HomeMy WebLinkAbout2006-P10282 - re-roof *
` PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o282
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
8/31/2006
SITE ADDRESS: 3365 Crystal Bay Rd Unit#
Wayzata, MN 55391
PID: 17-117-23-44-0016
DESCRIPTION:
Proposed Use: Residential Census Code O/S-Building
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: $ 251.25 valuation: $ 15,000.00
State Surcharge Fee: $ 7.50
TOTAL FEE: $ 258.75
APPLICANT: Ralphs Exteriors Inc. OWNER: J.R. Lofrano
17850 Gladiola St.NW 3365 Crystal Bay Rd
Andover,MN 55304 Wayzata MN 55391
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.
--, ,
� '/,�` i 2'ti ( i���V �V
,g �� , 1 �
A PL 'T ER TE G T E ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page I
r '
Total Fee: $ � d �� Date Received: �/3�/Q�
Entered By: � � Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print al!infof�mation)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 33�� ' � , ZIP: -��3 � �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ NO If yes, a specia/event permid is requir•ed 1�nith Police Departrnent and City Council appr�oval
60 davs prror to the eve��t. Shuttle bus servrce i��il/be required araless applicant deinor7strates
su�cie��t on-sr�te parlcing is avaifable. 1Von-peri��itted ever�ls will not be allowed.
NAME OF OWNER: Q PHONE: (home) qS,Z- �{7/•�$�
(work)
MAILING ADDRESS: 3 � � CITY: Q ZIP: 5�'39
�
CONTRACTOR: A���� �� �aQ rvC � PHONE:7�3 • ,Z f j � 6_��
CONTACT PERSON: MOBILE/PAG R: (� /Z- 25�v • �-� 3 S�
MAILING ADDRESS: � $ SU • � r o T• CITY: � t� ZIP: C���
STATE LICENSE: # �p 3[����y EXPIRATION DATE: � � 3 � ' D �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeVAltecation (ie: Siding, Windows)
Any earth movement ay re ire MCWD review and permits !
PROPOSED WOR (rlescribe in�letai�: —
l �
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACH�D DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /,s�, °``�
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���ork is not to start without a permit;and that the�vork will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE. DATE: �� J � ' d�
�t
Scc.13.04 RIGEITS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rigllts of individual on�vhom tlle data is stored or to be stored sllall be as set foRll in this section.
Subd.2. [nformation required to be given individual. An individual asked to supply private or contidential dataconcerning himselfshall be
informed of. (a)the purpose and intended use ofthe requested data within die collecting sta[e agency,political subdivision,or statewide system;(b)
whether he may retLse or is legally required to supply die requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the iden[ity of od�er persons or entities authorized b��state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply inves[igative data,pursuant to section 13.82,subdivision�,to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or properry tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infonned whether he is the subject of
stored data on individuals,and whether it is classitied as public,private or contidentiaL Upon 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 oY 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
mondu 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 d�e private or public data upon request by the individual subject of the data. The responsible auchoriry
may require the requesting person to pay the actual costs of making,certiYying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or�vithin tive days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,iY immediate compliance is not possible. [fhe cannot compfy with the request
wid�in that time,he shail so infonn the individual,and may have an additional five days within whicll to comply with the request,excluding Saturdays,
Sundays and legal holidays.
S ubd.4. Procedure when data is not accurate or complece. An individual may contest the accuracy or completeness of public or private data
concerning himselE To exercise this right,an individual shall notity in writing the responsible authority describing the nature ofthe disagreement. The
responsible audiority shall within 30 days either. (a)correct d�e data found to be inaccurate or incomplete and attempt to notity past recipients of
inaccurate or incompiete data,induding recipients named by the individual;or(b)notify the individual that he believes the data to be correc[. Data in
dispute shail be disclosed only if the individual's statement of disagreement is induded�vith the disclosed data.
The determination of the responsible authority 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 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 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, sorne information may become
public.
5. You have certain rights under 1�I.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 �liddlc Last
Address
Cily Stace Jip Pho��e
I underst y rights s stated bove.
�
Signat rc
Reset Form 32
� ATE TIME �
CITY OF ORONO CALLED IN � � �� 'O �
INSPECTION NOTICE SCHEDULED ' I� L� �..(�l
PERMIT NO. �/ U�-S'�o� COMPLETED
ADDRESS �' ' ��' C r ��- ��
OWNER CONTR.���''
TELEPHONE NO. �D Js�r��U " o�D.3� ����_
� DESCRIPTION �'�� � G-��
� 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
� 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
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
�
J
O
a
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d
W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN i;� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CA�L TO ARRANGE ACCESS.
Cal1 for the next ins ection 24 hours in advance. (J52� 249-46�0
OwnerlContrac i -
inspector.
White Copylinspector's File Canary CopylSite Notice
�� G�DATE TIME V
CITY OF ORONO CALLED IN ` �
INSPECTION N TICE SCHEDULED a_°D�
PERMIT N0. � COMPLETED
ADDRESS �-�'3� �
OWNER �� (�Vti'Q.f'�D CONTR. ,
TELEPHONE NO. � —"
� DESCRIPTION � ��� �/ �� g �fS
l� 01 FOOTING 11 MECHANICAL RI 18 CAV/GRADING/FILLINC3=T�?
Q02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAND��yl
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � �
Z04 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
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
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
J
O
>.
�
O '
�
W
�
Q
�
2
w
�
w
�
j
d _/
W WORKSATISFACTORY:PROCEED I�PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-460�
OwnerlCont r site:
Inspector. �
White Copyllnspector File Canary CopylSite Notice