HomeMy WebLinkAbout2001-P04083 - re-roof, chimney repair PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po4os3
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: �i�3i2ooi
SITE ADDRESS: 264o Fox st
WAYZATA,MN 55391
P I D: 04-117-23-42-0008
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Buildin Census Code O/S-Building
Permit Class: g
Permit T e: Minor Alterations Permit Sub-type(s): Building- Re-Roof
YP Chimney Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SU1I�MARY: Permit Fee: $ 111.25 Valuation: $ 4,075.00
State Surcharge Fee: $ 2.05
TOTAL FEE: $ 113.30
APPLICANT: Darrell Plucker OWNER: D&J PLUCKER
MN 2640 FOX ST
WAYZATA MN 55391
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 BUILDING CODE REQUIREMENTS.
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LI ANT P RMIT� S NA RE ISS BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing,1-Finance Page 1
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To�al Fee: �a Date Received: 7��3
Entere�.By: Permit#: �{D S�3
CITY OF ORONO - BUII..DING PERMIT APPLICATION
A11 information must be submitted in full before plan review will be started.
' (please print a11 inforncation)
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THE APPLICANT IS: (circle one) OWNER�R CONTRACTOR
JOB SITE ADDRESS: `� 6 yC) ���;�-' �l�, ZIP: ��� �.j l f
,� i ��f �� �✓ �LL.c�i�t' _ PHOI�TE: (home) ��5�- �/l6- �I�,9
NAME OF OWNER: �
(�vork) �Ni Syi Sy37
11�IAII�ING ADDRESS: o?C�10 �c-�s �-� . CITY: G��,rzu f,rs ZIP: �f3�(
CONTRACTOR: � ��/� PHONE:
CONT'ACT PERSON: tiIOBILE/PAGER:
1��IAILI�i iG ADDRESS: CTTY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGPIEER: PHO\TE:
�IAILL�'G ADDRESS: CITY: Z�:
�T��,�_ REGISTRATION# �
TYPE OF `VORK: Ne�v Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED'4VORK(describe in detai�: � Oc�� -' <��' ��� �`" �� ��� �f
i n
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STORIES: �_ SQ. FEET OF EACH FLOOR: /U G'�
NO. OF B�DROO�SS: '—� GARAGE STALLS: ATT�. 2_ � DET. � - -: . ., /
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ESTI1�i IA.TED CO�'STRUCTION VALUATIO\ (excluding land): � 32� �"� ���
g7S�
I hereby apply for a buildin� perniit and I acknowled�e that the information above is complete and
accurate; that the work will be in conformance wich the ordinances and codes of the Ciry and with
the State BuildinJ Code; that I understand this is not a perm.it and work is not to start without a
permit; and that the work will be in ac rdance with the approved plan.
APPLIC�,.��r'T'S SIGNATURE: � /��lr�� ��� � DATE: �—�3- U� —
1�'OTE! Parade of Homes events require separate permit approval by Police Depgrtment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.0-t RIGHTS OF SL'BJECTS OF D�Ta
Subd. 1. Tyg:oF daca. "Ihe rieh�s of individual on whom t;e data is s�:�.' c:to be s:�:rd shall be as set forrh in this secdoa.
Subd.2. Infocmation reqiri.red to be given individual. An i:.c'i�idual asd�t.^.r•ppiy pr.vatt or confidcnrial data coacern.iag hinse�F s�311
Ee informed of: (a) the purose and intended use of the requesccd daca wi�in the coL'r_:=.;"state a__�cy,polidcal subdivisioa,or saccx•i�e sysum;
(b)whe�`�ar he may r_fuse or is legally requir.d to suppiy rhe requesud dat�;(c)any�o x�_�:seque�ce arising froei his supplying or refi:sing to suppl,v
priva�e or conndend:1 da�;ar.d(d)che idendry of orher peaoas or endda����horizcd by s=:=or fede3!law ro rceive the data.."Ihis requir:�:ac s6a11
no�apply whzn an ir.divid�aI is asked eo supply invesdeadve daa,purs�:co saccoa 1:.=3, sutdivision 5, co a faw enforcement onice�.
"Ihe commissioner of rvenua rnav olace the no�ce r.auird er.�er this s.:a'.:':sion in �':e ir.dividual ir.come tax oc orooem ez r_fur.d
inscruccions inscazd of on t}:ose forms.
