HomeMy WebLinkAbout2001-P04532 - windows ° � PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P04532
Crystal Bay, Minnesota 55323 Pe�mit Type: Minor Alterations
(952) 249-4600 Date Issued: to�2ai2ooi
SITE ADDRESS: 278o Countryside Dr W
LONG LAKE, MN 55356
P I D: 04-117-23-12-0010
DESCRIPTION: UBC occupancy R3
Proposed Use: Kesidentiai
Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): W�ndows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 209.25 Valuation: $ 12,000.00
State Surcharge Fee: $ 6.00
TOTAL FEE: $ 215.25
APPLICANT: Metro Handyman Inc. OWNER: L J& D T SEWARD JR
1935 W Wayzata Blvd 2780 COUNTRYSIDE DR W
Long Lake, MN 55356 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 BUII,DING CODE REQUIREMENTS.
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APPLI ANT P�RMITGE I NATURE ISSUED BY SIGNATiJRE
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
, .
Total Fee: $ �/ � �� Date Received: � Ci -�� - G�
Entered By: E�Vk, Permit#: /"C� �/�"'-� ��
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � 7�'O C c�v;�/�-- ��f .S!�� �'�'- ZIP: _�S �S L
NAME OF OWNER: �W i��j S.�W.�,�� PHONE: (home)�Ca��� � �W- �o��
(work)
MAILING ADDRESS: �,I�O CGu., t�� 5�����`CITY: ����, �-+�� ZIP: �S'.�_�L
CONTRACTOR: �-G�RD N�••Z/v+��a� PHONE:� S� � ��(ic.1- 2�8 K
CONTACT PERSON: Q o t3 j�v-�������, MOBILE/PAGER:
MAILINGADDRESS: l�3Sw-wa�?.,H� �i�� CITY: �-�J �Ak� ZIP: �33��
STATE LICENSE: #�����j ;3C;3 5v�-+�-�-�`(
ARCHITECT/ENGINEER: PHONE:
NTAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure k 1
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �o l�i W�s��cs �rYp ..� � �S + ��
S C d--���� w���d�� C-1;'-zv� i �.�.�_ S`tz��n i�vR��� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 1� , �j��� _ �,(�
I hereby apply for a building pernut 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 accordance with the approved plan.
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APPLICANT'S SIGNATURE: �j� ✓ DATE: [ C�--
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 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 this secdon.
Subd.2. Information required to be given individual. M individual asked ro supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision, or statewide
system;(b)whether he may refuse or is IegaUy required to supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the idendry of other persons or enades authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to suppty investigative data, pursuant ro section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or orooertv tax refund
instructions instead of on those forms.
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 whether it is dassified as public,private or confidential. Upon his further request,an individual who
is the subject of srored private or pub(ic 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 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 public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The cesponsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request, excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five days 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 contest the accuracy or completeness of public or
private data concerning himself. To exercise this right, an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsibie authoriry shall within 30 days either. (a)conect 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 that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinauon of the respoasible authoriry 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 �ity 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 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 shazed 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 this application or permit.
�'�D � �U �e l F.��•�
First Middle Last
l �( 3 S W, !„� ��r z a r� T3��� 5,�� +t �� y
Address
` o�,� L p � i'vl�"� .�3.�� �� s�� �(�-r-�y�Y
City State Zip Phone
I understand my rights as stated above.
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Signamre
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� � DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT�CE SCHEDULED �� �
PERMIT NO. 1 G Y�� COMPLETED j � `�� ��
ADDRESS o���CJ ��i/�,1:� � <�'�. /`Z. /,�o
OWNER CONTR. �io�7�c�.fo-._.
TELEPHONE NO.� I t� ��O �_ .� 7�� �
� DESCRIPTION _/(CC.'YYI' v �' G/'�� ��"�Uws j
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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-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
J 10 PLUMBING FINAL 36 FOUNDATIONlREMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� �I WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W ��CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL�NSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Own�erlContractor on site:
Inspector���L��C�-L�l S
White Copyllnspector's File Canary CopylSite Notice