HomeMy WebLinkAbout2001-P03573 - re-roof .
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� PERMIT
C I TY O F O RO N O Permit Number:
2750 Kell�y Parkway - PO Box 66 P03573
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: 3i2i2oot
SITE ADDRESS: 50 Hackberry Hill
LONG LAKE, MN 55356
PID: 33-118-23-44-0025
DESCRIPTION:
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 4,807.00
State Surcharge Fee: $ 2.45
TOTAL FEE: $ 113.70
APPLICANT: W�ndow Star Home Improvements Inc. QWNER: MARY RIGELHOF AUTRY
12322 Business Park Blvd. 50 HACKBERRY HILL
Champlin, MN 55316-0000 LONG LAKE MN 55356
THE UNDERSIGNED I-IEREBY 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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APP I ANT P [TEE I ATURE ,1�[SSUED BY SIGNATURE '
Copies: City,Applicant,Assessor, Finance Page 1
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Total Fee: $ - f��� �� -;�
� 7�' Date Received: -�1�
Entered By: i��'u-- Permit#: t�G � S ��
CITY OF ORONO - BUII.DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � � �-� �`��-�'�r��( �r l� ZIP: � S� � � �
NAME OF OWNER: ���cf �� i� ��r y PHO��tE: (home) % � �-�1?1=Uo�(
-� (work) `� �.� ti�-i;� y�3�' �_� �Lc��� z
l�1AII.I�i tG ADDRESS: �u �'I�, h-vf�
� � �-1'� l/ CITY• G�::-�u ZIp• S �"3�-�
CONTRACTOR: L� w d o w `���� I-I v w-< .1 Ny,�.��-,..,. �i PHONE: 7( � ��I z� �,�� I
CONTACT PERSON: ��� �����; MOBILE/PAGER: b����,�� `�3��
MAILING ADDRESS: i"a��3� �3�:.����s s I��.r � ��'���� CITY: c��-��„ ��r ZIP: ;�>-�� �
STATE LICENSE: # 3� �� y 5 i�i
ARC��ECT/ENGINEER: PHONE:
_ ----- -
1�1AILING ADDRESS: � -�i�f��------_.____ ___ ZIP:
�J�ME; REGISTRATION# �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: j E� � ,� �., � �� �'`��� "���-�
STORIES: SQ. F'EET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIi��ATED CONSTRUCTION VALUATION (excluding land): $ �I � L � c._
I hereby apply for a buildin; pernut 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 acc ance with the approved plan.
, �
� i='� '' � �� DATE: �S - �-v �
APPLICANT S SIGNATURE: ,
NOTE! Parade of Homes events require separate permit approval by Police Deparlment 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 SUBJECTS OF DaT�
Subd. 1. Tvpe of data. The rights of individual on whom[he data is stored or to be stored shall be as sec forth in this secrion.
Subd.2. Information reqirired to be given indiridual. �.n individual asked to supply privace or confidendal data concerning himself shall
be informed of: (a) che purpose and in[ended use of the requested dara within the collecring"stace agency, pofidcai subdivisioo,or statewide rysum;
(b)whe[her he may refuse oY is legally required to supply the requested data:(c)any Irnown coasequence arising from his supp(ying or refusing to supply
priva[e or conndendal data;and(d)the idenary of ocher persons or endaes auchorized by state or federal law to receive the data. 'Ihis requir:meat s6a11
noc apply when an individual is asked to supply invesrieadve dara, pursuanc to secaon 13.82, subdivision 5, to a law enforcemenc o�cer.
The commissioner of re�enue r�av place the norice reauired under this subdivision in the individual income tax or propem nx refund
instructions instead of on those forms.
Subd. 3. Access to data by indi�-idual. Upon requesc to a responsible auchoriry,an individual shall be informed whether he is che subjecc
of scored data on individuals, and whe[her it is classified as public, privace or confidenrial. Upon his further request, an individual who is�he subjecc
of scored private or public data on individuals shall be shown the data wichout any cnarge to hirn and,�if he desires, shall be informed of�e concenc
and meaning of chac data. Aftzr an individual has been shown the priva[e data and informed of its meaning, the data need not be disclosed[o him for
si�c mon�hs chereafrer unless a dispute or acrion pursuan[to this secdon is ptnding or addicional data on the individuai has been collecezd or creaced.
The responsible auchoriry shall provide copies of the private or public data upon request by the individual subjecc of rhe data. The responsible authoriry
may require the requesring person to pay the acnial cosrs of making, cerdfying, and compiling the copies.
The responsible authoriry shall compiy immediately, if possible, wich any request made pursuant to this subdivision,or within five days of
the date of the requesc,excluding Saturdays,Sundays and leeal holidays,if immediace compliance is noc possible. If he cannoc comply with�he request
within thac dme,he shall so inform che individuai,and may have an addidona!five days wichin 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 pri�•ate
data conceming himself. To exercise chis right,an individual shalt noafy in wriring the responsible authoriry describing�he nacure of the disagreement.
The responsibte au�horiry shall within 30 days eicher: (a)correct che data found to be inaccurate or incomple�e and attempc to noafy past rcipiencs of
inaccurate or incomplete data, including recipiencs named by[he individual; or(b)notify the individual that he believes[he data to be correct. Data
in dispu[e shall be disctosed only if the individuai's sta[emen[of disagreement is included with the disclosed data.
The de�erminarion of the responsible auchoriry may be appealzd pursuanc to the provisions of the adminiscrarive procedure act relaang to
contesced cases.
DAT?� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your reauest
for a permit or license from the City of Orono or any of its departments may require you to furnish certain priva[e or
confidential information.
You are notified that:
1. The information you fumish will be used to determine your qualification for the pemut or license requested.
2. You may refuse to supply data, but refusai may require tha[ the Ciry deny the permit or license.
3, The informa[ion may be shared with ocher local, state or federal agencies [o the excent necessary co process
the permit or license.
4. If your requested permit or license requires Council action to approve, some informacion may become
public.
j. 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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I understand my rights as stated a,bove.
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Signature
� DATE TIME
CITY OF ORONO CALLED IN `�"���/
INSPECTION NOT �,35.73 SCHEOULED �-rJ D l ` c%.
PERMIT NO. COMPLETED �—�"7� � ` � �
ADDRESS :�U �i4C/���/�'y /LL,
OWNER j�9r°..�, /S�Nr1l�v��'v� CONTR.//.�`r�t(�G1r�.S'fZv� ��t�.� ,rh-�L'%"G'✓
TELEPHONE N0.
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� DESCRIPTION ���1�✓� l i1 �i�l'c,��
� 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING
Q 02 FRAMING 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNOATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �yNORKSATISFACTORY:PROCEED �ROJECTCOMPLETE
W (O CORRECT WORK 8 PROCEED � ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALLINSPECTOR
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46�0
OwnerlContract r site:
Inspector. �-�"� �R-��
White Copyllnspector's File Canary CopylSite Notice