HomeMy WebLinkAbout1997-009536 - tear-off/re-roof PERMIT
�G�TY OF ORONO PERMIT TYPE:
` 2750 Kelley Parkway- P.O. Box 66 :;.�,it�,:
Crystal Bay, Minnesota 55323 Permit Number: `,-�=r
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(612) 473-7357 Date Issued:
SITE ADDRESS:
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I' REMARKS:
FEE SUMMARY:
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CONTRACTOR: � : — — �. — � OWNER:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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i Total Fee: $ ' � ` � Date Received:
Entered By: �,�� Permit#: �/`.h��� '
CITY OF ORONO - BUILDING PERNIIT 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) OWNEI�OR CONTRACTOR
.
JOB SITE ADDRESS: ��al. � �.�4����Z��S � � G� ZIP:
NAME OF OWNER: �.2 [��G �� {� �. S f�-C PHONE: (home) �7 l — �7`� �'t'
(work) �'�..�"— �C��6
MAILING ADDRESS: �'�4 (it�L CITY: ZIP:
CONTRACTOR: �� C�, /-� 7' �� A`/ �C>��l,�-�G PHONE: SS'7 - ��c•7�
CONTACT PERSON: MOBILE/P�GER:
MAILING ADDRESS: /(c�7s -�S � ,14 � � CITY: � °u e�`'t't-F ZIP:
STATE LICENSE: # �, � �;
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detai�: � �-`Czp �1 �= �-PG� -
STORIES: � ��t- SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �3�� �'- ��'
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 Ciry 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 rdan wi the approved plan.
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APPLICANT'S SIGNAT , - �� �.� DATE: ( e� �.0
NOTE! Parade Qf 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 SLJB.TECTS OF D�TA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd.2. Information reqirired 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'stace agency, po(iacal subdivision,or statewide rystem;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any F�own consequence arising from his supplying or refusing to supply
• privace or conndenrial data;and(d)the idenrity of other penons or enriaes authorized by state or federal law to receive the data. This requirement shali
not apply when an individual is asked ro supply invesrieadve dara, pursuanc to section 13.82, subdivision 5, to a law enfo�cemen[officer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propem_tax refund
instructions instzad 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, privace or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown che data wichouc any charge to him and, if he desires, shall be informed of the content
and meaning of[hat data. After an individual has been shown the privace data and informed of its meaning, the data need no[be disclosed to hun for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individuai has been coilected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible authority
may require the requesdng person ro pay the actual costs of making, certifying, and compiling the copies.
The responsible authoriry shalt comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays 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 addiaonai 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 private
data concerning himself. To exercise this right,an individuai shall no[ify in wridng the responsible authority describing the nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccunte or incomplete and attempt to nodfy pas[recipiencs of
inaccurate or incomple[e data, including recipients named by the individual; or(b)nocify the individual that he believes the data to be correct. Data
in dispu[e shall be disclosed only if the individual's statement of disagreement is included with[he disclosed data.
The determination of the responsible au[horiry may be appealed pursuant to the provisions of the administnrive procedure act relaring to
con[ested 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 fumish 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 che 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 pernut 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.
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Ciry State Zip Phone
I understand�my ri�hts stated above
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Signature
DATE TIME
CITY OF ORONO CALLED IN �1J �G'�1 �
INSPECTION NOTICE SCHEDULED /0 ' 3 � '` : 3 d
PERMIT NO. 4��3.�o COMPLETED IO —�_ �' �QQ
ADDRESS I�.�� ���-c��,� p� �
OWNER `���1.��-�— � CONTR. �i�Lf"Gt/�c,Ci � .tic�
TELEPHONE NO. S .5 '� - ��o"� � "
� DESCRIPTION ��
� Ot FOOT 17 MECHA AL RI 18 EXCAV/GflADING/FILLING
� 02 FRAMING 13 MECHANICA�FIIJAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEMQ—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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�Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Z 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 2$CEDAR SHINGLES 36 FOUNDATION HEMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� � PROJECT COMPLETE
W ! CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O -_' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITH�N HOURS. � pHOTO TAKEN
INSPECTOR WILL RETUFN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance.473-73�J7
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OwnerlContractor site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE. scHE�u�E� '
PERMIT NO. �j_`7�S� COMPLETED �
ADDRESS 0 c� �C T' O�
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION I� �U " `�OO
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNO
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q ���
Z�//�05 6tNAL 14 SEWER HOOK-UP 06 PROGRESS
~ —D7 DEMO--SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMQ—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED
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O ;-' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -- pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins ection 24 hours in advance.473-7357
Owner/Contractor o te:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN `` �
INSPECTION NOJICE SCHEDULED �b/.�3/�� �
PERMIT NO. t7� ��% COMPLETED q
,
ADDRESS �e_ L�zz �
OWNER CONTR. � ee
TELEPHONE NO. �J7- �C 7�'
� DESCRIPTION ��Z-�
� 07 FOOTING Q(t MECHANICAL RI 18 D(CAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHOREJWETLANDS
Q 03 INSULATION 24/25 W�OD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
Z INAL�� 14 SEWER HOOK-UP 06 PROGRESS
~ O—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLL�W-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
_
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� f WORK SATISFACTORY'PROCEED PROJECT COMPLETE
W ,_ CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O i=' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. - pHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL tNSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' spection 24 hours in advance.473-73rJ7
OwnerlContract 't :
Inspector. .
White Copyllnspector's File Canary CopylSite Notice