HomeMy WebLinkAbout1999-011445-old PID# - tearoff/reroof PERMIT
����F ORONO PERMIT TYPE: -.
2.?50 Kelley Parkway- P.O. Box 66 �_ ` =...=-�T�'v`�
Crystal Bay, Minnesota 55323 Permit Number: :f,�� j:.;�,;�,�.
(612) 473-7357 Date Issued: ,_;:-,;��;_;;��-;._;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPUCANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE , - �
To�il Fee: $ Date Received:
Entered By: Permit#: %/5��-�
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CITY OF ORONO - BULLDING PERNIIT APPLICATION �
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All information must be submitted in full before plan review will be started.
(please print all information) :
--__--------------- �__
T'HE APPLICAi\"T IS: (circle one) �SVNER O CONTRACTOR
JOB SITE A.DDRESS: �D� � �-�7C'� �/�-�4= �(� _ ZIP: ��S v�C'/ �
IrTA.1�lE OF Oti��R:�/9�S�-��Lt� ��--� PFiONE: (home) �.3����1
(work)
�TAII.ING ADDF.ESS: G= ��`� Lc.�-C/�-��.r� �d CTI'Y: ,1a � ZIP: ���i/
CONi'R.ACTOR: � �Om �� C;�1��%l�►�-� PHOivE: ��- � ��
C01�1'I'ACT PERSO�': .(�L Q .�� �� -Pl�- NIOBILE/PAGER: , 4�/
I V I A,I L I ti i'G A D D R E S S: ��_S� (;7�'� J�� -�l L CITY: �/ � / � ZIP: S:S�" S
STATE LICEI�TSE: #
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ARCHI 'GItii'EER: _PHONE:
MA.LL T RESS: CIT'Y: ZIP:
�A�� - REGISTRA.TION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteratioz _ Land Alteration
PROPOSED tiVORK(describe in detain: �� 1�J t � �� �L-�� —
STORIES: �_ SQ.F'EET OF EACT3 FLOOR:
NO. OF BEDROOMS: _�_ GARAGE STALLS: ATT. �_ DET.�„
ESTII-i IATED 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 ordi.nances and codes of the City and with
the State Build�n� Code; that I understand this is not a pernut and work is not to start without a
pernut; and tha� the work will be in accordance with the approved plan.
A.PPLICA��'T'S SIGNATURE�:`; �,,�: `� DATE: �_�-� �'—�—_
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NOTE! Parade o�'Homes evenis require separate permit approval by Police Department and
City Council 60 days prior to tke event. Non permitted events wi11 not be allowed.
.
Sec.13.04 RIGFiTS OF SUBJEC'IS OF DAT?, '
Su�d. 1. Type o[data. The righ�s of individual an whom the dara is srored or to be swtrd shall be as set forch in this secdon.
Subd.2. In.formation reqirircd to be given individual. An individual uked w supply private or coafidendal dara concerning himself shall
be informcd o,`: (a)[he purpase aad inceaded use of the requested dam wichin the collecang�tate agency,polirical subdivision,or sacewide systm;
(b)whed:ec he may refuse or is.legally rrquir.d to supply the requesud data;(c)any Smown coasequeace arising from his supplying or refusing to suppty
privace or connder.aal dati;and(d)che idendry of ocher persoas or enrides au[horizcd by scace ar federal law to teceive che daca. 'IhiS requ'ucmenc shall
not apply when an ir.dividual is asked to supply invesagadve daca,purs�anc ro secdon 13.8?,subdivuion 5,to a law enfaczement officer.
T4a cer.imissioner of revenue mav place �he noac- rauir-d und-r chis subdivision in the individual income taz or orooem taz refund
inscruc[ions inscaad of on chose Corms.
Subd. 3. ?.ccess to data by individual. Upon requcst to a responsible auchority,an iadividual shail be informcd whe�her he is the subjecc
of stor:d daa on individuals,and whecher ic is class�ed as public, private or confidtnaal. Upan his further request,an individual who is[h:subje:c
of scored privace or pubtic dam on individua]s shall be shown�he dara wichout any charge to him and;if he desires, shall be infocmed of the eoatenc
and meaning of dtat data. After an individual has been shown the privare daa and informed of ia meaaing,the data need not be d'uclosed ro hira for
sis monchs�hereafrer uniess a disputo or acdon pursuanc to this secdon is pending or addidoaal dact on the individual h�s been collect�d or crea[�d.
The responsible authoriry shall provide eopies of the privam or pubiic data upon request by the individual subjecc of the dam. The responsible authoriry
may require the requesang per�on to pay[he accual eosu of making,cerrifying,and compiling the copies.
'Ihe resportsibla au[horiry shal!comply irrur,ediacely, if possible,wich any ttquest made pursuant to this subdivision,or wi�hin five days of
the dare of the cequesc,ezcluding Saeucdays,Sundays and legal holidays,if immediace compliance is noc possibte. If he canaot comply with the request
wichin that dme,he shall so inform the individual,and may have an addidonal fiv:days wichin which to comply wi[h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data it not accurate or complete. An individual may concest the accuracy or completeness of public or private
dara wnceming himself. To ezercise this righc,an individual shall nodfy in wridng the responsible authoriry describing the nacure of[he disagreomeac.
The�esponsible au�horiry shall within 30 days eict:er: (a)correc�[he data found to be inaccurate or incomplete and attempt to nodfy past recipiencs of
inaccutate or incomplete data, including recipiencs named by cht individual;or(b)nodfy the individual thac he believes the daca to be correcc. Data
in dispuce shall be disclosed ocily if the individual's stacemenc of disagreement is includtd with the disclosed data.
"f�e de�ernunauon of[he responsible auchoriry may be appealed pursuant to the provisions of the adminis�arive procedure act relaang to
contesmd cases. �
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "R.iPubs of subjects of data",we would like to inform you tha[your request
for a permit or license from the Ciry of Orono or any of its departmen[s may require you to furnish cercain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permi[or license requested.
2. You may refuse to supply data, but refusal may require that the Ciry deny the permit or license.
3. The information may be shared wich ocher local, stace or federal a�encies to the eztent 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 ri�hts 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 permic.
First �fiddle Lasc
Address
C�r! Sate Zip Phone
I understand my ri�hts as scated above.
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DATE TIME
CITY OF ORONO CALLED IN �s���/s s
INSPECTION NOTICE SCHEDULED S��n /4 s //•"�D
PERMIT NO. COMPLETED �'�" �'
!�
ADDRESS
OWNER � CONTR.
TELEPHONE NO.
� DESCRIPTION
t� 01 FOOTING 11 CHANICAL RI 18 EXCAV/GRAD�NG/FILLING
� MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ORK SATISFACTORY:PROCEED �; PROJECT COMPLETE
W CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN �
❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra ' e:
Inspecto
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