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Home My WebLink About2002-P05213 - re-roof PERMIT �i 7 Y OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Pos2i3 Crystal Bay, Minnesota 55323 Pet-mit Type: MinorAlterations (952) 249-4600 Date Issued: si22i2oo2 SITE ADDRESS: 240 Crestview Ave I.ong Lake,MN 55356 PID: OS-117-23-14-0055 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 29.60 Valuation: $ 700.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 30.60 APPLICANT: Owner/self OWNER: 7effrey Melby � . _ _ .240 Crestview Ave Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK�N STRICT COI�IPLI�NCE-WITH ALL GI'�'1'OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. , �, . /�r - � - , _ , _._ ,_,..,< . .. . . _ .. __.... . - :::- _ - : �_,, - , � � , ;�' ; � �/��`' /�� ,;. PL CANT PERMI'fEE SIG ATURE " = ' - ' "" " ' ISSUED B IGNATURE Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 , '`' Total Fee: $ 3 6-�� Date Received: Entered By: Permit#: CITY OF O ONO - BUII..DING PERNIIT APPLICATIOIeT All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) �O_WNER�R CONTRACTOR JOB SITE ADDRESS: -Z y CJ � �`.�(�; � � ,/� ZIP: -S S_5� Ca �--___'_' r --, NAl�iE OF OWNER: �l �� t !� �,�_"}� ; ,,, PHONE: (home)`�S 2 ��- S�(� � �.J (work) MAILING ADDRESS: Z_�/O c ;�_� �-; ; � �; l �,, CITY: L.,,,►�� L:f� , ZIP: S S 3.S CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAl��E: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �''��_ ; �'� �, (�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. EST�VIATED CONSTRUCTION VALUATION (excluding land): $ ; �� , � � 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 pernut; and that the work will be in ac rd with e approved plan. % APPLICANT'S SIGNATURE• DATE:S��— � -Z , NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � Sec.13.04 RIGHTS OF SUB.TECTS OF DATa Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. 3ubd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecang'stat$agency,polidcal subdivisioo,or sCatewide system; (b)whe�her he may refuse oY is lega(ly required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the idendry of ocher persoas or entides aurhorized by state or federal law to receive the data. This requ'uement shall not apply when an individual is asked to supply invesdgaave da[a,pursuan[to secaon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of r�venue mav place the nodce reauired under this subdivision in the individual income tax or oroperN tax refund instruc[ions insczad of on those forms. Subd. 3. Access to data by indi�-idual. Upon request to a responsible authority,an individual shall be informed whethet he is the subject of scored data on individuals, and whecher it is classified as public, priva[e or confidendal. Upon his further request, an individual who is the subject • of stored private or public data on individuals shall be shown che dara wi�hou[any charge to hun and,�if he desires, shall be informed of the contenc and meaning of chat data. Ahzr an individual has been shown the privace data and informed of its meaning, the dara�eed not be disclosed to hun for six mon[hs thereafter unless a dispute or accion pursuanc to this secrion is pending or addiaonal data on the individual has been coilected or created. The responsible auchoriry shall provide copies of the private or pubiic dara upon request by the individual subject of the data. The responsible authoriry may require the requesdng person to pay the actual costs of makine, certifying, and compiling the copies. The responsible authoriry shall comply immedia[ely, if possible,with any request made pursuant to this subdivision,or wi�hin five days of the date of the request,excluding Sarurdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wi�hin that time,he shall so inform the individuai,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or compfeteness of public or private data concerning himself. To exercise this righ[,an individual shall noafy in wridng the responsible authoriry describing[he nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccunte or incomplete data, including recipients named by che individual;,or(b)noufy the individual thac he believes the data to be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed data. The de�erminarion of che respensible au�horiry may be appealed pursuanc to the provisions of the aduunistrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "RiQhts of subjects of data", we would like to inform you that your reques[ 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 your qualification for the pemut or iicense 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 a�encies to the extent necessary to process the pernut or license. 4. If your requested pernut or license requires Council action to approve, some informa[ion may become public. j. 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. First �fiddle Last Address Ciry Srate Zip Phone I understand my pghts as t above. % / �' Signantre� / / DATE TIME CITY OF ORONO . CALLED w C�•- INSPECTION NOTIC �/�SCHEDULED PERMIT NO. COMPLETED `'� � �1 � � ADDRESS � �� T� OWNER `�� ' CONTR. � TELEPHONE N0. j =� ' L � , r � � DESCRIPTION � �� I '�� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 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 PLUMBfNG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � J O >. � O � W � Q � 2 W � W � � � � �NORK SATISFACTORY:PROCEED ROJECT COMPLETE W �O CORRECT WORK&PROCEED �SSUE CERTIFICATE OF OCCUPANCY � O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDiTION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP OROER POSTED.CALL INSPECTOR ❑INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 OwnerlContra to on site: � Inspector. / '/ �2�� //! � White Copyllnspector's File Canary CopylSite Notfce J DATE TIME CITY OF ORONO /CALLED IN INSPECTION TIC SCHEDULED ' -�� l/..G�d PERMIT N0. O �� COMPLETED '1 '� ��- � �� ADDRESS �G'' ��l�r p�v OWNER f � CONTR. TELEPHONE N0. � � 3 •�—S (o � DESCRIPTION �� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FAAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � ��a r � J , � 0 a � o —' . � W � Q � z W � W � � � ;�/ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARFANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contr r on site•� Inspector,l��" � White Copyllnspector's File Canary Copy/Site Notice