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HomeMy WebLinkAbout2008-00179 - roofing � +. CITY OF ORONO PERMIT NO.: 2oos-oo��9 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 08/28/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 3508 IVY PL PIN : 20-117-23-42-0024 LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO : LOT 183 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LTNDEFINED VALUATION : $ 13,000.00 NOTE: REMOVE AND REPLACE OLD ROOF SHINGLES,VENTS,VALLEYS,AND FELT&ICE AND WATER APPLICANT pERMIT FEE SCHEDULE 236.00 MN LAKES REMODELING STATE SURCHARGE(VALUATION) 6.50 155 MCCULLEY ROAD TOTAL 242.50 MAPLE PLAIN,MN 55359- (612)275-2767 Minnesota State License#:20631119 OWNER WILSON,STEPHEN 3510IVY PL WAYZATA,MN 55391 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 dces not grant permission for additional or related work which requires sepazate 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 applicant is responsible for assuring all required inspections aze requested in c fo c with the State Building Code.This permit may be revo at tim caus (/ /�/ � / / pplicant rmitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. a . �- Total Fee: $ � �a' S� DateReceived: ��� b Entered By: Permit#: 8�� 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 OR ONTRACTOR -- _ ___.._._._.� JOB SITE ADDRESS: / SO � �U � �L-�C� ��y�f� ZIP: � �� Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special everrt permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates su,f,)"iciend on-site parking is available. Non permitted events will not be allowed. , / r G� NAME OF OWNER: f�����'1 W/ S�(j�'1 PHONE: (home) ,/J�v��}7/$��� MAILING ADDRESS: 3SoS,L�Y�,��l�' CITY: fr✓��T�woZIP: 5�39� CONTRACTOR: � �A�("E /�E����.��I(/G PHONE: b�o�Z'���?6�7 CONTACT PERSON: �G 1L� .t� MOBILE/PAGER: MAILING ADDRESS: C � CITY: /`7,�'pL,����IP: SS3S� STATE LICENSE: # a(��3/�1`� EXPIRATION DATE: �-3/-� 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 may require MCWD eview an permits! PROPOS W RK(describe in detain: � �ct�' �''DO� �r� �e e 7� c�// v�- F'e �-..i��� STORIES: � SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED �� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 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 work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: l/ ^��(�� 31 ., , � 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 private or confidential data conceming himself shal I be informed of: (a)the purpose and intended use ofthe 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 azising 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 officer. The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax orprooerty 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 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 ofthe 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 himsel£ To exercise this right,an individual shal l notify in writing the responsible suthority describing the nature of the disagreement.T'he 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 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 administraYive 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 publia 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your ful(name is required to process this pplication or permit. � � � � 1�' r First � /��� ���� Middle Last Address i�a�o�� ��a�;� 0,"�'/T/ �5.�3�l �l�-�7f�7�> C��Y State Zip Phone I understand my rig ts as s e above. / Signstu 32 DATE TIME � CITY OF ORONO CALLED IN Z INSPECTION NOTICE SCHEDULED �'�-� � PERMIT NO. d�8—O�/7�I COMPLETED ADDRESS �S��l�/`!.� /�QE� OWNER CONTR,,/'�L� �� TELE�HONE NO. ��Z z 7 S Z 710 7 � DESCRIPTION .CX1T' — �7rlQ,�, � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILIING Q ❑ FRAMING p MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAI ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTON TO MEET YOU:_YES_NO ��., COMMENTS: � W a o ���e � � 0 � W � Q � z W � W � / � d � ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED SUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDiTIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQU►RED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor site: Inspector. White Copyllnspector's File Canary Copy/Site Notice