HomeMy WebLinkAbout1999-012132 - tear off reroof PERMIT
CITY OF ORONO PERMIT TYPE: -
. 2750 Kelley Parkway - P.O. Box 66 �
� Crystal Bay, Minnesota 55323 Permit Number: .__ _....
(612) 249-4600 Date Issued: � _ _ __ -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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PPUCANT/PER EE NAT ISSUED BY:SIGNATURE
� _ Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 7�� C� .�Q�n ��9��-�' ZIP: Jf,S..���
NAME OF OWNER: �,��iQ PHO:�TE: (home) ,3��' (oDyO
(work
MAILING ADDRESS: 7�� C7 CITY: ZIP: ,�.5 3 9 �
CONTRACTOR: l � ` PHO�TE: �a� `t� Y� X
CONTACT PERSON:_��' MOB /PAGER:� �— �/
MAILING ADDRESS:�G�{.� t�•s �(S 5 CITY: ,��� � ZIP:
STATE LICENSE: # ao/0 3i�5 `✓"s`���
ARCHITECT/ENGINEER: PHO�TE:
MAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
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TYPE OF WORK: New Addrtion Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�:
STORIES: _� SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIvi 1ATED CONSTRUCTION VALUATION (excluding lanc�: $ �� ��
I hereby apply for a building permit and I aclrnowledge that the information above is complete 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 ermi nd work is not to start without a
permit; and that the work will be in ac rda wi e a roved plan.
APPLICANT'S SIGNATURE: � DATE: �� � / �
NOTE! Parade gf Homes events requc parate permit approtial by Police Deparlment and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
_ �
Sec.13.04 RIGHTS OF SL'BJECTS OF DaTA
Subd. i. Type of data. The righ�s of individual on whom che data is stored or co be stored shall be as set fonh in this section.
Subd.'_. Information required to be given individual. .1n individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecang'state agency, polidcal subdivision,or statewide system:
(b)whether he may refuse or is legally required to supply che requested data;(c)any known consequence arising from his supplying or refusing to supply
private or conndendal data;and(d)[he identity of other penons or enndes au[horized by state or federal law to receive[he data. This requirement shall
not apply when an individual is asked to supply invesagadve data, pursuant to secaon 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 propertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data bv individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals, and whecher it is classified as public, privace or confidenaal. Upon his further request, an individual who is the subject
of scored private or public data on individuals shall be shown�he dara wichout any charge to hun and, if he desires, shall be informed of the contenc
and meaning of tha[data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hun for
six months thereafter unless a dispute or acaon pursuan[to this section is pending or addidonal data on the individual has been collected or created.
The responsible aurhoriry shall provide copies of the private or public data upon request by the individual subjecc of che data. The responsible authoriry
may require the requesring person to pay the actual cosu of makine, cerdfying, and compiling[he copies.
The responsible authoriry shall comply immediately, if possible, wi[h any request made pursuant to[his 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 wi[h 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 noafy in writing the responsible authority describing the nature of the disagreement.
The responsible au[horiry 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 correcc. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disctosed data.
The de[ermination of the responsible au[horiry 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, "RiQhts 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 permit or license requested.
2. You may refuse 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 agencies to the extent necessary to process
the permit or license.
4. If your requested pernut 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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First vtiddle � Last
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Address �� ��y� 6,a � � y�y
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Ciry State Zip Phone
I underst m ri tated ab .
Signature
DATE TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE SCHEDULED �_ / �•�
PERMITNO. �I�I.� COMPLETED � `- ��,��� ��
ADDRESS �3� ��a �l� �
OWNER CONTR. - I���`�? CG'I��'1�"v�,�
TELEPHONE NO.
-� . ,-
� DESCRIPTION .-�--� � l,L Cl-�' �';C �-�
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMIN� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� C7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,—, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector. =. ��°.,,1'c �,C� /� f
White Copy/lnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED Z��"
PERMIT NO. � I�'(T�c� COMPLETED / �'����T P��� 9
ADDRESS �� ���i'� �-rC -
OWNER CONTR. ��r�' C'.G��1��
TELEPHONE NO. __ .��- �LlI �'3��
� DESCRIPTION dh �C���
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
0=INAL � 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
D COMMENTS:
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�ORKSATISFACTORY:PROCEED �ROJECT COMPLETE
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W L� CORRECT WORK&PROCEED l ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �j pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector.yL,,�� -r
White Copylinspector's File Canary CopylSite Notice