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Home My WebLink About2004-P07457 - re-roof f - . . PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po�4s� Crystal Bay, Minnesota 55323 Pe►-mit Type: MinorAlterations (952) 249-4600 Date Issued: si4i2ooa SITE ADDRESS: 1905 Fagerness Point Rd WAYZATA,MN 55391 PID: 17-117-23-23-0008 DESCRIPTION: Proposed Use: Residenrial ��/ Permit Class: Building Census Code 4�"4 ��S ��'�' Permit Type: Minor Alterarions Permit Sub-type(s): Building�e-Roof ��j�j�� C`,'.�- DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 69.25 Valuation: $ 2,000.00 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 70.75 APPLICANT: Owner/Self OWNER: �'illiamHibbs MN 865 Townline Dr Independence 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 MINNESOTA BUILDING CODE REQUIREMENTS. •J \ � `' X� i �� C _ �� PP A ER I E IGNATURG SUED[3Y SIGNATURE Copies: 1-File(Si�nitures Requir•ed). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � . . Total Fee: $ Date Received: � - �%—C�� Entered By: r� Permit#: �v C 7y j� � CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------�=___=�----------------------------------------------------------- THE APPLICANT IS: (circle one) WNER R CONTRACTOR � JOB SITE ADDRESS: �G� �i� ��.��j �� ZIP: �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes `� No If yes, a special event permit is required with Police Department and City � Council approval 60 days prior to the event. Non permitted events will not be allowed. , NAME OF OWNER: �'lJ 1 I I � ��,j'�(� � ►J1!J� PHONE: (home) (d� - '� �-�`� , work) �� — — — � (� MAILING ADDRESS: � � � ( ��j�,� �ITY: '� Ip: T � CONTRACTOR: �,��( ` I I G�YIi� ' � �� C. Y PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration_� Land Alteration > PROPOSED WORK(describe in detai�: �� (,�(r�°L � >(� STORIES: �_ SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET_ ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � 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 accordance with the approved plan. APPLICANT'S SIGNATURE: � DATE: � � Sec.13.04 RIGHTS OF SL�BJECTS 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 suppiy private or confidential data concerning himself shall be in[ormed of: (a)the purpose and intended use of the requested data within the rnllecting state agency,political subdivision,or statewide system;(b) whe[her he may refuse or is le;ally required to supply the requested data;(c)am{:now n consequence arising from his supplying or refusing 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 shall not apply when an individual is asked to supply investigati�e data,pursuant to sectioo 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav �lace the notice reauired under this subdivision in the individual income tar or oropertv 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 in(ormed whether he is the subject of stored data on individuals,and whether it is classitied 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 ioformed of its meaning,the data need not be disclosed to him[or six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coiiccted or created. The responsibie 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,certifying,and compiling the copies. The responsible authority shall comply immediately,if possibte,with an}-request made pursuant to this subdivision,or within eve days of the date of the request,excludin;Saturdays,Sundacs and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional flve days within which to comply with the request,excluding Saturdays,Sundays and legal holida}s. 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 of the disagreement. 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 onl��if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuaot to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY AD�'ISORY In accordance«•ith 1�I.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��our qualification for the permit or license requested. 2. You ma�•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 ha��e certain rights under i�I.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 Yfiddle Last Address C�4' State Zip Phone I understand my rights as stated abo�•e. . Signature V DAT • TIME CITY OF ORONO cA� D IN �f�{ INSPECTION NOTICE /'� �I�CJ'�SCHEDULED �:,�- PERMIT NO. V' COMPLETED ADDRESS_ � 9�S �c-��i''� SS� OWNER ��2�CONTR. TELEPHONE NO. �'��- ��Z S� — �G 7O � DESCRIPTION �i`!��/ �" .(�f2�� 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 � 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 i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑Ct�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Ca11 for the n t inspection 24 hours in advance. (952� 249-460� OwnerlContra o or� 'te: � Inspector. ` v White Copyllnspector's File Canary CopylSite Notice V DATE TIME CITY OF ORONO CALLEO IN u 'v INSPECTION N TICE SCHEDULED � - (� -c�`f � l�M. PERMIT N0. 7 5 COMPLETED ADDRESS f��J ��1�/l,('-SS �d ir�,'�` `� , OWNER � CONTR.___C��/�'r TELEPHONE NO.�CP� � � ( Z �� 7 7 � DESCRIPTION�-C C��' O�`"t' ��— � Ot 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 BING FINAL 36 FOUNOATION/REMOVAL OWNE ONTRACTOR TO MEET YOU:_YES_NO � COMMENTS• � �,00 l�S o �o a^ —w� � � , � � - ; o , � 0 � W � Q � Z W � W � � d � WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFtCATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call forthe n t inspection 24 hours in advance. (J52� 249-460� OwnerlCont o ite: _ , Inspector. White Copyllnspector's ile Canary Copy/Site Notice