Subd.3. access to data bp indi�idual. Upon requesc to a r_r,.aasible ae�:ec;.,an indivi��al shall be informed whethec he is t.`�.e s.�bject
of scored dlta on individu�ls, and wha�her it is classified as public,priva�or confid��. lipon fus r�r�her requesc, aa individual who is�`��si:bjecc
of storad privare or publ:c da�a on individuals shalt be shown che dara v.i�ouc any c;.�_o :�him ar.d,-if he desires, shall ba informed of cie concenc
ar.d meaning of chac daca_ Aft:r an individu�i has been shown che privae�aa and iy:�—=o`ics�eri.ng.�he dat�need noc be discloscd to hirn for
six ¢:on;hs thareatter unless a dispuce or acdon pursuanc to this sec¢on is�eading o:z'__:_�eal day oa u`�e individual has been collected or c;ea[�d.
"Ihe res�,onsible aurtoriry shal!provide copies of�he privace or public dac�L.on req�e.s:t�__a ir.divi�caI subjecc of ch�da�a. The responsible au•,:.oric:
ray requir� che requesring peaon to pay the actual cos�s of making,ce-_.;:ir.g,ar:d co.-__:�:g the copies.
The responsibl�aurhoriry shalt comply im.�nediactly,if possiole,wich any r_�•_c_:mada pL-s�ant to this subdivision,or withi�five Zays of
th:dsce of[ha reques�,e.tcluding Sacurdays,Sundays and(egal holidays,i;ir..mediace ce—::�r.ce is r.c�possible. If h�canao[comply wich tl;e r_qu_st
wichin[ha�ame,h�shall so inform che individual,and may have an adCi�cr.�.(five da,s�:��z wtucn to comply wich tha request,etdudir:g Satir�ays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. :�.n individual�;•:ontes:tr_e accuracy or completeness of public o�pricate
daa conceming himself. To ezercise�his rieh�,an individual shall nori�r ia•xriting ce r_-�:sible au::.oriry d�scribing ehe nanire of the d'ua;r_�meac.
The responsibla au�horiry sh�ll wi�hin 30 days eicher: (a)corr:cc rhe dae;cand to�a i__c,:acz or i.comp(ere and ar.empc to norify past:�cipier.cs of
inaccurz�e or incomplete da�a, including recipienes named by tbe individ�•.=I;or(b) �o�; __=indivic��that he bdieves the daca to be coc:ce. Daca
in dispu�e shall be disclosed only if the individual's statemenc of disagrr_�ent is i^:c:c�_::'�i:n che dsclosed data.
Ttie decz:r,tinadon of tha responsible authoriry may bt appza:=a pursuac:t� _.= �rovisiors o�the admuuscrarive procedure ac:r�l�aag to
contu;ed cases.
DATA PRIV:�CY AD�Z�ORY
In accordance with M.S. 13.04, Subd.2, "RiQbts of sL�jects oi ea:_', we w•ouid like to inform you tha[your reeuesc
for a permic or license from the Ciry of Orono or any o[is dep�r.�.��� may require you to furnish cenain priva:� or
confidencial informacion.
You are notified that:
1, The information you furnish will be used to��:emune �'o:::c.:alif cation for the permit or licease reeuesced.
2. You may refuse to supply data, bu� refusat .:.ay require ;�at [he Ciry deny the perm.it or license.
;, The information may be shared wi�h o�her loc�!, stace o::e�e,al ag�acies to the ex�ent necessary to process
the permit or license.
4. If your requested permit or license requires Council ac�en to a�p:ove, some informacion may become
. public.
�. You have certain ri�hts under M.S. 13.0� (a�ailable u.c� requ:s�) to review priva[e data on yourself.
6, Your full narae is required to process this a�plicacioa c: �ermit.
Firsc �fiddlt L=s:
Address
Ciry Sra[e Zip Phone
I underscand my ri�hts a�s stated above.
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Si�nacurc
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N T CE SCHEDULED 7 � c_ ��. �',
PERMIT N0. � -G�3 COMPLETED �, ��
ADDRESS - , C �
OWNER CONTR. .P��
TELEPHONE NO.
� DESCRIPTION '- it,�-z'-- ? _ v %7 c ��
� 01 FOOTING 11 MECH CAL RI 18 EXCAV/GRADING/FILLING
Q 02 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 05 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 CQVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �1M(�RK SATISFACTORY:PROCEED �.PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTiON REQUIFED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContra o on '
Inspecto
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN V ''�
INSPECTION N I SCHEDULED ' —�� /� ��
PERMIT NO. � � COMPLETED r '�I ' �
ADDRESS .��i��D �t�1C
OWNER�' �� CONTR.
TELEPHONE NO. �Sa y7V '���/
�
� DESCRIPTION -�-
LL 01 FOOTING 11 MECH ICAL I 18 AV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� C �MENTS:
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GW �'�/VORKSATISFACTORY:PROCEED PROJECTCOMPLETE
� ❑CORRECT WORK R PROCEED ' ISSUE CERTIFICATE OF OCCUPANCY
W
O C: CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN
Cl STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
Cl INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector.y%7/-� �`�`/
White Copyllnspector's File Canary CopylSite Notice