The URL can be used to link to this page

Home My WebLink About2008-00320 - roofing CITY OF ORONO PERMIT NO.: 2oos-oo320 2750 KELLEY PARKWAY .�'� ORONO, MN 55356- DATE IssuED: 10/22/2008 � 952 249-4600 FAX: 952 249-4616 ADDRESS : 290 HOLLANDER RD PIN : 25-118-23-43-0011 LEGAL DESC : HOLLY ACRES : LOT 002 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT VALUATION : $ 17,580.00 APPLICANT PERMIT FEE SCHEDULE 309.75 GRUSSING ROOFING 4305 SHADY OAK RD STATE SURCHARGE(VALUATION) 8.79 HOPKINS, MN 55343 TOTAL 318.54 Minnesota State License#: 9212 OWNER MAHAFFY, DALE& SUSAN 290 HOLLANDER RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved pians and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not gran[permission for additional or related work which requires sepazate permits. Ail provisions of laws and ordinances goveming 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 no[ 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 applicant is responsible for assuring all required inspections are requested in conformance with t e tate Building Code.This permit may be revoked� any time for due ca ��' L� �� )._��,_� , ��7�'�� !O i .2,2 / 4 A licant ermitee Signature Date Issued By ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE. 1. �.,�� ' '�-,� Total Fee: $ Date Received: 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) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONT JOB SITE ADDRESS: '� �C �� 1 ( �- �1 � `� �`�a ZIP: � �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS �'1�o If yes, a special event permit is required with Police Department and City Council approval 60 days p��ior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed NAME OF OWNER: ��r�. �� c�, C1 G� ��V PHONE: (home) �� `� 7 5 '-�D 5 Cc� (work) MAILING ADDRESS: CITY: ZIP: 7 CONTRACTOR: r LL� S 5 G �� r %�/ � PHONE: 7�.,Z l'3 5 -�� CONTACT PERSON: � ��,c`v� � •�-u-55, OBIL /P GER: (fz l� �- �3 � MAILING ADDRESS: ��C> 5 S G1 � y �R�ITY: o (�-�?S ZIP: �' `�- `�_3 STATE LICENSE: # (� / � EXPIRATION DA E: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement m�ire M review and ermits! PROPOSED WORK�describe in detai. : � � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED � �� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � � � � �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 confor�mance with the ardinances 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 accordance with the approved plan� _..� aPPLicalvT�s siGNaTUxE: ' � ��'�?'��°� � � � naTE: �� =� ��—l' � 31 .1 . � Sec.13.04 RIGHTS OR SUBJECTS OF DATA Subd. l. 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 or confidential dataconceming himselfshall be informed 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 officcr. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authorit��,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 fuRher 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. Afrer 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 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 shal I comply immediately,if possible,with any request made pursuant to this s�bdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance 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 data 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)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 datato 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 contes[ed 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. First Middle Last Address City State Zip Yhone I understand y rights as stated abo e.� t�� i ��/�%� �) Signature ` � ��'�.: � Reset Form ' 32 ATE TIME " CITY OF ORONO � cI� l ��3/�0� INSPECTION NOTICE SCHEDULED �� PERMIT NO. `�'U 5 " �-��C COMPLETED ADDRESS ' �� '"��h� � OWNER CONTR. � �-�-rC �1.t„ TELEPHONE NO. �� - ��% -� �3 J � DESCRIPTION �-�h � �'/I i � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FR,4MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVA� Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES ' O � COMMENTS: � W C � � O � � O � W � Q ti Z W � W � j d >, W� /�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE . � W ❑CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� Owner►Contractor on site: Inspector. L 1 � White Copyllnspector's File Canary CopylSite Notice TE TIME � CITY OF ORONO CALLED IN �7� INSPECTION�N��OT)I E SCHEDULED —' PERMIT N0.�3S/��D COMPLETED ADDRESS �� 6��`L /e� OWNER TELE OPFE NO. CONTRACTOR � DESCRIPTION ��'t- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q�ON SLAB ❑ WATER HOOK-UP O PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMME � W a / � J O �,y �� .. �e�"d'TN" � ' ,� O � W > � Q � 2 W � W � J d W ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE � ❑CORRECT WORK 8�PROCEED ❑ IS CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR W{LL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTEO.CALL INSPECTOR ❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� -46�� OwnerlContractor on site: Inspector. White Copyllnspector's File anary CopylSite Notice