Upon his funher request,an individual who is the subjecc
of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be iniormed of the content
and meaning of that data. After an individual has been shown[hz privace dara and informed of its meaaing, the data need not be disclosed to him for
six monrhs chereafter unless a dispuce or acdon pursuant to this section is pending or addiaonal data on rhe individual has been collected or created.
The responsible authoriry shall provide copies of the privace or public data upon request by the individual subjecc of[he data. The responsible authoriry
may require the requesang person to pay the actual costs of making, cemfying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuanc to this subdivision, or wichin five days of
rhe date of the request,excluding Sacurdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannoc comply with the requesc
within that time,he shall so inform the individual,and may have an addidonal five days wi[hin which to comply wich the request,excluding Saturdays,
Sundays and legat holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or private
data concerning himself. To exercise[his right,an individual shall norify in wriring che responsible authoriry describing the nature of the disagreement.
The responsibte authoriry shall wichin 30 days either: (a)correcc the data found to be inaccurace or incomplete and attempt to norify past recipients of
inaccurate or incomplete data, including recipients named by che individual; or(b)nodfy the individual [hat he believes the data to be correct. Data
in dispute shali be discfosed only if the individual's statement of disagreement is included with the disclosed data.
Th�determination of the responsible auchoriry may be appealed pursuant to the provisions of the administradve procedure act relaaag 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 fumish cenain private or
confidential information.
You are notified that:
1. 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 Ciry 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 (available upon request) to review private data on yourself.
6. Your full name is required to process [his application or permit.
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I understand my rights as stated abov,�.
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Signature
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D� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � �'7/�� � 3�'
PERMIT NO. �� ' -� � COMPLETED � N
ADDRESS --�'�' � C7 ��a� ��ti �_�� -�� �'�.
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OWNER �v.��,�Z�,c`zJ�� CONTR. !�'-��
TELEPHON E NO. '�7� � �%/ '-� --'-�
� DESCRIPTION - ;
� 07 FOOTiN� 11 CHANICAL RI 18 D(CAV/dRADINQJFIWNO
y 02 FFlAMINO 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 WALL BD. 72 WATER HOOK-UP 17 SITE INSPECTION
� p5 FIWqL 14 SEWER HOOK-UO O6 PROdRESS
_
� 07 DEMQ-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUM@INCi FINAL � 36 FOUNDATION REMOVAL
� ,pVVNER/CONTRACTOR TO MEET YOU:�_NO
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� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN -
❑STOPORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance.473-7357
OwnerlContracto
Inspector.
White Copyllnspector's File Canary CopylSite Notice
D� TIME
CITY OF ORONO ,� CA�LED IN "
INSPECTION NOTICE /1 ��`' SCHEDULED �/5/r'r� 3 : 3�>
PERMIT NO. l COMPLETED
ADDRESS 3C� ` _. .F � �
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OWNER � CONTR. � %
TELEPHONENO. '�'1/- �I/ �3
� DESCRIPTION .��_'t����
� 07 FOOT1NCi 11 MECHANICAL RI 18 IXCAV/GRADIN(3/FILLINO
y 02 FRAMINC3 13 MECHANICAL FINAL 19 LAf�SHORE/WETLANDS
� 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� p4 W 12 WATER HOOK-UP 17 SITE INSPECTION
� p5 FlNqL 14 SEWER HOOK-UO O6 PROGRESS
J -67-F)EM(�-SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEMO—FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP
Z 09 PLUMBINC'a RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 1 MBINO FINAL � 36 FOUNDATION REMOVAL
Z NE CONTRACTOR TO MEET YOU: YES NO
� COMMENTS:
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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Caii for the next inspection 24 hours in advance.47�73�J7
OwnerlContracto ite:
Inspector.
White Copyllnspeclor's File Canary CopylSite Notice
OATE TIME
CITY OF ORONO CALLED IN s' /� ,h
INSPECTION NOTICE SCHEDULED -� -Z�'/i�- /� � c,z�
PERMIT N0. �1�� � COMPLETED _A N
ADDRESS ���Z��'''�i.��.f-t�r�_-� � '
OWNER _�,�zc-�� CONTR.
TELEPHONE NO. "�'7 / - G%/`� �
� DESCRIPTION � �z �-
� 01 F T1NO 11 �CHANICAL RI 18 EXCAV/(3HADIN(3/FIWN�
�Q 2 FRAMtFtC!—; 13 MECHANICAL FINAL 19 LAf�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
F` 07 DEM4—SITE 27 SEPTiC MAINT. 27 COMPLAINT
J
W 07 DEMQ—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Z 09 PLUMBINCi RI 23 SEP11C FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION FiEMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �wORK SATISFACTORY:PROCEED = PROJECT COMPLETE
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. rr pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REOUIRED.CAIL TO AFRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContract i e:
Inspector. �
Whife CopyllnspecloPs Fil Canary Copy/Site Nofice