HomeMy WebLinkAbout2006-P10188 - re-roof PERMIT
C�TY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o188
�rystal Bay, Minnesota 55323 Permit Type:
Minor Alterations
(952) 249-4600 Date Issued:
8/7/2006
SITE ADDRESS: 4079 Highwood Rd Unit#
Mound,MN 55364
PID: 07-117-23-44-0010
DESCRIPTION:
Proposed Use: Residential Census Code O/S-Building
Pcrmit Class: Building
Pcrmit Type:
Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Scparate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 8325 Valuation: $ 2,500.00
State Surcharge Fee: $ 1.25
TOTAL FEE: $ 84.50
APPLICANT: Incline Enterprises Inc OWNER: John Sanborn
26175 Birch Bluff Rd 4079 Highwood Rd
Shorewood,MN 55331 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES O DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOT UILDING CODE REQUIREMENTS.
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APPLI N"I'PERM[TEE SIGNA URE ISSUED BY SIGNATURE
Copics: I-File(Signar�n•es�Reqi�ired), 1-Applicant, 1-Monthly Reports, I-Assessing,(If Septic, I-Septic) Pa�e I
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Total Fee: $��, S Date Received:� 7
Entered By: ��"'�.-� Permit#: ( ��`�
CITY OF ORONO - BUILDING 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: (ci�•cle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �'�/ � � �{-�{,���,�„x� �� ZIP:
V1'ill this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ 1'es �No Ifyes, a special event permit is required with Police Depart�nent and City Council approval
60 days prior to the event. Shuttle bus service will be requi��ed unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed
NAME OF OVVN�R: ��� �U,,,-,�c}rt�1 PHONE: (home)
1I (work)
MAILING AllDRESS: C"�l� �`� t-t�y�„��=�� '�,� CITY: (���f�n� ZIP:
CONTI2ACTOR: /�c I,n� L'n(--�,�-��-�:�' PHONE: �'Ii `��� `1�(�3'
CONTACT PERSON: la-.�.� Sc�,��.(vz� MOBILE/PAGER: ���- �z� yo��
MAILINGADDRESS: �C�i �r 1�;�w 13��r� �� CITY: 5�;,�w:E� ZIP: s�;i�
STATE LICENSE: # ZJ��,����c EXPIRATION DATE: 3 - 3� - ��
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF VVORK: New Home Addition Accessory Structure
Move Home Reinodel/Alteration (ie: Sidi��g, Windows) k
Any earth movement may require MCWD review and permits !
PROPOSEll WORK(describe in detai�: -��u,� a!-!r � ,r�����-
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTKUCTION VALUATION(excluding land): $ �� ���c�
I hereby apply for a bui(ding permit and I acknowledge that the information above is complete and accurate;
tliat tlle work will be in conformance witll the ordinances and codes of the City and with the State Building
Code;that I understand this is not a pennit 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: � �' ��`��
31
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Sec.13.04 RIGHTS OF SUBJECTS OF D.4TA
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 private orconfidential dataconcerning himselfshall be
informed of. (a)the purpose and intended use of the requested data within the collec[ing 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 federai law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdfvision 5,to a law enforcement officer.
The commissioner of revenue mayplace the notice reguired under this subdivision in the individual income tax or proper[v 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 data on individuals,and whether it is classified as publ ic,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 char�e to him and,if he desires,shall be informed of the content and
meaning of that data. Afrer an individual has been shown the private data and informed of its meaning the data need not be disclosed to him for sia
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 authority shall provide copies ofthe private or public data upon request by the individual subject ofthe 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 ofthe request,e�cluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. If he 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 data
conceming himself. To exercise this right,an individual shall notily in w7itin2 the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days 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 disdosed only if the individual's statement of disagreement is included���ith 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 PRNACY 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.
^ �� ` � SC,��e,,,1 c�e. �
First Middlc Last
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Address
�1��� lu s���1� CS-� 3�3-- �i�?�
City State Zip Phone
I understan y r ghts as stated above.
Signatur
Reset Fom� 32
�� DATE �E
CITY OF ORONO CALLED IN ��
INSPECTION QTIC� Q� SCHEDULED � „
PERMIT NO. � 1 l� � O d COMPLETED ��
ADDRESS `��� ! � I� /A r5n � r�'� -
OWNER CONTR. .��'1 C;I�V�- C=/t I�ef�'�JZ.S
TELEPHONE NO. C�� �-J���7
� DESCRIPTION ��'�'� d��
l� 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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W , WORKSATISFACTORY:PROCEED �� PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑ CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L PHOTO TAKEN
INSPECTOR WIIL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the xt inspection 24 hours in advance. (J52� 249-4600
OwnerlContr o site:
Inspector.
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