HomeMy WebLinkAbout2005-P08567 - re-roof PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Poss6�
Crystal Bay, Minnesota 55323 Permit Type: M�nor aiteTacions
� 1952) 249-4600 Date Issued: a�a�2oos
SITE ADDRESS: 1719 Fagerness Pt Rd
Wayzata,MN 55391
PID: i�-ii�-23-2i-000s
DESCRIPTION:
Proposed Use: Residential
Buildin Census Code O/S-Building
Permit Class: g
Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 125.25 Valuation: $ 5,600.00
State Surcharge Fee: $ 3.30
TOTAL FEE: $ 128.55
APPLICANT: Owner/Self OWNER: LAUREEN E DARLING
�'IN 1719 FAGERNESS POINT RD
WAYZATA MN 55391
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 BUI.LDING CODE UIR�v1ENT
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�PPLICANT PERM E SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reoorts, 1-AssessinQ, 1-Finance Page 1
" 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 print all information)
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THE APPLICANT IS: (circle one�ER,�OR CONTRACTOR
JOB sITE ann�ss: ��j 1� rAC�i2�i kS� 'T , . �c'� _ zir: S s- 3 � I
Will this be a P�rade of Homes, Remodelers Showcase Home or other Display Home?
❑ yeS �,��0 If yes, a special event permit is required wilh Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicantdemonstrates
sufficient on-site parking is available. Non permitted events will nol be allowed.
NAME OF OWNER: ��(�!�y� 1J�;1� �-1 ���- PHONE: (home) S -�� � 1 -�� � 7
' 1 (work)
MAILING ADDRESS: j�,,M�' (-�� �o��CITY: LU�UZ.�j� ZIP: ^� I
r l�1`� �l'`� ���� �. '�l�.�-.. �'l�ti �'c' � V� �� \ � �- v.
�'T A1�C�1'QTZ:C.LA��tic� C��:;RS�d�� �HONE: �5a'� �f� -lv��k'
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY:;�l�c��'i:'�r ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCffiTECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: _���1., �� ��c��
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ;S �, C�% ._ �
1 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,ivork is not t start without a permit;and that the wark will be
in accordance with the approved plan.
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APPLICANT'S SIGNATURE: � � DATE: � � y 'C'S
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA �_
Subd. 1. Type of data. The rights of individual on whom 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 or confidential data conceming himself shall 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 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 state or fedecal law to receive the data. This requireme�t shall
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 may place the notice required under this subdivision in the individual income tax or pronerty 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 meaniog 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 requesting person to pay the actual costs of making,cer[ifying and compiling the copies.
The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and fegal 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 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
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The
responsible authonty 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 if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 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 ar permit. 1
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CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED .���
PERMIT NO. ,���7 COMPLETED
ADDRESS � � � �I �� C��/"��� �� ��
OWNER 1 " �Q�.'Yl C��-1 � . CONTR.
TELEPHONE NO. �'� � S� OZ��O � (o („(��
� DESCRIPTION /"�/ � � 7�G�C�
� 01 FOOTING 11 MECHANICAL RI � EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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
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INSPECTOR WILL RETURN
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❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-46QQ
OwnerlContract e:
Inspector.
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CITY OF ORONO CALLED IN -S "GJ'
INSPECTION N I E -7 SCHEDULED r �Dv P•'1�J
PERMIT NO. � .�' / COMPLETED
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OWNER �CL�I'.4.'�ir OGc%Iits, CONTR. �l/,��C1.��5 C�'7�•
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� DESCRIPTION ��Lz-�' C��f�� ��'G►L��
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 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 NAL 35 HARD COVER REMOVAL
J 10 PLUMBING F L 36 FOUNDATION/REMOVAL
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V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �,; PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952� 249-4600
Owner/Contra s te:
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Inspector. �
White Copyllnspector's File Canary CopylSite Notice
�'� DATE TIME �
CITY OF ORONO CALLED IN ��� /
INSPECTION NO�CE ! � SCHEDULED � �
PERMIT NO. ; C^i � 5 lv � COMPLETED
ADDRESS T�' /��
OWNER A-�� � �-�Ir ONTR. '
TELEPHONE NO. � �� � � ` �� � 7
� DESCRIPTION j.� �''Z ��
� 01 FOOTING 11 MECHANICAL RI 18 EX V/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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPtAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (J52� 249-46�0
OwnerlContra o ite:
. �j
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
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� DATE TIME
� CITY OF ORONO CALLED IN
INSPECTION NOTIC� _/ � �7 SCHEDULED �
PERMIT NO. ��S� l!' / COMPLETED �
ADDRESS__ l 7�� �� c�f'//LfS S �� l �'-�
OWNER ��' i/t " CONTR. �—���_�i���% %r��5 fr_�.o
TELEPHONE NO. S� y7/ d�CP �
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� DESCRIPTION __ 0�� _ •�--L''-/��
� 01 FOOTING 11 MECHANIC 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
�--MO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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O ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. L PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR `� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe nex nspection 24 hours in advance. (952� 249-4600
Owner/Contrac
Inspector.
White Copyllnspector's File Canary CopylSite Notice