HomeMy WebLinkAbout1996-007986 - tear-off/re-roof gutt PERMIT
� �I�Y OF ORONO �
PERMIT TYPE:
:� '50 Kelley Parkway - P.O. Box 66 ;:;���� ;3�r:�;�;
Crystal Bay, Minnesota 55323 Permit Number: �f;V}f,�;�;�,
(612) 473-7357 Date Issued:
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
� �'Total Fee: � DateReceived:
DateApproved:
Entered By: Permit�:
CITY OF ORONO - BLTILDING PERII�IIT APPLICATION
ALL I�YFOFt1vIATION I�LUST BE SLB�IITTED IPI FULL BEFORE PL��REVIEtiV tiVII..L
BE STARTED
---------------- -------
THE APPLIC��t'I' IS: (circle one) OW�tER OR CONTR.ACTOR
`� Jos srrE �n��ss: ,�'�`� ��; �'����h �,�� � ��� z�:
Na���oF o�v�,-�x: �����e1� �--��a���� - Pxoti-E: �nome> �-1�1�1-9``��'�
?� («-oric>
l�1AILI�i 1GADDRESS: ����J�En`�-�L.����. CITY: ��rC- (1�� ZIP:
.� CO�t'TRACTOR: W�����c �C��`� ����C ��' 1 PH0�1E: C��� ' (`���C �t
j` I�IOBILE P�IO�tE/PAGER:
MAILINGADDRESS: ��O�j � v�� ��t=�I �� CITY: 'r'�� �; ��,_ � ZIP: r�`-� I
STATE LICENSE: # CX% 1'--� �
ARCHITECT/ENGINEER: PHOivE:
I�IAILIPtG ADDRESS: CITY: ZIP:
NAlvIE: REGISTRAT'ION #
TYPE OF WORK: New Addition Accessory Structure
Move RemodellAlteration Lan�Alteration
PROPOSED WORK(describe indetail}:
STORIES: _______ SQ• �T OF EACH FLOOR: _
NO. OF BEDROOMS: G�RAGE STALLS: ATT. DET.
. ��;,
� ESTI1�i IATED CONSTRUCTION VALUATION(escludingland): $ ��t"��-�--'�
I hereby apply for a buildin� permit and I acknowledge that the information above is comple[e
and accurate; that the work will be in conformance with the ordinances and codes of the Ciry
and with the State Building Code; that I understand this is not a perm.it and work is not to start
without a permit; and that the work wiil be in accordance with the approved plan.
���� �,��� DA'TE: � -�
� APPLICAN'T'S SIGNAT'URE: � � ��= � -- -� .
NOTE! parade of Homes events require separate permit approval by Police Department and
Ciiy Council 60 days prior to the event. Non permitted events will not be allowed.
�
Sec.13.04 RIGHTS OF SUB.JECTS OF D?�T?.
Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored s6all be as set forrh in rhis secaon.
Subd.2. Information reqirired to be�ven individual. ?.n individual asked to supply priva[e or confidenaal data concecning himself shall
be informed of: (a) the purpose and incended use of[he requested data within the collecang'stace ageocy, poliacal subdivisioo, or statewide system;
(b)whether he may refuse or is legally required ro supply the requested data;(c)any lmown consequence arising from tvs supplying or refusing to supply
priva�e or confidendal dara;and(d)cbe idenary of other persons or enaaes authorized by stace or federal law co receive the data. This requirement shall
noc appty when an individual is asked co supply invesrigadve dara, pursuan�ro secnon 13.82, subdivision 5, to a law enforcemenc o�cer.
The commissioner of revenue mav place [he noace required under ehis subdivision in the individual income tax or orooertv tax refund
insttucrions inscead of on[hose forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whe[her he is the subject
of stored data on individuals,and whe[her ic is classified as public, priva[e or confidenoal. Upon his further request,an individual who is the subjecc
of stored private or public data on individuals shall be shown the data withouc any charge to him and, if he desires, shal]be informed of the concent
and meaning of thac data. After an individual has been shown�he private dara and informed of ia meaaing, the data need noc be disclosed to him for
six monchs thereafter unless a dispuce or acdon pursuant to this secaon is pending or addirional data oa rhe individual has been collec[ed or creaced.
The responsibie au[horiry shall provide copies of the privace or pubtic data upon request by[he individual subject of che data. The responsible authoriry
may require the requesring person to pay the acnial costs of cnaking, cerafying, and compiling the copies.
The responsible authoricy shall comply immedia[ely, if possibie, wich any request made pursuant to this subdivision, or wichin five days of
the date of[he reques[,excluding Saairdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request
wichin that time,he shal(so inform the individua(,and may have an addidonal Five days wi[hin 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 ot private
data conceming himself. To exercise�his right,an individual shall noafy in wriang che responsible authoriry describing the nature of the disagreement.
The responsible auehoriry shall wichin 30 days either: (a)correc�[he data found to bz inaccura�e or incomplete and attempt to nodfy past recipienrs of
inaccura[e or incomplere data, including recipients named by �he individual;or(b)nodfy [he individual that he believes the data to be correct. Dara
in dispuce shali be disclosed only if[he individual's statement of disagreemenc is includzd with the discfosed data.
The determination of the responsible au[horiry may be appealed pursuant to che provisions of the adminiscraave procedure ac[relating to
con�ested 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. The information you furnish will be used to determine your qualification for the perm.it or license requested.
2. You may refiue to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal a;encies 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 cenai.n rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process [his appiication or permit.
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Addre l� ����� (�1�j�� ! ���1 � ���,�
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Ciry ��
State Zip Phone
I understand my rights as stated abov�_, �
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Signacure
DATE TIME
CITY OF ORONO CALLED IN � _Z O
INSPECTION NOTIC � scHE�u�e� �
PERMIT N0. COMPLETED
ADDRESS ���� f'/�ta.Pil r' �lcP�
OWN ER CONTR.
TELEPHONE NO.
� DESCRIPTION '(�°- —'r0
� 01 FOOTINO 11 MECHANICAL RI 18 IXCAV/dRADINO/FIWNO
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAi�SHORElWETLANDS
Q 031NSULATION 24/25 WOOD BURNER/FiREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
_ � 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBINO RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �ORK SATISFACTORY:PROCEED , PROJECT COMPLETE
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� O CORRECT WORK&PROCEED C: ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE COND�TION WITHIN HOURS. �� pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOPORDER POSTED.CALL INSPECTOR '= CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra s e
Inspector. - �'�
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