HomeMy WebLinkAbout2001-P04460 - re-roof CITY OF ORONO PERMIT
Permit Number:
2750 ��` -!ley Parkway - PO Box 66 P04460
Cry�+�l Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: �oiai2ool
SITE ADDRESS: 3070 Farview La
Long Lake,MN 55356
P I D: 04-117-23-34-0013
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Buildin Census Code O/S- Building
Permit Class: g
Permit Type: Minor Alterations Permit Sub-type(s): Building- Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: � 209.25 Valuation: � 11,185.00
State Surcharge Fee: $ 5.60
TOTAL FEE: $ 214.85
APPLICANT: Flagship Roofing Company OWNER: David& Barbara Silus
3496 Shoreline Drive 3070 Farview La
Wayzata, MN 55391 Long Lake MN 55356
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 BUILD[NG CODE REQUIREMENTS.
,
/ . "
� ��
,r `_'�._ '_ �_(� �-�;,,-� �; -� �
<
APPLICANT PERMI �SIGNATURE ISSUE�BY SIGNATURE
Copies: I-File(SiQnitures Reauired), 1-Aoplicant. 1-Monthlv Reports, I-Assessine, 1-Finance Page 1
Total Fee: $ Date Received:
Entered By: Permit#:
�'
• CITY OF ORONO - BUILDING PERMIT APPLICATIOl`+T
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
___,
�
JOB SITE ADDRESS: So� � t l l��i�.� L,�I ZIP: ��5 ss �
NAME OF OWNER D C�t �t L 3 PHONE: (home) �7S= G U rY 2
� (work)
MAILING ADDRESS: �l10 �1���-e�— �,� CITY: �,�;,,���: ZIP: S"S 3 5 �c�
CONTRACTOR: c� � S�t� ? l e���=�• <<� PHONE: 9 7/ - �� �fi =�
CONTACT PERSON: � �;t�. MOBILE/PAGER: (�i 2 - s�'�7— c�� 3 c
MAILING ADDRESS: 's�(0 5��u,c ! ��,� r� CITY: C i� r ZIP: SS-3 `� c
STATE LICENSE: �2 a n "���?�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detai�: �"(�—�U�� �-�'c�i — <�� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /� /�S'- �'��
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: �Q— �— v 1
NOTE! Parade of Homes events require separate permit approval by Police Department and
Cily Council 60 days prior to the event. Non permitted events will not be allowed.
'�
Sec.13.04 RIGH'I'S OF SUB.TECTS OF D�1TA
Subd. 1. Type of data. The righ[s of individual on whom[he data is stored or to be stored shall be as set fonh in this secdon. ,
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and iatended use of the requested data within the colleccing"state agency, political subdivision,or statewide system;
(b)whether he may refuse ot is legally required to suppty the reques[ed data;(c)any Irnown consequence arising from his supplying or refusing to supply
private or confidenaal data;and(d)the identiry of other persons or enriaes authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrieadve data, pursuan[to secdon 13.82, subdivision 5, ro a law enforcement officer.
The commissioner of re��enue mav piace the noace reauired under this subdivision in the individual income tax or propectv tax refund
instructions inscead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible au[horiry,an individual shail be informed whether he is the subject
of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request,an individual who is the subject
of scored private or public data on individuals shall be shown the data wichout any charge to hun and, if he desires, shall be informed of the content
and meaning of chat data. Afrer an indi�+idual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuanc to this secrion is oending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or pubiic data upon request by the individual subjec[of che dara. The responsible authoriry
may require the requesting person to pay the accual costs of making, certifying, and compiling the copies.
The responsible auchoriry shall compty immediacely, if possible, wich 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
wi[hin�hat time,he shall so inform the individual,and may have an addirional five days within which to comply wich the request,excluding 3aturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may conrest the accuracy or completeness of public or pricare
data concerning himself. To exercise chis rieht,an individual shall noafy in writing the responsible authoriry describing�he nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipienu 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
ut dispuce shall be disclosed only if the individual's statement of disagreement is inctuded with the disclosed data.
T}ie de[erminarion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng 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 reauest
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 pemut 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 pernut 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.
(. Your full name is required to process this application or permit.
� I
I I n �y � l L ��I���
First
Middl Last
3`fi�(� 5���,� /�-e
Add�eS �i�.�7--C---- ��(I v S��`7� � � L�
Ciry I State Zip Phone
I underst my rights as stated above. .:.
Signature
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N I�E �//�.� SCHEDULED //n �/
PERMIT NO. U 7'Y/�-' COMPLETED /�/' /Z-�t ?-.<D
ADDRESS,�,� �' �C � �tih-ti�:.�t,�' �
.�
OWNER �;f�c�.-��a�- CONTR. �
TELEPHONE N0. ��� �l7 �- G� ��� �= -
� DESCRIPTION �
l� 01 FOOTING 11 MECHANICAL RI �EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARC COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMM�NTS:
� �^ �� l j � (�`�� I ��
�
J
�
�
�
0
�
W
�
Q
�
Z
W
Zc
W
�
�
d
W �'WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
WO CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR FEINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.���� ��"`� C��� �!�i
White Copyllnspector's Ffle Canary Copy/Site Notice
, / .��' " DATE TIME
CITY OF ORONO v � CALLED IN
INSPECTION �TI E SCHEDULED �b-3o _c7 n/
PERMIT NO. l O COMPLETED �� 9�� �l'D
ADDRESS � c?� ���'�
OWNER �� CONTR.
TELEPHONE N0. ��� 7 �� ��f�� �
� DESCRIPTION
� 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 W—ALL-—BD�. 12 WATER HOOK-UP 17 SITE INSPECTION
? FI�05 NAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
� �VORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W �❑CORRECT WORK&PROCEED �❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING �
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
O INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
Own�2rlConUactor on site:
Inspector.�C�L'� :�L;�
White Copyllnspector's File Canary CopylSite Notfce