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Home My WebLink About2000-P02949 re-reroof CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po2949 Crys�ai��Bay, Minnesota 55323 Per'mit Type: lvtinor Alterations (�12) 249-4600 Date Issued: ait3i2oo SITE ADDRESS: 1965 Country Club Rd LONG LAKE, MN 55356 PID: 27-118-23-42-0020 DESCRIPTION: Proposed Use: Permit Class: Building Census Code 434 Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 6,704.00 State Surcharge Fee: $ 3.40 TOTAL FEE: $ 142.65 APPLICANT: FLAGSHIP ROOFING COMPANY OWNER: PATRICIA A MONDALE 3496 SHORELINE DRIVE 1965 COUNTRY CLUB RD WAYZATA,MN 55391 LONG LAKE MN 55356 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. / �- / ------- ,. � (�"�-�� '/� ��`j�--� � �-- APPLI ANT P ITE SIGNATIJRE ISSU, BY SIGNATURE �� Copies: City,Applicant,Assessor, Finance Page 1 � • Total Fee: $ � ��= � " Date Received: c/��-�U ' Permit#: � � � t_,% — Entered By: �_t� /�c� , ; CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��(•��> '�,,�,.� ,�- �'�,�� ZIP: �"��'�i i - ( �� 1- � , � � 5 � < NaME oF owrrEx: �I �I�� 2 rxo�: �nome� �<� ,� - � �"�S— (work) MAILINGADDRESS: � 0 N ��CITY: (,c�� (�kL ZIP: �� I CONTRACTOR: ;�--'I ti cS��,� K�E7-�i,� � PHONE: `�� I - � `=��-'�.° CONTACT PERSON: ��S l,11 a��-y � MOBILE/PAGER , 1� -C`;�3 �� MAILING ADDRESS: " � �'� •�� ,' . CITY: ��Z�� ZIP: ��'S 1� I STATE LICENSE: # �Z.�,�;g� ��1 ARCHITECT/ENGI��ER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration x Land Alteration PROPOSED WORK(describe in detai�: 2 I��.�� -�c_n�-��--+� a�-�� F r,J l t�t �— _ t,��, ZS _�, - � iti��<' S STORIES: � SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. �� DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ (y � C -� , � �'� 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 I understand this is not a permit and work is not to start without a permit; and that the work will be in a cordance with the approved plan. /l /�G^�� ,' APPLICANT'S SIGNATURE: �Y / � D�TE: J—� �—�� NOTE! Parade o Homes events require separate permit approval by Police Department and City Coccncil 60 days prior to the event. Non permitted events will not be allowed. 5 � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in[his section. � Subd.2. Information required to be given individual. An individual asked ro supply prn•ate or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting srate a�ency,political subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(cl any know-n consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identiry of other persons or endn;s authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigati�e da[a, pursuant ro section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav�lace the notice reauired under this subdi�ision in the individual income tax or vrooertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible au�'�oriry, an individual shall be infornted whether he is the subject of stored data on individuals, and whether it is dassified as public,private or cenfidenqal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data withou�any charge to him and, if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the priva�:data and informed of its meaning, the data need not be disclosed ro him for six months thereafter un(ess a dispute or action pursuant to this sec�en is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or publ:c data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of rrakine,cerzifying,and compiling the copies. The responsible authoriry shall comply immediarely,if possible,with any reqt:e�made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immedia[e compliance is not possible. If he cannot comply with the request within that time, he shall so infornt the individual, and may have an addiconal five da}s within which to comply with the request, excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may cont�st the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in wrinna the responsible authoriry describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the dara feund to tx inaccurate or incomplete and attempt to notify past recipiencs of inaccurate or incomplete data,including recipients named by the indi�idual;or(bi notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disaoreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to d:e 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", �t�e 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: 1. The information you furnish will be used to determine y'our 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 appro��e, 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 this application or permit. ��5 ��i� h'1��-�-1 gi�s�� Middle Last ��l� `�� e 1 l --� �f Address � i ,,,<<��.,._ �� -��1 - 3�� C��, State Z�p Phone I understand my rig ts as stated above. Signature 6 DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. � COMPLETED , � l "�� ADDRESS �� S� C�'�'�'� ' Cl�-�- � OWNER CONTR. ��`� �a L� TELEPHONE NO.�4� � DESCRIPTION �`�� ly� �� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q02 FRAMIN � 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACT TO YOU: YES_ O � COMM NTS: ` �� a C� W '� �7�l 9 i� G�. � �1� G�.(�£(j � � J �, S , � �CC� PG` CL �Q PG�2� 0 � o� W v � - � Q � z W � W � � d ❑WORK SATISFACTORY:PROCEED = PROJECT COMPLETE W � ORRECT WORK&PROCEED f ISSUE CERTIFICATE OF OCCUPANCY W O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. . pHOTO TAKEN ' INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR ' CITATION ISSUED G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContr��q;tqr on site: Inspector. ��✓L- �f White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN �-�e-[�'? �--'��» INSPECTION NOTICE /,� SCHEDULED 9�zZ -� � PERMIT NO. P� Z`i`7 l COMPLETED �Z"Z�U jY ADDRESS /`�!v `�� n�z,-�� CiU� �� OWNER C�%i��jZ. CONTR. �/`9 Shi/J �2cY�f;rr� TELEPHONENO. � j� � 3�� — � DESCRIPTION • "` �f LV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FI�LING � 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W� ORKSATISFACTORY:PROCEED �PROJECTCOMPLETE W ;CORRECT WORK&PROCEED - ISSUE CERTIFtCATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED Ci INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. 249-460� OwnerlCont tor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice