HomeMy WebLinkAbout1998-010520 - reroof storm PERMIT
� ��Y OF ORONO PERMIT TYPE: —� — —
2750 Kelley Parkway- P.O. Box 66 �'`'''���'`��"=
Crystal Bay, Minnesota 55323 PermitNumber: �_}�.:f.���=_�
(612) 473-7357 Date Issued: _�:��'i?'�;��;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� ' '�otal Fee: $ f�� DateReceived: 7- z o - ��
Date Approved:
Entered By: Permit#: /0 5 z-o
CITY OF ORONO - BiJILDING PERMIT APPLICATION
ALL�tF'ORMATION MTJST BE SUB�fI'I"I'ED IN FULL BEFORE PLAN REV�W tiVILI-
BESTARTED
THE APPLIC�'YT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ���5_���esT� ,��'��s l�w e z�: ��-�3��t'
N�fE OF Oti�tER: � I�JG�� � l� S O/l/ PHONE: (home) L� Z� �G �G�G
(work) �`'iJ � - �2�s
�iAII.�'GADDRESS: � �J Jr Ca�esf r��CITY:����U ZIP: y�3�U
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CONTRACTOR: C U��O �U/U'S� -G�� PHOi�tE: �J� � J ����
f� v I O B I L E P H O i�t E/P A G E R: (��� 3.3 3
1 Y I A II�IN G A D D R E S S: l��l G 5� .5����'li�, CITY: , T `,� ZIP: S 3''1
STATE LICENSE: # � 3 5�___—
ARCHITECT/ENGliYEER: PHONE:
NiAILING ADDRESS: CITY: Z�:
N�I�IE: REGISTRATION #
TYPE OF WORK: New Addition Accessory S�ucwre
Move RemodeUAlteration C�_ Iand Alteration
PROPOSED`VORK(describeindetail): ���� C>�� �� /1�°��� ' -
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STORIES: _ SQ• �ET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTII�i iATED CONSTRUCTIONV_AI.UATION(eYcludingland): � � � � �
I hereby apply for a building permit and I acknowled�e 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 permit and work is not to start
without a permit; and that the work will be in accordance with the approved plan.
AP
PLICANT'S SIGNATURE: �G� %�'�-�J`'� DATE: 0 ^Z C� ~C
NOTE! Parade of Homes events require separate pernzit 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.13.04 RIGfITS OF SUB.TECTS OF DATA
Subd. 1. Type of data. The righu of individual on whom the dara is stored or to be stoied shall be as set forth in this secdo�.
Subd.2. Information required to be�ven individual. An individual asked to supply private or confidential data conceming himself shall
be informed of: (a) the purpose and intended use of the requesced data within the collecdng'state agency, political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested dan;(c)any known coasequence arising fmm his supplying or refusing ro supp(y
private or confidenrial data;and(d)the idendry of other persons or enddes au�horized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve data, pursuant to secdon 13.82, subdivision 5, [o a law enforcement officer.
The commissioner of revenue mav place che nocice required under this subdivision in the individual income tax or prooem tax refund
instructions instead of on those forms.
Subd.3. �ccess to data by individual. Upon request to a re�onsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals, and whether it is classified as public, private or co�dendal. Upon his further request, an individual who is che subject
of stored private or public data on individuals shall be shown the data wi[hout any charee to him and, if he desires, shall be informed of the content
and meaning of that data. After an individual has been shown[he private data and informed of ia meaning, che data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal data on the individual bas been collected or crza�ed.
The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the acrual coses of making, cerdfying, and compiling the copies.
The responsible authority shall comply immedia[ely, if possible, with any request made pursuanc to this subdivision,or wi[hin 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 requesc
within that[ime,he sha(1 so inform the individual,and may have an additional five days within which to comply wi[h the request,excludin;Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or compiete. An individual may contest che accuracy or completeness of public or private
data conceming himself. To exercise rhis nght,an individual shall nodfy in writing the responsib(e auchority describing the�ature of the disagreemenc.
The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomQlete and attempt to notify past recipienu of
inaccurate or incomplete data, including recipienu named by che individual; or(b) notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if[he individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve proceduce act relating [o
contesced cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riehts of subjects of data", we would like to inform you that your request
for a permi[ 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 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 with other local, state or federal aQencies [o the extent 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 rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process chis application or permit.
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First �7z�, Middl� Last
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Address , ���� L/ ?, � C� z — � �
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Ciry —7 Sta�e Zip Phone
I understand my rights as stated above.
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Signature
/ �y� DATE TIME
CITY OF ORONO f C� � f CALLED IN
INSPECTION NOTICE SCHEDULED �-� rU�ev
PERMIT N0. �P+v��►`l� COMPLETED _� �
ADDRESS t�SS ���� � l4�'�►''�.5 i-�4r�
OWNER ��C*,,9�lt,CS�i� CONTR. C�� C�nrST�
TELEPHONE NO.
� DESCRIPTION �����
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
� 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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. �.� pHOTOTAKEN -
INSPECTOR WILL RETURN
[-: CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
CJ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance.473-7357
OwnerlContrac ,��it
inspector. �
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