HomeMy WebLinkAbout2003-P06662 - re-roof � `,
�* L PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po6662
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: gi19�2o03
SITE ADDRESS: 2879 Farview Lane
Long I.alce,MN 55356
PI D: 04-117-23-34-0002
DESCRIPTION:
Proposed Use: Residenrial
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: $ 9�.25 Valuation: $ 4,000.00
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 99.75
APPLICANT: ABC,Inc. OWNER: Cynthia&Dennis Bremer
12247 Nicollet Ave So 2879 Farview Lane
Burnsville,MN 55337 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPUCANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Copies: 1-File(SiQni[ures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
,
, 6�/1412063 03:13 9528088846 ABC INC PAGE 01
` +952Z4Bd616 T•665 P.D02/003 F-61'f
AuQ-23�2001 08:23am From^CITY OF ORONO
�. � Date Received• �- /�-O�_
Total Fee: $ q 7 �
Ent�ered By: _� Petmit#: .�D_�v(o�i �
CITY OF ORONO - BUILDItrTG PE�tMIT A.�'PL�CAT'iON'
, All information�must be subnutted in full b�efore pian re�ieR"wi�ll be started•
- � (please princ�z11 ir�'orn�ation) � .^
_���.�.�----------......._�...�--- r'
� APPLICANT IS: (circle one} OWNE'�t OR CONTRACTOR
- . SS 3 ��
J08 SITE AYIDItESS: _ �� r��;�� zn�.
UW1�ER: I � �r�r�� pHaNE: (l�ome) 4'� �-1�3 ��-�i-
rIAl1� iF (work) 6 � a41
tiiAII.m1�AnDR�ss: a��� r"a�r ✓`�cv . c1't'Y-o►r� 2�: ss3s
_�_____
CaNI'RACTdR; � PHONE: C9$'� �o� -6 9�9
CONTAG"f PERSON: " MOBILEIPA,GER:„ 'L�- b ,
�,TNG ADn�S:�,(2��! �N;co r/�f v S. CITY: � v rrr�v��ZIP:��
sr����c�xs�: �_a�t 6�3�3 �
ARCHY'1`ECTIENGINEE�t: PHONE:
MAU�ING ADDRESS: CI'1'`Y: zTP:
NAME: �GLSTRATION�
Typ� 0� �rpg�; ly'ev�r Additi�a A.ccessory Structure
�ovc RemadeUAlcetation Land Alteratian
PR�POSED VVORK tdescribe in detain: Gc��d' ���-�
STOYtIES: . - SQ.FEE'!'OF�;ACH�T.,OOR:
NO. OF BEDROOMS: � GA�ItAG�STALLS: ATT. DET.
UCTIQN'VALUAT[Ol�i{excladinglanc�: $_ � d+e�i.. —
TSTIM�i'I'fiD CONSTR —�---�
I hereby a�ply fvr a buildia�permit and I acknowledge th�t the information above is comple're and
acCu=a�e; that the work wi11 be in confornaat�e with the urdi,t�anc�s and C°des of the C�ry an�i wit�
the State Buildin8 Code; tt�at I uudcrstand this is not a permit aad wor� is nat to st�rt witt�out a
perrnit; snd rhat the work will bc in accordanct with the apgroved plan.
LICAN'�"S SI�NATURE: __��� DA7�: �� I��0�,3
APP
,�pT�i r e �,�,� eve»ts require separate pern=zt approval by Pol�ce Departrnent and
� City Cou�cil d�days prior to thP event. Norr permitted events will not be aldowed.
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� ��a-i3�2701 08:23am From-CITY OF ORONO +9522494616 T-685 P 003/003 F-617
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Sr.13.Od RTGHTS OF S[18.1'EC7'S OF DaTA
Subd. I. Type of data. The righcs of individual on w4ow�e dao is swr�d oc m be s�ored shali bc as scc farth in�his secdoa.
