HomeMy WebLinkAbout2002-P05664 - re-roof � �.
PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway - PO Box 66 P05664
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: 9i2sizoo2
SITE ADDRESS: 1840 Fox Street
Wayzata,MN 55391
PID: 03-117-23-42-0008
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Pernut Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 293.25 Valuation: $ 18,000.00
State Surcharge Fee: $ 9.50
TOTAL FEE: $ 302J5
APPLICANT: A Friend of the Family,Inc. OWNER: 7ohn&Linda Massopust
11091 100th Ave North 1840 Fox Street
Maple Grove,MN 55369 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT P RMITEE S[GNATURE _� ISSUED SIGNATURE
Copies: 1-File(SiQnitures Reuuired), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ Date Received:
Entered By: Pernut#:
CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: /�'�� f��� S f. ZIP: 5��3 j�
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NAME OF OWNER: L.�rc c���� /�4-sso��y� PHONE: (�I�e�'�'s� `/��•����
(work)
MAILING ADDRESS: l�`{u �� �'f CITY: ��z�.�,:, ZIP: Ss,'; i
CONTRACTOR: A ��-.t_„',�� +tt �K,...�+, i�: PHONE: ��s--,r s�3:� ��
CONTACT PERSON: ,��,,� C��c��t� MOBILE/PAGER: �,> tic��- c' �: �
MAILING ADDRESS: ;r c+s', � oo�� h�.� �� CITY: ,=M��� G..:< ZIP: S� s c-'i
STATE LICENSE: # ,acsi 7os c
ARCHITECT/ENGINEER: PHOl�'E:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ?'' Land Alteration
PROPOSED WORK(describe in detai�: i�2_�,F,� �.�.,�� ��c� �
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ /�, c��� � �
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 SIGNAT ' :c��;-�" DATE: �- .=s=�'�-�
NOTE! Parade o�'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.13.04 RIGH'TS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom[he data is stored or to be stored shall be as set forth in this secaon.
Subd.2. Information required to be given individual. r1n individual asked to supply private or confidenual data conceming hicnself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision,or statewide system;
(b)whether he may refuse oT is legally required to supply the requested data;(c)any k�own consequence arising fmm his supplying or refusing to supply
private or confidenriai data;and(d)the identiry of other persons or enrities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to suppiy invesrieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav piace the noace reauired under this subdivision in the individual income tax or properry tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher it is classified as public, privace or confidendal. Upon his further request,an individual who is the subject
of stored private or pubiic data on individuals shall be shown the data wi�hout any charge to hirn and,-if he desires, shall be informed of the contenc
and meaning of[hat data. Afrzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acaon pursuan[to this secaon is pending or addidonal data on the individual 6as been collected or created.
The responsibie authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making, cerdfying,and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within 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 request
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply wich the request,excluding Saturdays,
Sundays and lega(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 this right,an individual shall norify in wridng the responsible authoriry describing[he nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correcc. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the tesponsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Ri�hhts of subjects of data", we would like to inform you that your request
for a pemut 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 deternune your qualification for the pemut or license requested.
2. You may refuse to supply data, but refusal may require Ihat the City deny the permit 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 Councii action to approve, some information may become
pubiic.
5. You have cenain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
First Middle Last
Address
C�ty State Zip Phone
I understand my rights as stated above.
,
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nature
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION IC SCHEDULED -O ��
PERMIT N0. C� � COMPLETED
ADDRESS 1 O �� P-�C ��-�X.�
OWNER %�� CONTR. �
TELEPHONE N0.��� -- ��-3�— ���Z���_
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTORTOMEET U:�YES NO
° COMMENTS: � . �� � � i�
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION RE�UIRED.CALlTO ARRANGE ACCESS.
Call forthe ne t inspection 24 hours in advance. (952) 249-4600
OwnerlContra r s te:
Inspector.
White Copyllnspector's Fil Canary Copy/Site Notice