The URL can be used to link to this page

Home My WebLink About2008-00218 - roofing . w. ' CITY OF ORONO PERMIT NO.: 200&00218 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �SSUEv: 09/15/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 185 HACKBERRY HILL PIN : 33-118-23-44-0008 LEGAL DESC : DANIELS LONG LAKE HEIGHTS : LOT 001 BLOCK 002 PERMIT TYPE : MINOR ALTERAT[ONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 4,000.00 NOTE: RF,MOVE OLDER PAR"I OF ROOF ON HOUSE AND GARAGE-REROOF/TEAR-OFF APPLICANT PERMIT FEE SCHEDULE 103.25 D.B. RASKOB CONSTRUCTION STATE SURCHARGE(VALUATION) 2.00 2864 ARDMORE AVE MEDINA, MN 55359 TOTAL 105.25 (763)479-1393 Minnesota State License#: 3481 OWNER PERRY,JEAN 185 HACKBERRY HILL LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicarrtis�,esponsible for assuring all required inspections are requested in conf�rmance wi[h the Sta uilding Code.This permit may be revoked at any�(me for due cause, � �'� � "� �' � � ��"J L, �� 7 �� 5�0� Applicant Permitee Signature Date Is�u d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . �.. Total Fee: $ ��--5- �S DateReceived: 9��,� �� Entered By: Permit#: l��" - �(� CITY OF ORONO - BUILDING PERMIT APPLICATION . Ali information must be submitted in full before plan review will be started. (please print a[I information) ------------------------------------------------------------------------------------------------------------------------ .---- --, THE APPLICANT IS: (circle one) OWNER O CONTRACTOR ) _� �._ _..—---/ JOB SITE ADDRESS: ��S ��C-�< ✓��?/l'� �� Zjp; S� �S � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �o If yes, a special evenl permit is regui��ed with Police Department and City Council approval v 60 days prior to the event. Shuttle bus service wiU be reguired unless applicani demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: ��r� ��'-�/'`-� PHONE: (home) ��7.3` �6 6 7 / n (work) MAILING ADDRESS:/�� '��LCd"� �-r' CITY: ZIP: CONTRACTOR: �)� �Z�,�C:� C�,;15 � PHONE: %G 3 ��% �J�j� CONTACT PERSON: (,v� /L AS�� MOBILE/PAGER: 61.z�6 S"-��7 MAILING ADDRESS• � �j('.v�C�n��. �'�,+� CITY: ��'-�� n � ZIP: 5,S 3.s�1 STATE LICENSE: # .� �� EXPIRATION DATE: .S- "6 9 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) _� ' s�'�/� Any earth movement may require MCWD review and permit PROPOSED WORK(describe in detain: �.n�-c�.2_ G � C�� + � (`�-�� tst� 12��, --� F�,r�1�2� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED �1 L�L-' ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 7 CS�)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 permit and wo is not to start without a permit;and that the wark will be in accordance with the approved plan. ,�r� / =� �/� ,/ �. APPLICANT'S SIGNATURE: ��('��viY /5��/DATE: � �� `�'' � 31 .� . Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. ]. Type of data. The righu 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 private orconfidential dataconceming himselfshall be informed of. (a)the purpose and intended use of the requested data within the collecting state agency,pol itical 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 da[a;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforoement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or pro�ertv tax refund instructions mstead 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 data 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 ofthe 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 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 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,excluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. Ifhe cannot comply with the request within that time,he shall so inform the individual,and may 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 da[a conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days either (a)correet the data found to be inaceurate 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 disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of 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 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 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. ��t�� j2✓1S1�� First Middle Last �l� G� cv�� w.rl G�t�- Address �yj['r�-,�� /�Y! �"✓ S ��S � �L�S � �� J�� City State Zip Phone - ---� I understarJd my right�as stated above. /' ' — ! Signatute Reset Form 32 f �� 1.� DATE TIME � CITY OF ORONO CALLED IN _� '� INSPECTION NOTICE �j SCHEDULED G1 ��,-f� � PERMIT NO. 1_[��•- ��'Z�O COMPLETED �� ADDRESS f�CZC �-i�/'T"1-- OWNER CONTR. �g TELEPHONE NO. �' �� —�LO J � c1Cr �� DESCRIPTION �� L-�� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUM8ING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:�YES�NO � COMMENTS: � W a � J O a � O � ti � Q � Z W � W � � d W �K SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �j pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ tNSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContract n i : Inspector. �`- _� White Copyll�spector's File Canary Copy/Site Notice