Subd.3. Informatioa req�rired to be giveu indi�idual, R,i inciividusi azkcd to Supply priva�e or confidcndal dsa concerning hisnsclf shail
be informed of: (a)thc purpose and inreaded use ol the requesrLd da�wi�in chc enllecriag Sutc agcncy,polidca!subdi�isioa,or sntewide syscem;
(b)whccher he may refusc ot is 2cgally rzquircd to supply me rrqucsnd san;(c)any lmewa consequencc arisiug f�m his supplying or refvsing ro suppiy
privace or conndcnaal dan;and(d)�he idenriry of oiher persons or enpacs�uthorized 6y s��c or fedaral!aw to r�ceive[he data.. This requiremenc shsll
no�apply whcn an iruiividual is asl•ed to supply invesagadve dsa,pursw3sit to secrion 13.83, subdi�ision S, �n a!aw enforcement o�cer.
7hc tom.'rii55i0�eT of_ ecenuc muv p1ac: tfie noocc reQuiircl undet dlis subdivision i.ti dte indi�idual i.zcome ffix or aropem ux rcFund
inStrUCI(0�5 inS[�.d af on those Pornts.
Subd.3. Acceu to clasa by individvaL Upon requcsc to a resporsible suihorip�,aa individual shall be informeQ wherher he is the svbject
of s�orcd data on individu�ls,and Whcri�cr it is classifud as public,pr.vate or confidential. Upoa his ft:csher rcquasc,sn individual who is�he subjec[
of scored priva�m or public data op individuals shall be shown rhe dan.wid�ous aay charge[o him and;if he desins,shall be info�ned of�he contcnc
and mcanag oP�hac ds3. Afccr an individua!has bren shown[he pri�su dara and infotnud of irs mea:ing,dae data Aeed nos be disclosed�o hL�n for
s't.ti monchs thenafur unlcss a dupute or acr.on purst�an�to shis secaors is pcnding or addiuoaa!dau on the individual 6ss bccn collcctcd or crca�ed.
The responsbie auc�oriry shail provida eopies of�he priva�e or publit aaa upon ccquuc by�he individua!subject of che dara. The responsible sushoriry
msy require rtie requcscing pz�son zo psy die acn►ai cosrs of maJdng, �crdfyir�,and compiluss nc�eopies.
Thc responsible a�oriry shaJt comply immediately,if possible,wid�aAy nquest made pursuant co chis subdivision,or within five days of
Lhe dau of rhe requesc,czclu g Santtdays,Sundays and legal holidays,if irnmcdiate compliancc is noc possible. If he csnao�comply wi�h d�e requesc
wichin[hac tima,he shail so inforrti thn individuaf,and may tfave an ad�iaonat hre days wirhics w6ich tv comply with the requess,excludiag Sanardays,
Sundays aM lega!hotidays.
Suhd.4. Proe�dure wher3 data is not accurr:e or comptete. An individuel may con�esz�he accuracy or eomplereness oP public or pri�•aQ
�B eanceming hirrselP. To exereisc�his right,an individual shal3 notdy in wricicg che responsibfe authotiry dacribing chc nazuce ot the disagrecmcnG
'^�e responsi6le au�horiry shalt within 30 dsys eid�er. (a)corrcet thc ana foued ro be insccutate er lncompleu and aaempt to norify past rccipienrs of
iaa::urtr�or incomp:ac data, inciuding recipiena named by d�t iudi��idc:sJ; or(b)aotify thc individunl that he Delieves rhe dats to bc corrce[. Dact
in dispuce shsll be 4isclosed oNy if�hc individual's sneemenc of disa�sceement u includad with the discloscd data.
Thc dc�e:minaaon of�ha responsible auchoriry may be apE�aled pursuanc w che provisions of nc� adm:nisaacive proccdure acc nladng co
eon�esmd cases. . '
DpTa pR1YACY ADVISQR'Y
In accordance wi�h:�.5. 13.04, Subd.2, "12ighu of subjects af daca",we would like To inform you that your request
for a permiz or license from the Ciry of Orono or any uf iu departmeats may require you to fumish cer�ain private or
confidential information.
