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Home My WebLink About2004-P07718 - windows . a ♦ PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po��is Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: ��19izoo4 SITE ADDRESS: 8o Hackberry Hill LONG LAKE,MN 55356 P I�: 3 3-118-2 3-44-002 2 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: .,,�-�-- - - ---� —�-�-- --�------- - -� ----,--- __...,..�...�........ .........��.�r:�..�...�......... ........,..� ...... . . ... ..... ............. FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 7,000.00 State Surcharge Fee: $ 4.00 TOTAL FEE: $ 143.25 APPLICANT: JAMES ERICKSON MOCK OWNER: JAMES ERICKSON MOCK 80 HACKBERRY HILL 80 HACKBERRY HILL LONG LAKE MN 55356 LONG LAKE MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. -� � ��-- � �� AP ICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Si¢nitures Required), 1-Applicant, 1-Monthlv Reoorts. 1-Assessine, 1-Finance Page 1 ♦ �� I (_I V 1 �� Total Fee: $ /�J�� J Date Received: 7-/Q-D� Entered By: Permit#: �� 7 7�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pri�zt all i�iforr�zation) ------------------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWN 'OR CONTRACTOR JOB SITE ADDRESS: �f`Q �ac��..�-,�,�,� �-� c �,� ZIP: � � 3 S L Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required with Police Department aizd City Council c�ppYoval 60 days prioY to the event. Non permitted events will not be allowed. NAME OF OWNER: �Q w�k 5 � c� � � PHONE: (home)_`�S� - �(?S-`�"?� I (work) � � 2. - 3 i :3 -- �? ��o MAILING ADDRESS: �� ;c��.�,��r� �� ( CITY: � �Q t.rt o ZIP: ��';�, CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration �k` Land Alteration PROPOSED WORK(describe in detai�: (�:�,,,.,r ��( k..�,�.,��, ; ,,� ,-1-�I, .2 t,�; ,� �Q<<�% ; .S l,-, �t�l�� l�•,v-w-�f C3�� I��._0 1 a � [.r ✓:n � i�c c �ri i.s �h �Q�� ( S'c►vr�� S� Z-�� STORIES: SQ. FEET OF EACH FLOOR: � (� C NO. OF BEDROOMS: 3 GARAGE STALLS: ATT.�_ DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �, pc; e I hereby apply for a building 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 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: � - � �1 " C' y .+ . , Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply priva[e or conCdential data concerning himself shall be intormed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement oTficer. The commissioner of revenue mav U�ace the notice required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored duta on individuals,and whether it is classified as public,private or confidential. 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. After 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 this section is pending or additional data on the individual has bee�collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,ercluding Saturdays,Sundays and Iegal holidays,if immediate compliance is not possible. If he cannot comply with the requestwithin that time,he shall so inform the individual,and ma,y have an additional 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.Thc responsible authority shall within 30 duys either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients 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 disagrccment is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions o(the administrative 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 infor�n 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 con�dential 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 refusa!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 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. First Middle Last Address City State Zip Phone I understand my rights as stated above. G'G��'-v`e-- Signature � V C!/ D E TIME CITY OF ORONO CALLED IN ��- INSPECTION N ICE SCHEDULED !/-/S-O� -o� PERMIT NO. 77 COMPLEfED ADDRESS D C� OWNER ✓�d /�4�-C� NTR. TELEPHONE NO. 101a ��o� 7l SO � DESCRIPTION ��-� �� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 1; 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 OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTORTOMEETYOU:_YES_NO � COM�,ENTS: a �' � � c,�I/� iruv+� � vl�i�r'' � ` ' � `— C�,S � Cl. � � � � 0 � W � Q � Z W � W � � � d W� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE W ❑ ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O RRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REOUIRED.CALLTO ARRANGE ACCESS. Cali for the ne t inspection 24 hours in advance. (952� 249-4600 OwnerlContracto ite: Inspector. White Copyllnspector's File Canary Copy/Site Notice � � DATE � TI�� CITY OF ORONO CALLED IN � ��' INSPECTION�I SCHEDULED � PERMIT NO. � � COMPLETED ADDRESS_ __ � �C-�O�i��-� �LC OWNEFt..J�M h�Y�CCC. CONTR. TELEPHONENO. �� - ��a �2�0 � DESCRIPTION��w+. �?a.L� v��c�c�u�S lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS ti Q 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 06 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 COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O >. � O � W � Q � Z W � W � � d W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe n t inspection 24 hours in advance. (952� 249-46�0 OwnerlCo ite: Inspector. 1 White Copyllnspector's le Canary CopylSite Notice i� CITY OF ORONO C LLED IN ��D� TIME INSPECTION NO E --7 (J CHEDULED �,(19'/�S � PERMI [ ��rl COMPLETED A RESS �U �IQCi�V�f'-Yll� /-�� lI WNER �_)�vY► MOG�- CONTR. TELEPHONE NO. � �lsO � . > DESCRIPTION �-'� ��-� — �-�'�''�1�-' � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O 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 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 7 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 9 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL JPLUMBING FINAL / 36 FOUNDATION/REMOVAL � WNERICONTRACTOR TO MEET YOU�YES_NO � C MMENTS: a7 ? I"�� w-�� - -I-�r.v� : 7�`+ �Yl[� ��`Zt� ��— � J O � ��Gl vv�� S s �( � 0 � � w � Q z r�o��9 P��. W � W � � a W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContr s te: `�e+'p Inspector. � White Copyllnspector's File Canary CopylSite Notice