HomeMy WebLinkAbout2001-P04573 - re-roof PERMIT
C I TY O F O RO N O Permit ►vumber:
2750 Kelley Parkway - PO Box 66 P04573
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: ioi3ii2oot
SITE ADDRESS: 114 Chevy Chase Dr
WAYZATA,MN 55391
P I D: 3 6-118-23-41-003 5
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Permit Class: Building Census Code O/S-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: $ 139.25 Valuation: $ 6,900.00
State Surcharge Fee: $ 3.45
TOTAL FEE: $ 142.70
APPLICANT: Carlson Roofing Remodeling OWNER: ROBERT LANGGUTH& WIFE
533 79th. Ave.NE 114 CHEVY CHASE DR
Spring Lake Park, MN 55432 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REOUESTS PERM:SSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AN D 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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L[ ANT PERM[TEE I NATURE ISSUED BY SIGNATURE '
Copies: 1-File(Signitures Required), 1-Applicant, l-MonthlyReports, 1-Assessing, 1-Finance Page 1
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Total Fee: $ f�a� 7� Date Received: i0`�3/-U/
Entered By: j't-. Pernut#: /'��5�3
CITY OF ORONO - BUILDING PERMIT APPLICATIOIeT
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
JOB SITE ADDRESS: !��� (� l�l<�y � (�,�s t �� ZIP: �� 3 9 /
NAME OF OWNER: � �-��{,2 �a,�.�� � c,�t �,� PHONE: (home)
(work)
MAILING ADDRESS: CITY: d� v n �� ZIP:
CONTRACTOR: I ,,� ���,1 , -e.n„:��1�:� � PHONE: �%2- ��D-.5��'G?
CONTACT PERSON: ,'u� fs 1 MOB /PAGER:
MAILING ADDRESS: � `�' %!1�^`'� ,/�,c< /7.� CITY: �',v�,/1..t,y�' r ZIP: s'��;y-�/�'
STATE LICENSE: # � C -°�.�2 �?�5 j 3
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 detain: �� f�, �;`�
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ro�1(� (� , C� d
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 accordan e with the approved plan.
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APPLICANT'S SIGNATURE:� ,.,,.r.� DATE: ` i� " 3�� 0 �
NOTE! Parade o�'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 SUBJECTS OF D�TA
Subd. 1. Tvpe of data. The righrs of individual oo whom[he data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information cequired 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 collec[ing'state agency,poliacal subdivision,or statewide rystem;
(b)whether he may refuse oY is legally required to suppty the requested data;(c)any laiown consequence arising from his supplying or refusing to supply
private or co�dendal data;and(d)the identiry of o[her penons or enriaes authorized by sta[e or federal law to roceive the data. This requirement shall
not apply when an individual is asked to supply invesrieauve dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re��enue mav place the notice reauired under this subdivision in the individuat income tax or propertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by indi�lduai. Upon reques[to a responsible au[horiry,an individual shall be informed whe[her he is the subject
of stored data on individuals,and whecher it is classified as public, private or confidendal. Upon his further request, an individual who is[he subject
of stored private or public data on individuals shall be shown che data wichout any charge to hun and, if he desires, shall be informed of the content
and meaning of[hat 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 oending or addido�al 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 data. The responsible authoriry
may require the requesting person to pay the actual cosu of making, cervfying, 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[he request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inforrtt the individual,and may have an addidonal five days within which to comply wi[h the 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 pri�•ate
data concerning himself. To exercise this right,an individual shall notify in wricing the responsible authority describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to norify past recipients of
inaccurate or incomplete data, including recipients 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 of disagreement is included with the disclosed data.
Tlie determination of the rzsponsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relaring to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "RiQhts 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 pemut 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 pernut 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 Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
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Signatu -
� ��' I DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED /� �_
PERMIT N0. �� COMPLETED
ADDRESS_ /l� �/�� �������,�c� •
OWNER CONTR.��Z�'"�.<L�Y► /2 L���
TELEPHONE N0. (,� /a -t���� -�ln (0'7
� DESCRIPTION f '�r�7
� 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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 O6 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
� OWNER/CONTRACTOR TO MEET YOU:_YE NO
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W� �WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP OFDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site:
Inspector. � �� ��t• �-•.—
White Copyllnspector's Fiie Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED ��" S `V� �`_ � �
ADDRESS_ �l C�'rL ��f ��l�f+��CrT
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHAN CAL 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
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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 BEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRr4CTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,GALI,FOR F�EINSPECTION „,rn., .' \ TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAG€CONbITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN- '='.-
❑STOP ORDER POSTEb.CALL�INSP6CTOR
❑CITATION ISSUED
❑ INSPECTION REQUIF�ED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
Own�rlContractor sit
Inspector.
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White opyH�specto�s File Canary Copy/Site Notice