You are notified that�
1. The information you furnish will bt used to desernline your quatification for the permi�or license requested.
Z, You may refuse [o supply dara, but rcfusal may require that the Ciry deny �he permic or lieease.
3. The informaGion may he shared wirh ocher 1oca1, s�aie or federal agencies to the ex�enL necessary to process
che permit or Iicense.
4. If your requested permit or license requires Council acsion to approve, seme information may beeome
publiC. •
5. You have cenain rights under M.S. 13.0-3 (available upon request) to review private da�a on yourself.
6. Your full name is required to process this applicatiou or p�rmic. •
�us� �tiddle Las[
Address �
Ciry Sn�e Zip Pnone
I understaz:d my righu as stased a ove.
�
Signaiurc
� • ku�-23-2001 08:23am From-CITY OF ORONO +9522494616 T-685 P 002/003 F-617
�
+ Total Fee: $ 17ate Recei'ved:
Entered By: Permit#:
CITY O�' ORON� - BUII.,DI�G PERMIT APPLICATION
All information must be submitted in full before plan review wilI be started.
(please print��ll inforn�ation)
TI� APPLYCAN� IS: (circle one) QWNER OR CONTRACTOR
' , �-�s} ��
JOB SITE AriDRESS: ���� r��z�����ti z�:
NA.ME OF 4'VS'I�'ER: .��.��s 'nU �'-e�v _'Y' PHONE: (home)��f'� ���.-w' ��}--,t-
� � (work)(� ► � `13,�. -- �t 61 v
�IAILTNG A.DD�2ESS: ����'`� r"c.t�'' ✓��� . CITY:v,�:r�-� ZIP: ��7 S�
CONTRACT4R: .� � c_ __ PHON'E: C`r s�J �u '� -6 `i s"`t
CONTACT PERSON: �,p,q,�l:a MOBILE/PAG�ER: �J;t'L- ���� �7,d?�
MAIL.ING ADnRE,SS: /��Y nI:�c/lr r�4✓r S� CITY: !� �=r rrA✓�y l�._ZIP• s� 3 � "+�
5TATE L�CENSE: �{ ��I 6�� ��A '�
ARCH7'Y'ECTIENGIIVEEI2: PHOI�'E:
iViAILIl�rG�ADDRESS: CITY: zYP:
N��: REGISTR.A.TYON# .
TY�'� OF �'ORK: New Addition Accessary Structure
Move RemodeUAlcerauon Land Alteration
PROpOSED WORK(describe in de1a��: (,c��� ��G� ����✓hf�/
STQ1tIES: SQ.FEET 4F�;ACH F'i.00�t:
1�r0. OF BEDR04MS: GARAG� STALLS: ATT. llET.
ESTIMA"T'E)
CO\'STRUCTION VALUAZ'ION (exClud.i.ug land): S � ��
I hereby apply for a buildin'permit and I ackaowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances a.nd codes of the Ciry and with
the State Building Cade; that I understand rhi� is not a permit and work is not to start without a
permi�; and that the vc�ork will be in accordancz with the approved plan.
APPLYCANT'S SI�NATURE: ��y � DATE: o ' !7`d3
NOT,L�'! P�rade Q,f Nr�mes events require separate permit approval by Police Department and
Gity Council 60 days prior to the event. Non permitted events will not be allowed.
���� a �� �9 �1'�a
DATE TIME �
CITY OF ORONO CALLED IN -C��,�_
INSPECTION NOT CE SCHEDULED `�-�`03
PERMIT N0. ' � COMPLETED
ADDRESS ��'7�� ���C./'Ulu�� LGt-l.-e.
OWNER CONTR. �,�G
TELEPHONE N0. [1%loZ , �L�3 �,.���
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� DESCRIPTION I� I` � ��eti� C� ��«,� �.�C� r��0��r��
� 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 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 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HO'llRS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (95Z� Z49-46��
OwnerlContractor o s te:
Inspector.
White Copyllnspector's File Canary Copy/Sfte Notice