HomeMy WebLinkAbout2001-P03660 - re-roof � _ PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po366o
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: 3i3oi2ool
SITE ADDRESS: 3630 Eileen St
MAPLE PLAIN,MN 55359
P I D: 0 5-117-2 3-21-0013
DESCRIPTION:
Proposed Use: ttesidentiai
Census Code 434
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: $ 167.25 Valuation: $ 8,500.00
State Surcharge Fee: $ 4.25
TOTAL FEE: $ 171.50
APPLICANT: David [lse OWNER: D H ILSE& S L tLSE
3630 Eileen St 3630 EILEEN ST
Maple Plain, MN MAPLE PLAIN MN 55359
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 BUILDING CODE REQUIREMENTS.
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PP A PEiR 'C NATURE ISSU BY SIGNA7'UR� ,
Copies: City, Applicant, Assessor, Finance Page 1
. . � � 30/ U
Total Fee: $ Date Received: �/ �
Entered By: ��� Permit#: �/.��� � �-40 �
CITY OF ORONO - BUILDING 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 OR CONTRACTOR
JOB SITE A.DDRESS: ��p �J� � 1 �'� � Z�� S S 3S � �
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NAME OF OWNER: �v � � ���' PHOiVE: (home) � ,�
(work)
l�IAILING ADDRESS: SG(�Q, . CITY: Q I ZIP:��S°)
CONTRACTOR: � '�'� PHONE:
C0�ITACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # ; __
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: Z��
N��; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move �emodel/Alteration Land Alteration
C�1 c� '_ c I�
PROPOSED`�'ORK(describe in detain: �,�.Y vU'� 11���'
STORIE
S; SQ.FEET OF EACH FLOOR�r�- 1 Ul.� �P
NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. �_ DET.
ESTlI�i IATED CONSTRUCTION VALUATION (exclud.ing land): � 7 �d� _
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; ihat the work will be in conformance with the ordinances and codes of the Ciry and with
the State Buildina Code; that I understand this is not a perm.it 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: �I Z-Y I O�
��
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.0-1 RIGHTS OF SUB.TECTS OF DAT�
Subd. 1. Type of data. The righ�s of individual on whom[�e data is s�:_3 or to be stored shall be as set forth in this secdoo.
Subd.2. Informadon reqirired to be given individual. r1n iLdividual ask�3 to supply privace or confidenaal data concerning himself shall
be informed of: (a) rhe purpose and incended use of the rtquesud dara wi�in the colleccing'stace agency, potidcal subdivisioo,or statewide system;
(b)whe�'�er he may refuse oY is legally required�o supply che requested dan;(c)any l�own conscquence arising from his supplying or refusing to supply
privace or conndendal data;and(d)the idenary of other persoas or enddes�achorized by scate or federal law to receive the data..'Ihis requiremene s6ali
noc apply when an individual is asked to supply invesdeadve daa, purs�ac to secaoa 13.82, subdivision 5, to a law enforcemenc o�cer.
The commissioner of r^venua r�av place the norice RQllICEd L'P��r this s�bdivision in che individual income tax or propem tax_refund
instructions inscezd of on those forms.
Subd. 3. access to data by indi�-idual. Upon request to a rest�onsible aet:^.oriry,an individual shall be informed whether he is the subject
of s�ored data on individuals,and whe[her it is dassified as public, priva�.or confid�naal. Upon his further request, an individual who is the subjecc
of stored private or public data on individuals shail be shown che data wiu out any c:.arge to him and,'if he des'ues, shall be informed of rhe con�enc
and meaning of chac data. Aftzr an individual has been shown�he priva�Ca�and i�:ormed of ia meaning,che da[a need not be disclosed to him for
six �or.�hs chzreaiter unless a dispute or acrion pursuanc to this section is��nding o;additional data on the individual has been collecced or creaced.
The responsib(e authoriry shall provide copies of the privace or public dac�L�on reques:by[he individual subject oF che data. The responsible authoriry
may require che requesring person to pay the actual cos�s of making, cer.�:ing, ar.d compiling the copies.
The responsible au[horiry shall compiy immediately,if possibi=.wi�h any r�quest made punuant to this subdivision,or within five days of
the dace of�he reques[,escluding Saturdays,Sundays and legal holidays,it ir.^.mediz�e compliance is not possible. If he cannot comp(y with che request
wichin thac dme,he shall so inform che individual,and may have an addicer.al Five da:s wichin which to comply wirh the request,exciuding Saturdays,
Sur.days and legal holidays.
Subd.4. Procedure when data is not accurate or complete. ?.n individuzl may contest the accuracy or completeness of public or private
daca conceming himself. To exercise�his ri¢ht,an individual shall nodE�ia wriang 4:=responsible authoriry describing�he na�ure of the disagreemenc.
The responsible au�horiry shall wichin 30 days ei[her. (a)coaect the dae tcund to bz inaccurate or incomplece and aazmpc to norify past recipien�s of
inaccura�e or incomplete data, including recipiena named by the individLaI;or(b) rorify the individual that he bzlieves the data to be corcect. Data
in dispu�e shall be disclosed only if rhe individual's sta�emen�of disagree�:nc is i.c:::ded wieh the disctosed data.
Tfie deczrminarion of[he rosponsible authoriry may be appea::�pursuac:to the provisions of[he administrarive procedare act reladng to
concested cases.
DATA PRIV�CY AD�ZSORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects oi data", we would like to inform you that your reouest
for a permit or license from the Ciry of Orono or any oi i�s depar.�.znts may require you to furnish certain priva�e or
confiden[ial information.
You are notified that:
1, The informacion you furnish will be used to de:ermine �'our qualification for the permit or license requested.
2. You may refuse to supply data, buc refusal nay require that the Ciry deny the peruut or license.
3, 'Ihe information may be shared with other loc�l, state or federal a�encies to the exten[necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
. public.
j, You have cenain ri�hts under M.S. 13.04 (a�ailable upon request) to review private data on yourself.
6, Your full name is required to process this aoplicacion or permit.
�'j�QrC��CQ.s� .t�� l,.f� � �—�—
First � ��fiddie - Lasc
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Address rn S�S� � S a- u� b -
Ciry Stace Zip Phone ��`� h� L
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I understand my rights as stated above.
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Signacure
� 3 d/6 / TIM E
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED
PERMIT N0. � COMPLETED t -Z�G�� 2'-�f
ADDRESS � C� �� �I �� C' � J�
OWNER � CONTR.
TELEPHONE NO._ �S' - ����G' ` ��b�
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� DESCRIPTION /�� � � ��� U��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FR,4MING 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 OS FINAL 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:
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� '�VORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL REfURN
O STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContra tor on si :
Inspector.��� �
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White Copyllnspector's File Canary CopylSite Notfce
� DATE TIME
CITY OF ORONO CALLED IN "�-3D`�I
INSPECTION NOTIC SCHEDULED _��_L___L_ Cl M
PERMIT N0. �a��06� COMPLETED � �D
ADDRESS �Cp.�_ � . �/ �tZL� �`•
OWNER .�IS�- CONTR. OG✓�-e-/`
TELEPHONE N0._ �S � �fi ��P v�Q D 7
� DESCRIPTION �Gd � �! /��-�
� 01 FOOTING 11 MECHANICAL RI 18 EXCA�//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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
0 CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL AETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CAIL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. �952� 249-46��
OwnedContr tor on site:
Inspector ��
White Copyllnspector's File Canary Copy/Site Notice