HomeMy WebLinkAbout1992-004684 - re-roof/tear-off � ; PERMIT
CITY OF ORONO �
1335 BROWN RD S BOX 66 �ERMIT TYPE: ����3L?;�t�t!
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CRYSTAL BAY, MN . 55323 'ermit Number: _ _
473-7357 �ate Issued: �s''���=�����-
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APPLICANTiPERMI SIGNATURE ISSUED BY:SI ATURE
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� ' ' ' CITY OF ORONO - BUILDING PERMIT A.PPLICATION
Total Fee: $ Date Received:
Dat� P.pproved:
Entered By: � ��
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PermitQ: � �
ALZ INFORMATION MIIST B$ SDBMITTSD IN FIILI� BEFORE P7sAN REVIEW WILL BE STARTF.D
(See Check-eff List EncZosed)
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THE A.PPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDR.BSS: �C��� �'C��_���F_ �A� ZIP: � �'j��
(work) 332-851. �
x� oF owrr�x: �7A1/� (� d�,J�-AlL F-- �l 21� �u A 1J pHorr�: (home) �4-4�' I
MAILING ADDRESS: Iq��_���.�a� �ITY:�'t1_���(� ZIP:��-2f�_
NTRACTOR: � ()4,S�L L�-���,F�J PHONE:
i�iAILING ADDRESS: . CITY: ��J�Q��__/(t'�''� ZIP:�7
STATS LICENSE: $
ARCHITECT/EN \ PHONE:
;SAILING ADDRB CITY: ZIP:
N�ME: REGISTRATION �
TYPE OF WORK: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate�_ Land Alteration
PROPOSF.D WORR (describe in detail) : � � D/ ArF, �Fl���,_(?�,l'1�
STORIES:�_ SQ. FEBT OF EACH FZOOR: ��(�(�
NO. OF BEDROOMS:� C:ARAGB STAI�LS: ATT. r� DET.
ESTIMATED CONSTRIICTION VA�IIATION (eaclnding Iand) : $ �� �,�t,�
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 wiI 1 be in accordance with the approved plan. . .
APPLICANT'S SIGNATDRE: �� ,�� � �;;.,�...+�-� DATE= —
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Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� - � � On the North Shore of Lake Minnetonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
l.icense 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 Iicense 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 Iocal , state or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Your full name is required to process this application or
permit.
�r�b )1� �. MA� � �12,�_� n�
First Middle Last
��-� � �In��, RI�_
Address
012df� I�-�I�• �3 5�
City State Zip
'_�c f CI _c��r� (
Phone �
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I understand my rights as stated above. �� � ��
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Signature . � ^ (� �
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BUILDING&ZONING—d73-7357 • ADNItiISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESSI;�IG
. � ;
�.04 RIGHTS OP SIIBJECTS OF DATA
Subdivision L Type of data- The rights of individuels on whom the data is
stored or to be stored shall be es set forth in this section.
Subd. 2. Information required
to be given inc�v��l- An.individuel asked to
� � supply private or confidential data concernina am�i�n� collecting state agency,
purpose and intended use of the requested
political subdivision, or statewide system; (b) whether he ma� refuse or is legally
required to supply the requested date; (c) any known consequence arising from his
1 rivate or confidentiel data; and (d) the identity of
supplying or refusing to supp y p
other persons or entities authorized bYd vidual iseaskedlto supplyein est gat ve da a
requirement shall not apply when an in
pursuant to section 13.82, subdivision �, to a law enforcement officer.
The commissioner of revenue ma� ropertv tax re�und instQucteonsu nsteadhos
subdivision in the individual incom� tax •r �
on those orms. . - - -
Subd. 3. Access to �ata by in�viduel- Upon request to e responsible �
authority, an individusl shall be informad�h blic,pr vateeor confidential.e Upon his
individuals, and whether it is classifie P ublic data on
further request, an individuel who is the subject of se to�mrl�ae if he desires, shall
individuals shall be shown the date witho ofan�y ��g. After an individual has been
�e informed of the content and meaning t� �ta need not be �isclosed to
shown the private data and informed of its meanin$, unuant to this section is
him for six months thereafter unless a dispute or action p
� pending or additional data on the in� of the hri ate or public datarupongrequest by
responsible authority shall provide copi�The res orLsible authority may require the
the individuel subject of the data• p �Qrtif n and compiling the
requesting person to pay the actual costs of making, Yi g�
copies. immediately, if possible, with any request
The responsible authority shall comply of the date of the request,
made pursuant to this subdivisi�d le al tholida e if�immediate compliance is not
excluding Saturdays, Sundays g �'
possible. If he cannot comply with the request within that time, he shall so in�or h the
have an additional five days within which to comply
individuel, and may and le al holidays.
request, excluding Saturdsys, Sun�Ys g
Subd. 4. Proce�e �►hen data is not acc�ate or complete. An ind��e�. To
contest the accuracy or completeness of public or private data concerning
ht an individual shall notify in writing the responsible authority
exercise this rig ,
describing the nature of the disagreem�Q beT�c�g e oren omQlet and att pt to
days either: (a) correct the data found
notify past recipients of inaccurate or ���P�t�e t�e esdthe datalto be correct
the individuel, or (b) notify the indivi
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the disclosed data. � gPpe�ed pursuant to the
' The determination of the responsible authority to contested cases•
provisions of the administrative Qrocedure act relating
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED
PERMIT NO COMPLETED
ADDRESS �
OWNER_� CONT .
TELEPHONE NO.
� DESCRIPTION � �-'�
� 01 FOOTING 11 MECHANIC RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANI L FINAL 19 LAKESHORE/WETLANDS
y 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 FINA 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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��WORK SATISFACTORY:PROCEED �JECT COMPLETE
W �C C7 ORRECT WORK&PROCEED �❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �_.� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-7357
Owner/Contra o o si :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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DATE TIME
CITY OF ORONO CALLED IN ! .�Z-G�/9Z
INSPECTION N (I�C, �/ SCHEDULED � � �J��
PERMIT NO. �`�' T COMPLETED I�( �-t,
ADDRESS - � ���
OWNER�l� >�'-��-. � CONTR. a%/�J�J� �
TELEPHONE NO. ��� 3 " ��'� �' _
� DESCRIPTION ���, -:��,�z�-�
ltr 01 FOOTING 11 CHANICAL RI 16 WELLTEST PUMP
� 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
�
031NSULATION 24125 WOOD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
� 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Z
OS FINAL ' � 13 METER SET(TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
`� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� C7 CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, pHOTOTAKEN
INSPECTOR WILL RETURN �
❑STOP ORDER POSTED.CALL INSPECTOR !-' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra �ite:
Inspector.
White Copyllnspector's le Canary Copy/Site Notice