HomeMy WebLinkAbout2000-P02648 - re-roof r � ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po264s
Crystal Bay, Minnesota 55323 Pe�mit Type: 1v�inor Alterations
(612) 249-4600 Date Issued: �noi2oo
SITE ADDRESS: 325 Crestview Ave
LONG LAKE, MN 55356
PID: OS-117-23-14-0031
DESCRIPTION:
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 26.55 Valuation: $ 600.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 27.05
APPLICANT: wir.[,iAM suLL[vatv OWNER: WILLIAM L SULLIVAN
8417 REGENT 325 CRESTVIEW AVE
OAK PARK, MN 55443 LONG LAKE MN 55356
TIiE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPEC�IED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI�C NT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
• �.
Total Fee: $ Date Received:
Entered By: Permit#:
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) �C�OR CONTRACTOR
JOB SITE ADDRESS: .� � � �� �5��' � �� ZIP: .� ���
NAME OF OWNER ��j l/r�G� � ;�f�/✓ �t-r�� PHONE: (home).� � � ��
�� �� (�ork)
NIAII.ING ADDRESS: � � � � '� � _ CITY: L IG'f; �/�-Y � K ZIP: `' .3
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/E�IGINEER: PHONE:
1IAII�ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: � � ��� �� �
STORIES: I _ SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: ,�� GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $,���. Q� _
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 ac�ordanc ith the approved plan.
APPLICANT'S SIGNATURE: DATE: D � �
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 SLBJECTS OF D�T�
Subd. 1. Type of data. The rights of individual on whom che data is s[ored or to be s�ored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency,poliacal subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any known coasequence arising from his supplying or refusing to supply
priva�e or confidendal data;and(d)the idenriry of ocher persons or enaaes authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigaave dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav pla�e the notice reauired under this subdivision in the individual income tax or propertv 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 whe[her it is classified as public, private or confidenaal. Upon his futther requesc, an individual who is the subject
of stored private or public data on individuals shall be shown the data wirhout 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 ics meaning, the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to [his secrion is pending or additional data on the individual has been colfected or created.
The responsible au[horiry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of makine, certifying; and compiling the copies.
The responsible authoriry shall comply immediately, if possible, wi[h any request made pursuant to this subdivision, or within five days of
the date of[he request,excluding Sacurdays,Sundays and leeal holidays,if immediate compliance is not possible. If he cannot comply with the reques[
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Sarurdays,
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 chis right,an individual shall noafy in wriang the responsible authoricy describing rhe na[ure of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attemp[to nodfy past recipients of
inaccurare or incomplete data, including recipiencs named by the individual; or(b)notify the individual that he believes the data to be correct. Data
ut dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The de[ermination of the responsible authoriry may be appealed pursuant to the provisions of the adaunistnrive procedure act rela[ing 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 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 [o supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared witb other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council action to approve, some informa[ion may become
public.
�. You have cenain 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 Viiddle Last
Address
Ci�, State Zip Phone
I understand m�rights as s ted above.
Signature
DATE TIME
CITY OF ORONO CALLED IN ,�, �
INSPECTION NO E SCHEDULED
PERMIT N0. � � COMPLETED r '-`�U �/Z:%'S
ADDRESS � 5 ��
OWNER ��^''� CONTR.
TELEPHONE NO. ��3'�(���
� DESCRIPTION�/"��f��'
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
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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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FIN 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Ow lCont ctor on site:
Inspectohv'���(��(,LI S
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE ,� SCHEDULED �''���' rv�'�
PERMIT N0. J���"b ,� COMPLETED /— —`'� "" •'��
ADDRESS 3�� ����P�
OWNER CONTR.
TELEPHONE NO. �G� —SgZ�
� DESCRIPTION ���� 5���'/ �
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� 02 F 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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f i CORRECT UNSAFE CONDITION WfTHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
C 1 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
�:l INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContract r on site:
.
Inspector. C?'�e �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N�TI�� SCHEDULED ��/� �--�—
PERMIT NO. �C 1- `�� COMPLETED ��� � ' L��
ADDRESS �J ���V��
OWNER l�1t� ���� � u�����`�G9CONTR.
TELEPHONE NO. � �l � 5 5^
� DESCRIPTION �j0���GI
l� 01 FOOTING 11 MEC NICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTA�L. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTO TO MEET YOU:_YES_NO /
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0 � BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C; INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-4600
OwnerlContractor on site:
Inspector.///'��.� �( t��.v�'�
White Copyllnspector's File Canary CopylSite Notice