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Home My WebLink About2007-P11677 - re-roof � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P11677 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 11/13/2007 SITE ADDRESS: 745 Dickey Lake Dr Unit# Long Lake, MN 55356 PID: 34-118-23-22-0008 DESCRIPTION: Proposcd 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: $ 181.25 valuation: $ 9,800.00 State Surcharge Fee: $ 4.90 TOTAL FEE: $ 186.15 APPLICANT: Plymouth Roofing&Insulation OWNER: Robert&Lisa Hanten 17525 Cty Road 24 745 Dickey Lake Dr Plymouth, MN 55447 Long Lake,MN 55356 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. /, ;� � 4�.. �: '' '� �.—Z � ��-yrc�� f=� /��, A A T ERMITGE SIGNAT 1.SUED BY SIGNATURI� Copies: 1-File(SignaturesRequired), 1-Applicant, I-MonthlyReports, I-Assessing,(IfSeptic, 1-Septic) Pagel • Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. � (please pYint all information) ------------------------------------------------------------------------------------------------------------------------ .__ .�. _ _. THE APPLICANT IS: (circle one) OWNER Oli CONTRACTOR .� � _ __.. _.._._.... JOB SITE ADDRESS: ��S ��iCi�c'�� l��c? l�r ZIP: SS�S,� ; , Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � NO Ifyes, a special event pei•mit is required with Police Department and Citv Council approval 60 days prior lo the event. Shuttle bus service will be reguired unless applicant demonstrates sufficient on-site pa�-king is available. Non permitted events will not be allowed. NAME OF OWNER: �,�� C��/��! PHONE: (home) �S�-�7/a--�� (work) MAILING ADDRESS: 7�fS IDic�a�, l�,/lt� j7r, CITY: D/QD.�dc� ZIP: .5"S' S _, CONTRACTOR: � , ;� C��i�� PHONE: 7��3- ��3�3�i 7 CONTACT PERSON: ; MOBILE/PAGER: " /� - 7i�--�7 S3 � MAILING ADDRESS: /75�� CD 2�f �� CITY: f�l y/2�c��` ZIP: S$�� STATE LICENSE: # Sj,$� EXPIRATION DATE: � - 3i— �� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits ! PROPOSED WORK(describe in detai�: 1�� .�' �� , � ��,(��/pr �S��/�'r��i�S/N5' �i?/�l/�i�-�'GF� �c��iYll�v�,� 5�' ��i%-s—�i,,.is-�1 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED -, cv ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��--� I hereby apply far 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 accordance with the approved plan. , � � APPLICANT'S SIGNATURE: , ,� �.:�',�� ,� - .__ DATE: ��-`l�' 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. ]. Type of data. The rights of individual on whom the data is stored or to be smred shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supplY private or confidential data concerning himselfshall be informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally req�ired to supply the requested data;(c)any known consequence arising from his supplying or refusin�to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax orpropert} 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 whether it is classified as public,private or confidential. 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 of 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 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 ofthe data. The responsible authority may require the requesting person to pay the actual costs of making certifying,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 the date ofthe request,excluding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible. Ifhe cannot complY with the request within that time,he shall so inform the individual,and may have an additional 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. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify 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 ifthe individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions ofthe adminisVative procedure act relating to contested cases. DATA PRIVACY ADVISORY ln 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 federaf 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 Middle Last Address City State Zip Phonc I understan�y righ��s�s st�ted�bov . . :j X` ° . . ;, i �, SYgnature � � Reset Forrn 32 �� ATE TIME V V '� CITY OF ORONO CALLED IN � � �:'-7 INSPECTION NO CE SCHEDULED — - '7 � PERMIT NO. w r�� COMPLETED ADDRESS �� C��-L-� � �� L.�.� OWNER CONTR. � � TELEPHONE N0. �� ' w � DESCRIPTION �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL `/ ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:L YES_NO /1 � COMMENTS: � W a � J O �� O � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED �OJECT COMPLETE �/ � ❑CORRECT WORK 8 PROCEED '7 ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECT�ON REOUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on ite- Inspector. ,� P White Copyllnspector's File Canary CopylSite Notice �� I I I I �� DATE TIME �/ CITY OF ORONO CALLED IN INSPECTION NOTIC SCHEDULED �' -� PERMIT NO. �� COMPLETED ADDRESS �U� �C� Q ��i � �, I�_ OWNER CONTR. ��ICLl.�1 TELEPHONE N0. �' �� " ��I� � C�C��J�� DESCRIPTION .��/_2,2�lr��/ - �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WAIL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPIAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. o � � �� — � 7�,Q�' ��' 1 c2�1<S G�CX�c-! 0 � W � Q � z W � W � � d W� �\WORKSATISFACTORY:PROCEED C� PROJECTCOMPLEfE W��`CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CAIL FOR AEINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN r CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-460� OwnerlContractor on ite: Inspector. � � O �/ � � White Copyllnspector's File Canary Copy/Site Notice