HomeMy WebLinkAbout1999-011446 - tearoff/reroof PERMIT �
C���' �`� ORONO PERMIT TYPE: - -
p 275�, � arkway- P.O. Box 66 �`�_� -
Cr iinnesota 55323 Permit Number: _ _ _ _
Y" Date Issued: - --
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SITE ADDd3ESS:
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REMARKS: `
FEE SUMMARY:
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�PPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��.
Total Fee: $ Date Received:
�Entered By: ,�' 1 . Permit#: %/`� ''
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CITY OF ORONO - BLTII..DING PERMIT APPLICATION
All information must be submitted in full before plan review ��-ill be started.
(please print all information)
THE A.PPLICAi�'T IS: (circle one) O�NER OR CONTRACTOR
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JOB SITE ADDRESS: ;�-�1 Iu �'�'L2,�/�/,�� Z�:
NA1�IE OF O��fi�R: �` � ����c' ���a�tz�- ��� ,�� PHONE: (home)
(work)
MAILING ADDRESS: `=C%�j ,�.� �c�ti`���, CTTY: Gti �� ,)�� _ZIP:
CON'TRACTOR: E-� A C� t��� �t�����ti�4' C����,�
PHONE: ��/� - y ?�-� �- 't 7 ? .�
CONTACT PERSOti': �I �� { ,�_,.� t:� MOBILE/PAGER:
MAII�Itii'G ADDRESS: �C1�v �� c;;�� �( �� _CITY:y�= � c �<< ,�,;,._ ZIP: �-r- 2 _�,�
STATE LICE�'SE: # L�� � `�_
ARCHITECT/ENGItii'EER: PHO`'E:
i1�IA.ILI�i'G ADDRESS: CITY: ZIP:
���,�: REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED ti�ORK(describe in detai�: QZ� ,,,�,;� �N R �c €' �G�� � C �`�''��-`�" �'�''
C-� �� S.. ^�� c�� ._.� � �'�1tJ< C �i � lC � ��'•C�C �� S LC '-�c"` �r•
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STORIES: SQ.FEET OF EACIi FLOOR:
NO. OF BEDROOiI�IS: GARAGE STALLS: ATT. DET.
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ESTII�IA.TED CO�tSTRUCTION VALUATION (excludi.ng land): $ 1 � �'('� �- �
I hereby apply for a buildina 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 Buildin� Code; that I understand this is not a pernut and work is not to start without a
pernut; and thac the work will be in accordance with the approved plan.
A.PPLICAl�"T'S SIGNATURFs:� ��,.�_._ ��-������ DATE: =% � � `� ��`� —
NOTE! Parade o,�Homes events require separate permit approval by Police Department and
City Counci160 days prior to tke event. Non permitted events will not be allowed. �
♦
Sec.13.04 RIGKtS OF S[JBJECTS OF DATA '
Suhd. 1. Type of data. The righ�t of individual on whom chc data is stored or co be stored shall be as set forch in this secaon.
Subd.2. Intormatioa reqirired to be given indiridval. An individual asYed to supply privare or confidenrial data concerning himself shaIl
be inform:d o`: (a)the purpose and intended use oE the requuted dara wichia the collecdng�tart agency,poliacal subdivision,or sratewide rysum;
(b)whet2:e:he may refuse or is.legalIy requir.d to supply che r_quesud data;(c)any lacown coasequence arising from his supplying or refusing to supply
privaco or connder.da!data;and(d)the idenary of o�h:r pecsoas or enrides au�horized by suce ar federal law to receive t�e data. 'Ihis requiremeac shall
no�apply when an ir.dividual is asked to supply invesdgadve dara,pursuan�to secdon 13.82,subdivision S, co a Iaw enforcemeac officer.
he eerlmissioner of revenue mav oiace che nodc- r-�uird under this subdivision in the individual income raz or orooem taz refund
inscrucaons inscead of on chose forms.
Subd. 3. Access to data by individual. Upon reques�to a rssponsible auehoriry,an individual shall be informed whtcher he is the subjecc
of scored daa on individuals,and whecher it is classified as public,private or confidenrial. Upon his furcher rcquest, aa iadividua! who is[he subje:c
of stor.d private or public data on individuals shall be shown the dam wichout any charga ta him and;if he desues, shall be infocmed of che concenc
and meaning of that data. Afrer an individuai has been shown che privare daa and informed of ics meaaing,che dam aeed not be d'uclosed to him for
six mondu thertafter unless a dispuce or acaon pursuanc to chis secdon is pending or addidooal dara on the individual has been collecc:d or erea�d.
The Rsponsible authoriry shall pcovida copies of che privar�or public data uFon request by che individua!subjecc of�he daca. The responsible auchoricy
may require che requesaag person to pay the accual coscs or makinz,certifying,and compiling the copies.
The responsible authoriry sha]l comply immediataly, if possible,wich any reques[made pursuan�to[his subdivision,ar wichin five days of
the date of�he ceques[,ezcluding Saturdays,Sundays and(egal holidays,if immediace compliance is not possible. If he canaot comply with the reques�
within chat dme,ht shall so inform the individual,and may have an addidonal five days wi[hin which to comply wich ttie 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 oPpubtic orpri�•ate
dara concerning himself. To ezercise this right,an individual shaIl noafy in wridng thc responsible au�horiry describing the nature of the disagreemenG
'Ihe responsible authoriry shall within 30 days ei[her: (a)correcc[he data found to be inaccurate or incompiece and attempc to nodfy past recipien�s af
inaccura[o or incomple�e data, including recipien�s named by che individual;or(b)notify the individual thac he believes the data to be correct Data
in dispuce shall be disclosed only if the individual's sra[emenc of disagreement is included with the disclosed data.
The determinarion of the responsiblz auchoriry may be appealed pursuanc to the provisions of the adminisaarive procedure act relaang to
contesud cases. -
DATA PRiVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hcs of sub}ects of data",we would like to inform you tha[your request
for a permit or license from the City of Orono or any of ics departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish wi11 be used to determine your qualification for che permit or license requested.
2. You may refuse [o supply data, but refusal may require that the City deny the permit or license.
3. �he information may be shazed wich o�her local, state or federal a�encies to the e�tent 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 have certain ri�hts under N1.S. I3.04 (available upon request) to review private data on yourself.
6. Your full name is required [o process this applicatioa or permic.
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I underscand my ri;hts as stated above.
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DATE T E �,1
CITY OF ORONO CALLED IN ��' '��I �/��
INSPECTION NOTICE. scHE�u�Eo l.�r �3 /O�M
PERMIT NO. f)/��i COMPLETED
ADDRESS � ���a�� � /� L � �
OWNER �h.,�N�GQ CONTR. �� CA�t.Q
TELEPHONE NO. �OC' CJDCs?.�- �
� DESCRIPTION ���� — ��
� 01 FOOTING 11 MECHANICAL Rf 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 B�. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINA 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
� COMM NTS: .
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� ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W �CORRECT WORK&PROCEED i-1 ISSUE CERTIFICATE OF OCCUPANCY
� U CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. r-� pHOTOTAKEN
INSPECTOR WILL RETI}RN
� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice