HomeMy WebLinkAbout1998-011051 - re-roof PERMIT
t CITY OF ORONO PERMIT TYPE:
. 2750 Kelley Parkway- P.O. Box 66 ��E-��.�--=:�i'��-;
+ Crystal Bay, Minnesota 55323 Permit Number: ;_;� �;:,�;
� (612)473-7357 Date Issued: � ^,�;i;;;�_�:;�,
SITE ADDRESS:
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APPLICANTPERMI E SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ �'� � , �� Date Received:
�� Entered By: Pemut#: � J 6 5�
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CITY OF ORONO - BiJII.DING PERNIIT 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: (circle one) OWNE OR CONTRACTOR
JOB SITE ADDRESS: �Spq S�y P lo.ce ZIP: 5 5 3`� 1
NAME OF OWNER: �ei�e � Co�c PHONE: (home) �-t�I - £'�7��
(work) 4��-9��8
MAILING ADDRESS: 35�9 �y 1P1c..c.s� CITY: O r v v�o ZIP: ��3�t (
CONTRACTOR (�e h� ��x-1;� PHONE: �3'1 - 8 ZS�1
CONTACT PERSON: �� MOBILE/PAGER: S 3 5 - �t S�O
MAII.ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �i" Land Alteration
PROPOSED WORK(describe in detai�: -I�a� o�- o1d �af . some �ec�e�k��c �
f'�sh�n�(.� roo� -
STORIES: l SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �f?9 O '°Q
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 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 be in accordance with the approved plan.
APPLICANT'S SIGNATURE: G��-�C�o DATE: �2- 7-�P�
NOTE! Parade o Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be aZlowed.
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Sec.13.04 RIGH'TS OF SI.TBdECTS OF DATA
Subd. 1. Type of data. The righ[s of individual on whom rhe dara is stoced or to be scored shall be as set focth in this secdon.
Subd.2. Information req�ared to be givw individual. An individual aslced to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and inrcnded use of the csquesred data wi�hin d►e collecting 3tate agency,polidcal subdivision,or stacewide system;
(b)whether he may refuse oY is kgaily requized to supply rhe requesud data:(c)aaY knoa'n c°°sequenc°arising fr°m his suppiyiag or refusing to supply
private or confidential data;and(d)ttte idenary of other petsoas or entiaes authorized by state or fedecal law w receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve dara,punuant[o section 13.82,subdivision S,w a law enforcement officec.
The commissioner of revenue mav alace che nodce rec�uired under this subdivision in the individual income tax or provertv tax refund
insnucaons inscead 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 whecher it is classified as public,private or confidential. Upon his further nquest,an individual who is the subject
of stored private or pub(ic data on individuals shall be shown t6e data wirhout any charge to him and:if he desires,shall be informed of the content
and meaning of that data. Afur an individual has been shown the privarc data and informed of iu meanin8,the data need not be disclosed ro him for
six mondu theroafter unless a dispute or action pursuanc to this secaon is pending or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public daca upon request by the individual subject of the data. The responsible authoriry
may require the nquesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall compiy immediately,if possible,with apy request made pursuanc to this subdivision,or wirhin five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediaa compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal five days within wluch 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 nodfy in wridag the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found ro be inaccurate or incomplete and aaempt to nodfy past recipienu of
inaccurate or incomplete dara,including recipients named by che individual;or(b)notify the individual that he believes the data to be correct. Dara
in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminisaadve procedure act relaang w
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rirhts 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 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 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.
1_Q��Se.I �.e r.e.e_ C-�7°
Fint Mlddle �t
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Address �� ��c�� (,� '�l` �?�p� '
r�U phone
Ciry State Z�P
I understand my rights as stated above. .
Signaturo
CITY OF ORONO CALLED IN `� D/O`�S ��3� n'J
INSPECTION NOTICE SCHEDULED /s� •j I -c��.w,
PERMIT NO.�f/�SI COMPL N ��
ADDRESS
OWNER �C. CONTR. ��SG
TELEPHONE NO. ��I " d ��'Y
� DESCRIPTION -
� 01 F 11 MECHANI A RI 18 EXCAV/GRADING/FILLING
,� . FRAMING 13 MECHANI L FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATI 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 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance.473-7357
Owner/Contract�s' :
inspector.
White Copyllnspector's File � Canary Copy/Site Notice