HomeMy WebLinkAbout1999-011684 - tearoff/reroof PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 :-;:_;��y;-;�;.�i�
Permit Number:
� Crys�l Bay, Minnesota 55323 Date Issued: .`��� ���"�"�
(612) �73-7357 �"��''��°� :�_=:.=i
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REMARKS:
FEE SUMMARY:
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APPLICANTiPE I E SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ ,� ��• � � Date Received•
Entere�`By: ,����.�_ Permit#: ��
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CITY OF ORONO - BUILDING PERMIT APPLICATION �
A,.11 i.nformation must be submitted in full before plan review �-ill be started. .
(please print all information) .
TrI� APPLICAI�"T IS: (circle one) O�firER OR CONTRACTOR
JOB SIT'E ADDRESS: G `1 Z � ��,�-(/is"l,�,� �.ti°. _ ZIP:
NAI�IE OF Oti��R �c n�L- �S n�l, s � PHONE: (home) y�4 2 �� � �
(work)
�IAILING ADDF•FSS: Z t Z� -�����<<,-; �.N CTTY: ��<<��ti'� ZIP:
CO�I'I'RACTOR: G� +=s i�t:�..� PHONE: ��� - c�o y 3
CON'I'ACT PERSON: J�.� I�'SOBTLE/PAGER: 3�`� - `��� �
MAILI�'G ADDRESS: ��c���� �C�w���-,t� CITY: I . �.. ��4-�-. ZIP: S-s�l�r �
STATE LICE�'SE: # r� � � �
ARCHITECT/E�'GII`TEER: PHONE: �
MA.II�Iti'G ADDRESS: CITY: ZIP:
��: REGISTRATION�
TYPE OF ti�ORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED'SVORK(describe in detai�: (�� /��� � �L�� ^- �'��, -
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �
ESTII�iATED CONSTRUCTION VALUATIO�t (excludi.ng land): $ i4, ���� .
I hereby apply for a building perrnit 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 Build�n� Code; that I understand this is not a permit and work is not to start wichout a
pernut; and thac the work will be in accordance with the approved plan.
APPLICAi�'T`S SIGNATURE: � DAT'E: �-��� - 9 �
NOTE! Parade pf Homes event��require separate permit approval by Police Deparhnent 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 SUBJECTS OF DATA '
Satd. 1. Type oC data. The righcs af individual an whom the data is stoced or co be smrd shalI be as sa forch ia this secrioa
Subd.2. IaformaCon reqirired to be girm indlridual. An individuaI azk:d W supply privace ar coafidendal dam concerning himself shaIl
be iaform:d of: (a)the purpase and intendcd use of the r�qucsud dan wichia tfie collecang�nm agenty,goliacal subd.ivisian,ar samwide sysc:m;
(b)whec�e:he:..ay r::vse or u_legalIy tequir.d to supply,the rquesc:d data;(c}aay Imawn eonsequcnce arisiag from his supplyiag or refusing to suppiy
privace or coarider.eal daa;and(d)the idenary of o�her per�oas or e:��_s a�•�ocized by s��e ar federal law to receive t�e da�a. This requiremene s�all
not apply when an ir:dividua!is asked co supply invesagadve dam,pursuant to secdoa 13.8?,subdivision 5.�o a[aw enfoccemeac ofnce�. . -
'i�e ee:lmissioner of revenu� mav DI3Ce the noace re�uir_d under chis subdivision in the individual income taz oc orooercv taz refund
insrrvcaons inscead of on those forms.
Subd.3. �ecess to data by indiridual. Upon requesc to a responsible auchoriry,an individuaI shall be informed whether he it che subjecc
of stor.d dan on individuals,and whe�her ic is e[ass�:d u public,privace or conFdenaal. Upaa his furcher r_quesc,an icdividuaI who is ehe subje:c
of scor.d privace or public dara an individuais shall be shown che daa wichaut any charge to him and;if ha desira,shall be informed of the coatenc
ar.d meaning of chat data. Afcer an individuai ha.s been shown the private dac�and informtd o[iet meaaing,the daca need not be d'uclosed to him for
siz monchs�her.aFwr urless a dispuu o�acaon pursuan�to [his s::don is panding ar addidonal dac�on the individual has been collecc_d or crea`d.
