HomeMy WebLinkAbout1999-011365 - tearoff/reroof ��'ERMIT
�ITY OF ORONO PERMIT TYPE:
�w�� Kelley Parkway- P.O. Box 66 �: :�� ::;;�,;i;
} Crystal Bay, Minnesota 55323 Permit Number: ^ Y -
(612) 473-7357 Date Issued: _ _.�^ »
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS: � �
FEE SUMMARY:
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J APPUCA PERMITEESIGNATURE ISSUEDBY:SIGNATURE
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i���tal Fee: $ Date Received: � _�i�%%
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�ntered By: �'�`�'��,�' Permit#: �'�-'�
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CITY OF ORONO - BUII..DING PERMIT APPLICATION
All information must be submitted in full before plan revie�v will be started.
(please print all information)
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THE APPLICAI�'T IS: (circle one) OWNER R CO TRACTOR
� V�- ZIP: / � 1
JOB SIT'E ADDRESS: �� cZ— ��f � .
NA1�IE OF Oti�'ER: � � ,� A l � PHONE: (home) C/�:�' � �'6�
P (work)
ivIA�.P1G ADDr•Ess:�C�,�`� ��91��i r`'�� crTY: ji�i Ov,�� zIP: �' 3 6 �
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COl CTOR: PHOivE:
CONTAC ERSON: MOBILElPAGER:
MAILI�i'G AD S• CITY: Z�'
STATE LICENSE:
ARCHI CT/ENGII`TEER: PHO�TE:
i�IAII�ING DRESS: CIT'Y: ZIP:
vAME; _ REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSE WORK escribe in deta :
� � ��L�� f���vS �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�i IAT'ED CONSTRUCTION VALUATION (excluding land): $ � T ��� �U .
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 Buildin� Code; that I unders d this is n pe ' and work is not to start without a
pernut; and that the work will be in cc rdance � ' p roved plan.
APPLICANT'S SIGNATITRE: ; - DATE: / ��� ` �
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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.
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Sec.13.04 RIGHTS OF S[JBJECTS OF DaTl. ' ,
Suhd. 1. Type of data. The righcs of individua!on whom che data is storcd or to be scored shall be as set forch ia this section.
Subd.2. Information reqirired to be given individual. An individual asked to suppiy priva�e or confideuaal data concerning himsetf shail
be informed of: (a)che purpose and in[ended use of the tequated dara wi[hin the collecaag 3tace agency,polidcal subdivision,or stacewide ryscem;
(b)wheck:en c�may rfuse or is.legally reqnir.d ro supply che requesud data;(c)any faiown coascquence arising from his supplying or refusing to supply
priva�e or connder.rial data;and(d)the idenary of other peaoas oc enddes au[horized by sc�ce or federdl law to rrceive[he data. This requiremenc shalt
not apply when an individual is asked to supply invesdgadve dara,pursuan[co secdon 13.82,subdivision 5, to a law enfoccemenc o�cer.
The cerimissioner of revenu- mav pla-- che nodc- r-auired und-r chis subdivision in the individual income taz or oropertv mz refund
instrucdons inszead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subjecc
of sto�ed daca on individuals,and whecher it is c(ass��d as public, private or confidendal. Upon his further request, an individual who is the subject
af stor.d private or public daca on individuals shall be shown[he dara wichout any charge to hun and,-if he desires, shall be infocmed of the contenc
ar.d m:aning of[hat data. After an individua!has been shown the privam dan and informed of ics meaaing.[he dara neod not be disclosed ro him for
six monchs thereafter unlcss a dispute or acaon pursuanc co this secdon is ptnding or addidonal dan on the individual has been collec�d or creared.
The cesponsible authoriry shall provide copies of che privace or public data upon request by the individual subject of the dara. The responsible auchoriry
may require the requesring person to pay the actual cosu oi making,cerdfying,and compiling the copies.
The responsible authociry shall comply immediatety, if possible, wieh any request made punuant to this subdivision,or wi[hin five days of
the dace of the request,ezcluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he canaot comply wi[h the cequesc
wichin chat dme,he shall so inform the individual,and may have an addidoaal five days wichin which to comply wi�h the request,excluding Sacurdays,
Sundays and ltgal holidays.
Subd.4. Procedure whea data is not accurate or complete. P.n individual may con�est tha accuracy or completeness of public or privace
dara conceming himself. To exercise this right,an indiviCual shall noafy in wricing che responsible au[horiry describing the nature of the d'uagreement.
The responsible auchoriry shall within 30 days eic2:er: (a)correcc[ha data found to be inaccurate o�incompiece and aaemp�to nodfy past recipiencs of
inaccumte or incomple�e data, including recipiencs named by che individual; or(b)nodfy the individual thac he believes the daca to be eorrect. Data
in dispuce shall be disciosed only if the individual's sta�e^enc of disagreemenc is included with[he disdosed data.
The determinaaon of the rtsponsibte aurhoriry may be appealed pursuant to the provisions of tha administrarive procedure act relating to
contesud cases. �
DATA PRiVACY ADVISORY
In accordance wieh M.S. 13.04, Subd.2, "Ri�hcs of subjects of data", we would like to inform you tha[your request
for a pernuc or license from the Ciry of Orono or any of its departments may require you to furnish certain private or
confideotial information.
You are notified that:
1. The information you furnish will be used to decermine 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 ocher local, stace or federal agencies to the eLtent 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 (availabie upon request) to review private data on yourself.
6. � Your full name is required to process this application or pe�
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I underscand my ri;hts se�ted above.
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Signacure
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� AT� TIME �
CITY OF ORONO CALLED IN -��
INSPECTION N TI SCHEDULED X-�D� ��
PERMIT NO. D � COMPLETED
ADDRESS �D S �%�/"�c � �
OWNER CONTR. _ _ t�Q��io�_—
TELEPHONE N0. ! �2 Z70 ��� 7
� DESCRIPTION �
� 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
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
v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMB�NG FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,--�, PHOTOTAKEN
INSPECTOR WILL RETURN
7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next ins ection 24 hours in advance. (952� 249-4600
OwnerlContract n sit
Inspector.
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