HomeMy WebLinkAbout2007-P10895 - re-roof PERMIT
CITY OF ORONO
2750 Kelle;: Parkway- PO Box 66 Permit Number: P10895
Crys`,.�I Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
4/17/2007
SITE ADDRESS: 2875 Deer Run Tr Unit#
Long Lake,MN 55356
P��� 04-117-23-24-0009
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: Pernut Fee: $ 23�•25 valuation: $ 14,000.00
State Surcharge Fee: $ 7.00
TOTAL FEE: $ 244.25
APPLICANT: Home Exteriors Inc OWNER: Mark&Christine Robbins
Dale Schlosser Inc 2875 Deer Run Tr
7950 Co Rd 26 Long Lake MN 55356
Minnetrista,MN 55359
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
MINNESOT DING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: l-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ DateReceived:
Entered By: Permit#:
CITY OF OROI�'O - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pYint all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
Jos sITE an�REss: ��15 l���l� �C t �"��� ,�f� ziP: SS 3S�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �No !f yes, a special event perrnil is reguired with Police Departnient and Ciry Coarncil approval
60 days prio�-to the event. Sha�ttle bus service ivill be requirecf unless applicant den�onstrutes
su�cient on-site parking is available. ]�'on-pernritted events wi/l not be allo�ved.
NAME OF OWNER: I�I��� (�0�1� ;r.5 PHONE: (home) �S�-�IG�-1-9810
(work)
MAILING ADDRESS: S�._ ..b ���,,` CITY: ZIP:
CONTRACTOR: ����c. Ex�i���rs PHONE: `�53.- 4-7�.-"L2S�'�j
CONTACT PERSON: 1�..,1 c.. MOBILE/PAGER: �t-7,- �,"1�J- ,.1`1�
MAILINGADDRESS: �9SQ C� 1'�.-� 2� CITY: M:�-�,r;s�-,� ZIP: ,SS359
STATE LICENSE: # �03153��`7 EXPIRATION DATE: 3- 31-��
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structuce
Move Home Remodel/Alteration (ie: Siding, Windows).
Any earth movement may require MCWD review and permits !
PROPOSED WORK(clescribe in detarn: �"�„� ��� c,,..( re r.-r,� •
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �y,c�nn . M
I hereby apply for a building permit and I acknowledge that the infonnation above is complete and accurate;
t11at the�vork will be in conformance ���itl: �dinances and codes of the City and��rith the State Buildin�
Code;that I understand this is not a per it an o• is not t tart without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: �1'17'n�7
�l
Sec.13.0� RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The ri�hts of individual on��hom 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 orconfidential dacaconceming himselfshall be
infonned of: (a)the purpose and intended use of the requested data wid�in the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or entities authorized by stare or federal law to receive the data. This requirement shall
not apply when an individual is asked ro supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tar or�ooerry tax refund
instructions instead of on those fonns.
Subd.3. Access to data by individuaL Upon requestto a responsible authority,an individual shall be infonned whether he is the subjectof
srored data on individuals,and whether it is classified as public,private or contidential. Upon his fuRher 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 sho���n the private data and informed of its meaning,the data need not be disclosed to him for six
months 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 the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesti�g person to pay the actual costs of making,certifi�ing,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
che date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply witll d�e request,excluding Saturdays,
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
conceming himselP. To esercise this right,an individual shail notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall�vithin 30 days eithec (a)correct the data£ound to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by die individual,or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be disclosed only if d�e individual's statement of disagreement is included wilh lhe disclosed data.
The determination of the responsible aud�ority may be appealed pursuant to the provisions ofthe administrative procedure act relating[o
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, 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 �liddle Last
Address
City Statc Zip Phone
I unders nd s s ed above.
Signature
Reset Form .i�
��� � ATE .�} TIME r
OF ORONO CALLED IN v �
INSPECTION NQ�ICE g�,,�. r SCHEDULED �7 ^ �
PERMIT NO. �' ,' �LL� COMPL TED ��
ADDRESS ����� � � �Z�L(��
OWNER CONTR. ����Y� �i5��
TELEPHONE NO. �� 5� �` � �� �
� DESCRIPTION �•_����C�Z !
ly 01 FOOTING 11 MECHANICAL RI XCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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 COMPIAINT
� 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:
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W ORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE
� C CORRECT WORK&PROCEED [-: ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR -�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (952� 249-46��
OwnerlCo act o ite:
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice