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Home My WebLink About2004-P08037 - re-roof PERMIT CIT� OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Pogo3� Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: ioisi2oo4 SITE ADDRESS: 300 Crestview Ave I.ong Lake,MN 55356 PID: OS-117-23-14-0043 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-rype(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: -:�- n 'rr�'`--t-� r'---- .�G.....G ...,..C.......�.:..w.,..C.. �:.:..:b:, FEE SUMMARY: Pernut Fee: $ 44.85 Valuation: $ 1,200.00 State Surcharge Fee: $ 1.10 . TOTAL FEE: $ 45.95 APPLICANT: Owner/Self OWNER: Thomas Betz � 300 Crestview Ave 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 CI'TY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. / 7 �i � _ ` . . _ _.. � '�'� APPLICANT PERMITEE SIGNA URE IS D BY SIGNATURE G�� Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 � Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDIN�G PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pri�it all iiiformatioii) THE APPLICANT IS: (circle o�ze) OWNER R CONTRACTOR C� �-y �� JOB SITE ADDRESS: ��'r�-�-� ��--��!L'��-� J ZIP: �� Will this be a r de of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special everit permit is required with Police Department and City Coa�ncil approval 60 days prior to the eve��t. Non.permitted events will not be ccllotived. NAME OF OWNER: / 31,��J� '"'�- � '� PHONE: (home)��l� Z�'� �?��`�`-� �' (work) MAILING ADDRESS: -�� '�— CITY: ZIP: CON'I'RACTOR: ��✓�"�-� PI'�JNE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe i�z detai�: �L;�.c--�Q� � /"`-'L- ��`L%�,— '��'��LL-�'`' C�--�--�-��.._ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. __-� ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� I hereby apply for a building pemut and I aclrnowledge 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 o start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: /� ��y-�' ( � � DATE: /--J�� i' Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.i. Type of data. Thc 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 or confidential data concerning himself shall be informed of: (a)the purpose and iatended use ot the requested data within thc collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legall,y required to supply the requested data;(c)any known consequence arising from his supplying or re[using to supply private or confdential data;and(d)ttie identity of other persons or entities authorized by state or tederal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav n�ace the notice required under this subdivision in the individual income tax or nropertV tax refund instructions instead of on those forms. Subd.3. Access to data by individual. C;pon request to a responsible authority,an individual shalt be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. L'pon his further request,an individual who is the subject of stored private or public 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 necd not be disclosed to him for six months thercafter 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 b,y the individual subject of the data. The responsible authority may require the requesting person to pay thc actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of thc date of tlic requcst,escluding SaturdaYs,Sundays and legal holidays,if immediate compliance is not possiblc. I[he cannot compl��with the request within that time,he shall so inform the individual,and may have an additional Fve days within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. P�rocedure when data is not ace�rate or complete. An individual may contest thc accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagrcement. The responsible authority shall�vithin 30 days eithe�: (a)correct[he data found to be inaccurate or Incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipicnts 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 o(disagreement is included with the disclosed data. Thc dctermination of the responsible nuthority may be appcaled pursuant to thc provisions of the administrativc proccdure 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 furnisli certain private or contidential 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 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 this application or permit. First ltiddle Last Address City State Zip Phone I unders nd m rights as stated abo . �� ' .� Signature � /�TE// TIME CITY OF ORONO CALLED IN INSPECTION N I SCHEDULED O-/ -iD �•7,'� PERMIT NO. O COMPLETED � ADDRESS OWNER CONTR. TELEPHONE NO. � o�oZ � - ag��") � DESCRIPTION + cJC "r � 01 FOOTING 11 MECHANICAL RI 1 EXCAV ADING/FI I G Q 02 FRAMING 13 MECHANICAL FINAL LAKES E/WETLANDS y 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 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 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � _ . O � �u � Q � Z W _ � W � � d W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK 8,PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W � ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR � CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next ins ection 24 hours in advance. (952� 249-46�0 OwnerlContra or ' e: Inspector. White Copyllnspector's File Canary CopylSite Notice