HomeMy WebLinkAbout1995-007539 - tear-off/reroof FERMIT
CITY OF ORONO '
2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: ,.
Permit Number: -'-`��'�'�
Crystal Bay, Minnesota 55323 � -��
(612) 473-7357 Date Issued: : -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: �� �J � � - OWNER:
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PLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: S DateRecei��ed:
Date Aoproved:
Entered Bv: Pe:mit7:
CITY OF ORONO - BLTILDI�tG PER1l�IIT APPLIC�.TION
ALL Ir�'ORtiI�TION 11LST BE SL-BIiTI�`ED Pi F�ZL BEFORE PL��t REV�tiV ti�II.,L
BE ST:�RTED
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THE �PPLIC:�:`TI' IS: (circ:e one) O�Vi�ER C� �ONTRACTOR _ _
Jos sl� ���ss: � ��� ��.� ��; z�:
�1�l�LE OF O�VYER: �>'��� c_�. A� � �_���-�� - PHO�tE: (home)
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(work) �.� � - `><:���-t�
� — CITY: ���•���<. ZIP:
l�1AILI�i �''G�DDRESS: 1� �� �-�_ � �� � �—
_ PHONE: �+ti `� -�, �� '
CONTR�CTOR: �> �� � �� a, ; ., �r:�,.�.��,� � _-�
I�IOBILE PH0�1E/PAGER �,��_ - -t� e z - `�.4 ,
CITY: ��,,<: �->«r_ ZIF: - , �..,�
I�IAII.ING?�DDRESS: ��4,�5 � �:r�� � �-,2��:',_ ��
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ST:�TE LICENSE: n w��� �t
ARC�IITECT/E�GL��ER: PHOV"E:
�IAIL�iG�.DDRESS: CITY: ZIP:
N�1�IE: REGISTR.�TIO�i �
TYPE OF `�'ORI�: :`lew �ddition Accessorv Smicture
iVlove Re.�odeL�:�lte:at n �� T.�Alteranon
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PROPOSED"'ORh(describe inde*ail): �i - �����t r�` +'- �����_ ��� => _�' <"� ` -, „ , c
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDR00�1S: G�iR�GE STAi:LS: �TT. DET.
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ESTLI�TATED CONSTRL'CTIOti�%�LL'�TION(eYciudin�land): � �,`-+�'�`-�
I hereby apply for a buildina permit and I acknowledQe that the information above is complete
and accurate; that the work wiil 'ae in contormance wiLh the ordinances and codes of the C:�'
and with the State Buildina Code; that I understand this is not a perrnit and work is not to start
without a permit; and that the work will be in a��ordance with the approved plan.
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�PPLIC�'v'I''S SIGNAT'URE: �.0` ..�,� �� � DATE: ���� _<<��
NOTE! Parade of Homes events require separate permit approval by Police Department and
Citv Council 60 days prior to the event. Non-permuted events will not be allowed.
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Sec.13.04 RIGHTS OF SL`BJECTS OF D?.T�1
Subd. 1. T}•pe of data. 'Ihe nghts of individual on whom�he data is stored or to be stored shall be as sec for[h in this secdoo.
Subd. '_. Information required to be�ven indicidual. An individual asked to supply private or conhdendal data concerning himself shall
be informed of: (a) the purpose and incended use of the requesred data wi[hin the collecting'stace agency, political subdivision,or sta[ewide rystem;
(b)wheeher he may refuse or is Izgally required to supply�he requesced data:(c)any Imown consequence arising from his supptying or refusing[o supply
private or confidennal data:and(d)[he idenoty ot ocher persons or enddes au[horized by state or federal law to receive the da[a. This requiremeat shall
not apply when an individual is asked ro supply invesdgadve data, pursuan[to secdon 13.82, subdivision 5, ro a law eniorcemen[oificer.
The com.missioner of re�erue r�av �lace ,he roric eauirPd under �his subdivision in che individual i.^.come taz or oropem taz ret"u^d
instruc�ions inscead ot on those forms.
Subd. 3. :�ccess to data by individual. lioon request to a responsible au�horiry,an individual shall be informed whether he is the suoject
of stored data on individuals, and whecher i[is classitiui as puolic, pnvate or con2idennal. lipon his tur[her request, an individual who is rhe subject
of stored pnva[e or public data on individuals shall be shown the da[a wichout any charee to hun and, if he desires, shall be informed of the content
and meaning of tha[data. .�her an individual has been snown che priva[e data and informed of irs meaning, the data need not be disclosed to hun for
six months [hereafter unless a dispute or acnon pursuanc to chis secaon is pending or addiaooal data on the individual has been collected or crea[ed.
The responsible autnonry shall provide copies of the pm a�or public data upon request by the individual subject ot the data. The responsible auchori[y
may require the requesting person to pay [he actual costs of making. cerrifying, and compiling the copies.
The responsible aurhority shall comply immedia[ely, if possible, wirh any request made pursuant to this subdivision, or within five days of
the date of the requesc, excluding Sa�urdays,Sundays and legal holidays,if immediate compliance is not oossible. If he cannoc comply wi[h[he reques�
wi[hin that time,he shall so inform the individual,and may have an addidonal five days wichin which ro comply wich the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise[his neht,an individual shall notify in wnang the responsibte authonry describing[he nacure of the disagreement.
The responsibfe auchoriry shall within�0 days ei[her. (a)correct the data found to be inaccurate or incomplete and a[temp[to nodfy past recipients of
inaccurate or incomplete data, includine recipienu named by the individua(; or(b) nodfy the individual that he believes the data to be correct. Data
in dispu[e shall be disctosed only if the individual's stacemen�of disagreemen[is included with [he disclosed data.
The decermina[ion of the responsible au[honry may be appealed pursuan�to the provisions of the administradve procedure act relating to
contested cases.
D:�T:� PRIV:�CY ADVISORY
In accordance wi[h M.S. 13.04, Subd. 2, "Riehts of suojects of data", we would like �o inform you thaC your request
for a permit or license Trom the Ciry of Orono or any of i�s departments may require you to fumish certain pri��ate or
confidential iniormation.
`:'ou a:e rotified chat:
1, The information you furnish will be used[o decermine your qualification for the permit or license requested.
2. You may reTuse to supply da[a, but refusal may require that the Ciry deny the permit or license.
�, The information may be shared wi[h other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Council action ro approve, some information may become
public.
j. You have certain rights under ti1.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this applica�ion or permit.
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First `tiddle Last
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Address
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City Stare Zip Phone
I unders[and my rights as stated above.
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Signature
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DATE TIME
CITY OF ORONO CALLED IN //-'��-��
INSPECTION NOTICE SCHEDULED .'/ -i ��- `'f ��'�
PERMIT NO. 'S � 1 COMPLETED ���� ��
ADDRESS ��� �� ���
OWNER �C,c���.��-��'��-� CONTR. �'� '����'� � Qk��,
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TELEPHONE NO. �f� `� ' �� � � �
� DESCRIPTION �� '�i���`�`-'
l� 01 FOOTING 11 MECHANICA RI 18 EXCAV/GRADING/FILLING
02 FRAMING� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� �03 INSULATION ` 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 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
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i 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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d �WORKSATISFACTORY:PROCEED �= PROJECTCOMPLETE
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� ❑ CORRECT WORK 8 PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY
W
O C; CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ` pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED
C� INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in9pection 24 hours in advance.473-7357
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OwnerlContra�tor pn site� :
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Inspector. � - ' '
White Copyllnspector's File Canary CopylSite Notice