"Ihe respocuibte aurhoriry shall provide eopies of�he privam or public dara upon request by ehe individual subjecc oF che dam. The responsible auchoriry
may requir_ che cequesang person to pay che accual eoscs ai making,ceccifying,and compiling the eopies.
The responsible auehoriry shall eomply immediacety,if possible,wich any requesc made pur�uant to this subdivision,a�wi�hin five days of
the date o[che request,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he eannoc comply with the requesc
wichin chat dme,he shall so infocm[he individual,and may have an addidoaaI five days within which to comply wich the request,exciuding Sacurdays,
Sundays and legal holidays. . �
Subd.4. Praeedure when data is not accurate or eomplete. M ir.dividual may conc:sc the accuracy or compteteness of public or pri�•ate I
dam conceming himself. To exercise this right,an individual shall noafy in wriaag[he responsible authociry describing the nature of the disagreemeac
The responsibie authoriry shall wichin 30 days eichec (a)correct che dara found to be inaccurat-or incomplcte aad accempc to nodfy past recipien�s of i
inaccuace or incomplece data, including recipients named by the individuaI:or(b)noafy the individual thac he believes the data to be correcG Dati �
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in dispuce shali be disclosed only if the individuai's statemenc of disagreement is included wich the disclosed data. I
The detecminaaon of the rtsponsiblz au�horiry may be appealed pursuant to the pcovisions of tht adminisaanve proc:duro act relating ro I
concesc-d cases. • �
DATA PRIVACY ADYISORY
In accordance wich M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would like to inform you that your request I
for a permit or license from the City of Orono or any of its depanments may require you to furnish ceRain private or
confidential information.
You are notified that: li
1. The information you furnish will be used to detemune your qualification for che permit or license requested.
2. You may refuse to suppty data, but refusal may require that the City deny the permit or license.
3. The information may be shared wich ocher local, stace or federal a�encies to the e�cent necessary to process
the permit or license. �
4. If your requested permi[ or licease requires Council action to approve, some information may become
public.
5. You have certain ri�hts under M.S. 13.04 (available upon request) to review priva[e data on yourself.
6. Your full narue is required to process chis applica�ion or permit.
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I us nder�and my ri�hts as stated above.
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Sigrucure
DATE TIME
CITY OF ORONO CALLED IN - — E^ /��
INSPECTION NOTICE SCHEDULED -�7-` �-�� �
PERMIT NO. I/ �P� 5� COMPLETED
ADDRESS ��
OWNER CONTR.�N��"� �
TELEPHON NO. 3 � --
� DESCRIPTION �
lL 01 FOOTING 11 MECH ICAL RI 18 EXCAV/GRADING/FILLING
Qg,Q2�RM0�INC�� 13 MECHANICAL FINAL 19 LAKESHORE/WETIANDS
y 03 W�SULATION 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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALI. 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
� COMMENT • �
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ ORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �-: pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Cail for the next in 'on 24 hours in advance.4 -73�J7
OwnerlCon a t o si�`e <
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Inspector. -- �
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hite Copyllnspector's Fi e Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN ��7� l a�TS
INSPECTION NOTI E SCHEDULED —�'-;:� -�..'3 z�
PERMIT NO. � � COMPLETED
ADDRESS c�I� 7 ��'c,�Lh.C�c,��� �c..,-��
OWNE(��.�-rvn�� �-�'�-- CONTR. ���C ��
TELEPHONE NO. 3 c ��� �-
� DESCRIPTION � -- -�
ly� 01 FOOTING 11 MECHANI L RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINAL j 14 SEWER HOOK-UP O6 PROGRESS
h 0 - ITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR T MEET YOU:_YES_NO
� COMMENT :
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W� ❑WORKSATISFACTORY:PRQC�EED �^ PROJECTCOMPLETE
W ❑ RRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� 8 FORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne ' ' n 24 hours in advance. �73�J7
OwnerlCont c n s'te:
;
Inspector.
White Copyllnspector's File Canary CopylSite Notice