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Home My WebLink About2001-P04533 - re-roof � ti CITY F R N PERMIT O O O O 2750 Kelley Parkway - PO Box 66 Permit Number: Po4s33 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: lo�2a�2oo1 SITE ADDRESS: 860 Forest Arms La Mound,MN 55364 P I D: 07-117-23-12-0006 DESCRIPTION: UBC Occupancy R3 Proposed Use: Kesiaentiai Permit Class: Building Census Code O/S- 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: $ 111.25 Valuation: $ 5,000.00 State Surcharge Fee: $ 2.50 Misc. Fee: $ 111.25 TOTAL FEE: $ 225.00 APPLICANT: SG Construction OWNER: Mr.&Mrs. Sorensen 31125 Gable Ave. 860 Forest Arms La Stacy, MN 55079 Mound MN 55364 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 BUII,DING CODE REQUIREMENTS. -� . � �". , � �-L /` �. � Cc L��i��l��L�.- �, � ��'�� " PPLI ANT PERMITEE I NATURE ISSUED BY SIGNATIJRE Copies: 1-File (Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 + � Total Fee: $ Date Received: Entered By: Pernut#: CITY OF ORONO - BUILDING PERNIIT 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: ��7 �6�� }Q rl, �� ZIP: NAME OF OWNER: ��L-� Sb�,�� ,-� PHONE: (home) � ��- ��-�.�� (work) MAILING ADDRESS: �j��.� ��'� ��r'' CITY: Ua��` ZIP: CONTRACTOR: �� cw'�S tI''�v�. PHONE: �I�—��)� � ,�`�'� CONTACT PERSON: (�qy �p�1�S�,��-�, MOBILE/PAGER: S,4-w-r MAILING ADDRESS: 3l1��" (S�I'lr 1�(� CITY: .St�(c:,Y' ZIP: -S"o STATE LICENSE: # �! �'� /l/ 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�: �`�,�,�R �ri= o l� ��Iw�/�- S�� 5��.�1�' ��c t,1 ` STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � �� 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: - ��y��-i DATE: �� f'-af NOTE! Parade Qf 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. Sec.13.0-i RIGHTS OF SLJBJECTS OF D�TA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecting'state agency, policical subdivisio�,or sntewide system; (b)whether he may refuse oY is legafly required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply priva[e or confidendal data;and(d)the identiry of o[her persons or enuties authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara, pursuanc to seccion 13.82, subdivision 5, to a law enforcement ofFicer. The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propem_tax refund instructions instzad of on those forms. Subd. 3. Access to data bv individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public, private or confidendal. Upon his further requesc, an individual who is ehe subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be infomted of the content and meaning of chat data. Aftzr an individual has been shown the private data and informed of its meaning,che data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to this secaon is oending or addiaonal data on[he individual has been collected or created. The responsible authoriry shaii provide copies of the private or public data upon request by the individual subject of the dara. The responsible authoriry may require the requesting person to pay the acmal costs of making, cercifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or wichin five days of the date of the request,ezc(uding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply wi[h the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individua(may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise this rieht,an individual shall nodfy in writing the responsible authoriry describing�he nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify 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 in dispute shali be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. Ttie de[ermination of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relaring 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 permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut 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. 6. Your full name is required to process this application or permit. First Middle Last Address Ciry State Zip Phone I understand my rights as stated above. /i / � Signature DATE TIME CITY OF ORONO CALLED IN INSPECTION N TIC� SCHEDULED �"� 5 �L. PERMIT N0. �S � COMPLETED /� � I � ADDRESS �Lo�) ��5% �,C�it%�S L� • OWNER �UY(�1'I.S.et.. CONTR. 'S�� nS�rvc:.T• TELEPHONE NO. LP�,� �.� '�f—��'7,� � DESCRIPTION � - � � tL Oi FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q02 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 O6 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 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W a � � O � � � O • � W � Q ti 2 - W � W � � � � �'yVORKSATISFACTORY:PROCEED �81iOJECTCOMPLETE v W O CORRECT WORK 8 PROCEED �O ISSUE CERTIFICATE OF OCCUPANCY � O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR W4LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �9�2� 249-4600 OwnerlCo t�a tor on site: Inspector�l'/G�-�C��L-t/1 � White Copyllnspector's File Canary CopylSite Notice