HomeMy WebLinkAbout1998-010620 - tearoff/reroof PERMIT
4 �'TY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 =:k'"`=-�'3`''�`;
Crystal Bay, Minnesota 55323 Permit Number: ;.i�_;;-,'�;-,
(612) 473-7357 Date issued: ;#;,f'�-;,�_�;;-;
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANfi'PE ITEE GNATURE ISSUED BY:SIGNATURE --
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� Td'�il Fee: $ Date Received:
Entered By: �% � Permit#: ;�� ,�'. :; :
CITY OF ORONO - BUII�DING PERMIT APPLICATION �
All information must be submitted in fu11 before plan review will be started.
_ (please print all information) .
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. . . . . . .
THE A,PPLICAItiTT IS: (circle one) O�NER OR NTRACTO �
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JOB SITE ADDRESS: � � C G-iV ZIP: �� �,�(�=
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� NAME OF OWNER: �U�r� �- P(�� 1 PHO�tE: (home) 4�� ��G���
� (work)
MAIGING ADDRESS: �1-(U� � l. �iv CTTY: �)1p..c�n,v ZIP: >�
CO�TTRACTOR: ��'��S�v�w C�� � S� � � PHONE: ��I�-v��� ��
CON'TACT PERSON: trb w` 3�11-lc�ti s OBILElPAGER: �
MAII�ING A.DDRESS: �7 o S ^%���1� (�7 I(�`t CITY: ���vu,�;�rN ZIP: ��yY
STATE LICENSE: # ��o i�{2 �� .
AI'.CHITECT/Ei�'GINEER: PHO�TE: �
MA]I,ING A.DDRESS: CITY: ZIP:
T,T��: REGISTRATION#
TYPE OF tiVORb'.: New Addition Accessory Structure
Move � � RemodeUAlteration ✓ Land Alteration
PROPOSED tiYORK(describe in detai�: �� , ��e /�U�= _
STORIES: SQ.FEET OF EACH T'LOOR: • -
NO. OF BEDROOiI�IS: GARAGE STALLS: ATT. DET.
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EST 1MATED CONSTRUCTION VALUATION (excluding land): $ C�, �� �e �
I hereby apply for a buildin;permit and I aclrnowledoe 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 a permit and work is not to start without a
permit; and that the work will�ae-ia rdance with e approved plan.
APPLICANT'S SIGNATZTRE: DATE: � � f Z^ �7 ta
NOTE! �Parade of Homes events require se�arate permit approval by Police Department and
� City Counci160 days prior to the event. Non permiited events will not be allowed.
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Sec.13.0.RIGHTS OF SIIB.JECTS OF D�,TA .
Subd. i. Typc of data. The righcs of individual oa whom the data is stored or to be scard shaIl be as set forth in this secaon. -
Subd.2. Informatioa req�red to be givea individual. An iadividual uked to supply private or confidenrial data conceming himself shall
be informed of: (a)the purpose and incended use of the r�qucs�daca wichia[he collecang Sute agency,potiacal subdivisioa,or satewide rystem;
(b)whether he may r_fuse or is legally requi-:d to supply the requesud daca;(c)any Irnown coasequcnce arising from his supplying o�refusing w supply
privam or confidendal dara;and(d)ehe idenary of ocher peaoas or enddes auchocized by scate or federal law co teceive the dam. This requiremeat shall
not apply when an individual'u asked to supply invesdgadve dam,pu�suan�to secdon 13.83,subdivision 5.to a law eaforcement officer. •
'ihe commissioner of revenue nav place the noace reauir.d under this subdivision in the individuai income raz or orooem taz refund
ins�rucdons inscead af on those forms.
Subd.3. Accas to data by iadiridual. Upon requesc to a responsible aurhoriry,an iadividual shall be informed whether he is[he subject �
of stnrd dara on individuals,and whaher ic is dassified as pubiic,private or conFdenrial. Upon his furcher request,an individuai who is the subject
of scored privace or pubiic dat►on individuaIs shall be shown the dara wichout any eharge to tiim and;if he desires,shall be informed of the eontenc
and meaniag of chat daca. Aher an individual has been shown ehe privace dara and informed of iu meaniag,cbe dara need not be d'uclosed to him for
six monchs[heceaiur ariless a dispuce or acaon pu�suan[to �his secdon is pending or addidonal daca on the individual hu been co[iecmd or ereared.
The r:sponsibie au�horiry shall provide copies of the privace or public da[a upon requesc by the individu�l subjecc of�he dara. 13e responsible auchoriry
may require[he requesang person to pay the accual cosis of making,cerrifying,and comp�ing the copies.
'Ihe responsible aurhoriry shall comply immediacely,if possible,wi�h any request made pursuant to this subdivision,or wichin five days of
the date of che requesc,exciuding Sanicdays.Sundays and tegal holidays,if immediace compliance is not possible. If he cannot comply wi�h the requesc
wi�hin chac ame,he shall so inform che individuai,and may have an addidonal five days wichin which to comply wich the requesc,e�cluding Saairdays,
Sundays and legal holidays.
Subd.4. Pracedure v�hen data i�not accurate or eomplete. M individual may coatest the accuracy or compleceness otpublic orpri�ate
dara conceming hinself. To ezercise chis ri¢ht,an individual shall nodfy in wridng the respoasible auchoriry describing the nature of the disagceemeat
The responsible auchoriry shall within 30 days eicher: (a)eorrect che dara found ro be inaccurate or incomplae and attempt co nodfy pazt ncipieau of
inaccurcce or incomplete daca, induding recipienes namcd by�he individusi; or(b)noafy the individaal that he believes the daca to be cocrecc Data
in dispute shail be discloscd only if the individual's sc�cem�nt of disagreement is included wich the d"uctosed daca.
Tha dececminaaon of che responsible au�horiry may be appealed punuant to the provisions of che admicusaaave procedure act relaang to
contestcd casts.
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 Ciry of Orono or any of its departments may require you to furnish cercain private or
confidential informacion. "
You aze 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. Zhe information may be shared wich other local, sta[e or federal agencies to the ezcent necessary to process
' the permit or license.
4. If your requested permit or license requ�res Council actlbn to approve, some information may become
public.
5. You hav� ceriain rights under M.S. 13.04 (available upon request) to review private daia on yourself.
6. Your full name is required to process this application or permit. . •
�c�/�i�Z�� � y�}—�J� i'�rc—c,t-�i2 .
First tifiddle L.asc
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Address
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Ciry Snm Zip Phone
I undecstand my ri�hts az state above.
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Signature ..._ _-_ .
DATE TIME
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CITY OF ORONO CALLED IN _�,Zrrt
INSPECTION NOTICE c�° �`�� SCHEDULED ��'��-� "��
PERMIT N0. `�j COMPLETED =+� � ti�
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ADDRESS O S C-c, � ��-�--
OWNER � � CONTR.��1��.(.�-�-L��
TELEPHONE NO. `T?S" ����.3 ���47/ �l
� DESCRIPTION ��/4-t`L`�
�
l� 01 FOOTING 11 MEC ,4NICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICA�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
�_05 FI��NAL ��> 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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d , WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
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� ❑CORRECT WOFK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL REfURN ❑ PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR �- CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
Owner/Contrae�tono s�'te:
Inspector. �- ,
White Copy/lnspector's File Canary Copy/Site Notice