HomeMy WebLinkAbout1997-008999 - tear-off/re-roof PERMIT
� t,�Y OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 = � - _�
Crystal Bay, Minnesota 55323 Permit Number:
(612)473-7357 Date Issued: - -
SITE AaDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/P ITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ Date Received:
Entered By: Pernut#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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TI3E APPLICANT IS: (circle one) OWNER aR CONTRACTOR `� ..
JOB SITE ADDRESS: 5�j� �-t-� ���j 7�•c_•� ZIP: 5� 3 S F:��
NAME OF OWNER i'\�,��,;,,,�c z L�I� , PHONE: (home)
(work)
MAILING ADDRESS: ;�1X' t-� � ;`�c , t CITY: , ` , : ZIP: . >�� �,
CONTRACTOR: � . t�� r7��l<,��� ��� � C�� � � PHONE: ���� ��� .����� i
CONTACT PERSON: �c��� � u�.�';v � � MOBILE/PAGER:
MAILING ADDRESS:'��,,�-n; (►17�c ri ,,�_ << CITY: ; , �y�_ , � , ZIP: - ,,
STATE LICENSE: # ;��;�;�;��
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration K'c r'`'` `"
PROPOSED WORK (describe in detain: �-,� ,.,,�, � y �,�, _,�y��,�_, i ,� � �,��.,. .i <�_..
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ i 1 � � 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 pernut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: .%`�<�-�� � ������/ DATE: ':���J'i�`!-)--
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NOTE! Parade of 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 RIGHTS OF SUB.TECTS OF DATA
Subd. 1. Type ot 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 confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the mquested data within the collecting'state agency, polirical subdivision,or statewide system;
(b)whether he may refuse or is legally required ro supply the requested data;(c)any known consequence arising fmm his supplying or refusing to supp(y
private or confidential data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesriearive dara, pursuanc to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or propem tax refund
instrucdons instzad of on[hose forms.
Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whe[her it is classified as public, priva[e or confidenrial. Upon his further request, an individual who is the 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 informed of the content
and meaning of that data. Afrer 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 action pursuant to chis secrion is pending or addidonal data on the individual has been collected or created.
The responsible 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 cosrs of making, certifying, and compiling the copies.
The responsible authoriry shall compiy immediacely, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and leeal holidays,if immedia[e compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal 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 individual may contest the accuracy or completeness of public or private
data conceming himself. To exercise this rieht,an individual shall norify in writing the responsible authoriry describing the nature of ihe disagreemen[.
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)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act relating 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 request
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. 1fie information you furnish will be used to determine your qualification for the pemut 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 permit 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.
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Address � � 5 5�. �; /j �� c. -
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City . State Zip Phone
I understand my rights as stated above.
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/ Signamre ��
ATE TIME
CITY OF ORONO CALLED IN `'��S J
INSPECTION N�TICE SCHEDULED ��Z��
PERMIT NO. � � ��/ COMPLETED �_ � ��-�L�
ADDRESS �;� �c �
OWNER� CONTR. �
TELEPHONE NO. '�7-S �.2C'i �7
� DESCRIPTION /��i �-�
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLINQ
y 02 FRAMING 13 MECHANICAL FINAL 19 LAf�SHORE/WETLANDS
Q 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 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBIN�FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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PROJECT COMPLETE
W C CORRECT WORK 8 PfiOCEED - ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CAL�FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. -, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance.473-73rJ7
OwnerlContra r s t :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �'„�Z:� �
INSPECTION NOTICE SCHEDULED �.�3 %> // � 3b
PERMIT N0. ��%�
COMPLETED ���?-�� J I �3J
ADDRESS �.�=��� C�% �
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OWNER � ��-� CONTR. �,�kizs-c z �
TELEPHONE NO. � �-S"�C�l �
� DESCRIPTION ��Q_2_pa�
� 01 FOOTING 11 ECHANICAL RI 18 EXCAV/GRADING/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 VUALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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�Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATiSFACTORY PROCEED
W PROJECT COMP�ETE
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� i= CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
C1 STOPORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73rJ7
Owner/Contractor �
Inspector. � (� -�-
White Copyllnspector's File Canary Copy/Site Notice