HomeMy WebLinkAbout1997-009456 - tearoff/reroof �� . PERMIT
CITY OF ORONO PERMIT TYPE:
� 275G Kelley Parkway- P.O. Box 66 .{'w�-�
Crystal Bay, Minnesota 55323 PermitNumber. �;;�;'-:.r:.c:;-:;
(612) 473-7357 Date Issued:
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APP CANT-PERMITEE SIGNATURE ' ISSUED BY:SIGNATURE � ,`� � "
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Total Fee: $ Date Received:
Entered By: Permit#: �r" -L
CITY OF ORONO - BUII�DING PERMIT 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) OWNER CONTRACTOR,,
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JOB SIT'E ADDRESS: �1 I �����LE �2•� n/ ZIP: � ; , ��-�?.
NAME OF OWNER: C� �tA�Z��- �Z�c� PHONE: (home)
(work)
MAILING ADDRESS: ��t� �c-.�,�,ai.� i� �� CITY: c�:z�,��, ZIP:
CONTRACTOR: S;�;�u u�P� �x�t���., � PHONE: �-1 Y •a - S�'7�
CONTACT PERSON: `�tz�F�� �o��-�r� MOBILE/PAGER: L��-�,�i � _
MAILING ADDRESS: �Y a� �..��s�:�,�,..,��.� �7 CITY:y�.J:t �,z��- ZIP: sS�;�
STATE LICENSE: # k 2-�9
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteratic� Land Alteration
PROPOSED WORK(describe in detain: ;� ��R-���- � ,�,�� ��3-� i��„.,�-�;_ 5:�..-4-� tZ�`�-cc
t,.:.;�� ��� ����,_ ���.�� _
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ ��Z.3 3
I hereby apply for a building permit and I acknowledge that the i.nformation 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 accordanc�e wit/t� e. approved plan.
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APPLICANT'S SIGNATURE: � DATE: `i -2� - ��
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGFiTS OF SUB.fECTS OF DATA
Subd. i. Type of data. "Ihe righ�s 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 conceming himself shall
be informed of: (a)the purpose and inreoded use of the requesred data within the collecdng'state agency,polidcal subdivision,or statewide system;
(b)whether he may refuse oY is tegally required to supply che requested data;(c)any known coasequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idendry 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 investigadve dara, pursuant to secdon 13.82,subdivision 5, to a(aw enforcement o�cer.
The commissioner of revenue mav piace the nocice reouired under this subdivision in the individual income tax or propercv tax refund
instrucrions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of scored data on individuals, and whecher it is classified as public, private or confidenaal. Upon his further request,an individual who is the subjecc
of stored private or public dara on individuals shall be shown the data without any charge to him and,-if he desires, shall be informed of the content
and meaning of that data. Afrer an individual has been shown the privare data and informed of its meaning,the data need not be disclosed to him for
six monchs thereafter unless a dispute or acdon pursuanc to this secdon is pending or addidonai dara on the individual 6as been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individuai subject of the dara. The responsible authority
may require the requesdng person to pay che actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall 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 compliaace is not possibie. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or camplete. An individual may contest the accuracy or completeness of pubiic or private
data concerning himself. To exercise this right,an individual shall nodfy in wriring the responsibie aurhoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipiencs of
inaccurate or incomplete data, including recipiencs named by [he individual; or @)nopfy the individual that he believes the daca to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included wich the disclosed data.
The determinaaon of the responsible authoriry may be appealed punuant to the provisions of the adaunistradve procedure act relaang to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri;hts of subjects of data", we would like to inform you that your request
for a pemut or license from the City of Orono or any of its deparcments 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 permit 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 wi[h other local, state or federal a;encies to the extent necessary to process
the peruut or license.
4. If your requested perm.it 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 da[a on yourself.
6, Your full name is required to process this application or permit.
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City Stace Zip Phone
I understand my rig s as�,�y�ted above.
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Signature
DATE TIME
CITY OF ORONO CALLED IN ` �S �`> %
INSPECTION NOTIC/E SCHEDULED �� °`��� � '1 '� -- .
PERMIT N0. , '7 `� � COMPLETED
ADDRESS - �� �� ,�< < . �6.. i,'
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OWNER_�.� , . CONTR. -�c� r :� L <
TELEPHONENO. "�`--f i - `� 'j `/i
� DESCRIPTION �- �, � , - ,/
� 01 FOOTING 11 MECHANICAL AI 18 EXCAV/GRADING/FILLING
Q WG 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 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
W PROJECT COMPLETE
� C CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
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O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance.473-7357
Owner/Contra�o^ ite:
Inspector.
White Copyllnspector's F le Canary CopylSite Notice