HomeMy WebLinkAbout1998-010850 - tearoff/reside r
PERMIT
= CITY OF ORONO PERMIT TYPE: �;;_�;4__;; ;;
2750 Kelley Parkway- P.O. Box 66 - -.:-�```�
Crystal Bay, Minnesota 55323 Permit Number: '.%i{':_��=__� `
(612)473-7357 Date issued: _ .. .`�_�`���'=��_�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNAT E ISSUED BY:SIGNATURE �
� Total Fee: $ �/�/ �� Date Received:
Entered By: �l Permit#: �(">`�'�u
CITY OF ORONO - BUILDING PERMIT 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 '
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JOB SITE ADDRESS: �j ���)� _l C.���C.�/�« (��l ZIP: ���C� /
NAME OF OWNER: ,J��J�F�� �1�7�n�� rxorr�: (home) �-{7I--D���
(work)
MAILING ADDRESS: 33�.3 C�1 t�'S�Q l�L,� ITY: �Q,(../ZQ ZIP:_��/
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CONTRACTOR: 5,����'�GI / TUU Cl� �1C tE'�'�U%5 PHONE: �-{�3��3�
CONTACTPERSON: (��,Zy (��; �,- ���j2n MOBILE/PAGER:
MAILING ADDRESS: I�C�S-- �rtl� �fi CITY: �/�(��)f(� ZIP: s�
STATE LICENSE: # �CY�/ �/���
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: r��;�•/� 'C�, �/'1 V r/)t,�' l 5 ��'�//� �
r�i�%m,i�r:�-� Sc;�Fr f 4 fC�S i � c� u �r.� F t�,m
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��, �GU `�
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 a ordance with the approved plan.
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APPLICANT'S SIGNATURE: � ' � � . . DA'�: ��-���C�
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 RIGIITS 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 focth in this secrion.
Subd.2. Information req�rired 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 requesced data wichin the collecring'state agency, polidcal subdivisioo,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from his supplyiag or refusing to supply
priva[e or confidenrial data;and(d)the idenriry of o[her persons or enriries authorized by state or federal law to receive rhe data. This requirement shall
not apply when an individual is asked to suppiy invesrieauve dara, pursuant[o section 13.82, subdivision 5, to a law enforcemen[o�cer.
The commissioner of re�enue mav place the nodce required under this subdivision in the individual income rax or propercv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public, private or confidenrial. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown[he data wichout any charge to him and, if he desires, shall be informed of the content
and meaning of chat data. After an individual has been shown che private data and informed of iu meaning,the dara need not be disclosed to hicn for
six months thereafter unless a dispute or acdon pursuan[to [his secdon is pending or addiaonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authority
may require the requesring person to pay [he actual cos[s of making,certifying, and compiling the copies.
The responsible authoriry 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 compiiance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal 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. M individual may contest the accuncy or completeness of public or private
data concerning himself. To exercise this right,an individual shall nodfy in wriang the responsible authoriry describing che nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correcc the data found to be inaccunte or incomplete and aaempc to norify pasc recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes che 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 determinarion of the responsible authoriry may be appealed pursuant to the provisions of the admuusaarive 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 suppiy data, but refusal may require that the City deny the pemut 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.
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City State Zip Phone
I understand , rights as stated above.
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Signamre ,
DATE TIME
CITY OF ORONO CALLED IN '3 0 !d:S� ayr,
INSPECTION NOTICE SCHEDULED %� -d( ��� r�
PERMIT N0. f� e�6�_ COMPLETED � �
ADDRESS -=�3���� ( �� 1����/
OWNER �irr �� CONTR. ��-�-�-a��-�C�'
TELEPHONE NO. ���������
� DESCRIPTION �/ /�U'�O
ty� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 12 WATER HOOK-UP 17 SITE INSPECTION
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
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ,,PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED �_ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CAL�FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. CpHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for t xt'n pection 24 hours in advance.473-7357
OwnerlContra t n s e:
Inspector.
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE ,/9� SCHEDULED O 1,Z _0��,
PERMIT NO. � � ��' co PLETED � '���
ADDRESS -�3 5 G..� ��
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION �e — S < <��I
Lu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� OQFRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 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 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d �I WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
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W C� CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. L pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTIONREQUIRED.CALITOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra r ite-
Inspector. ��
White Copy/lnspector's File Canary Copy/Site Notice