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Home My WebLink About2005-P09352 - re-roof ^ i . . PERMIT ,i CITY OF OI�ONO 2750 Kelle Parkwa ;- PO Box 66 Permit Number: P09352 Y Y , Crystal Bay, Minnes�ta 55323 Permit Type: Minor Altera 'ons (952) 249-4600 Date Issued: 10/25/2005 SITE ADDRESS: 3155 Jamestown Rd Unit# Long Lake,MN 55356 ; PID: 28-118-23-33-Op12 I � I DESCRIPTION: I Proposed Use: Residential Census Code O/S-Buildin Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re Roof I DETAILS: Approved per resolurion#: I Separate permits required: � I I NOTICES/REMARIKS: I I I � FEE SUMMARY: Permit Fee: $ 181.25 �i Valuation: $ 10,000.00 � I State Surcharge Fee: $ 5.00 � � � i � TOTAL FEE: $ 186.25 APPLICANT: � Owner/Self ' OWNER: Ian Gatehouse � MN 3155 Jamestown Rd � Long Lake MN 55356j � � I THE UNDERS�GNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIF ED AND AGREESITO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES D STATE OF MINNESOTA�UILDING CODE REQUIREMENTS. � � �� /, . APPLIG ERMITEE SIGNATURE SUED BY SIGNA Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(If Septic, 1-Septic) Page 1 I Total Fee: $ Date Received: � Entered By: Permit#: � �ITY OF ORONO - BUILDING PERMIT APPLICATION I All information must be submitted in full before plan review will be started. I ' (please print all information) --------------�-----------------------------------------------------------------------------------------------�--------- THE APPI�ICANT IS: (circle one) �OWNER R CONTRACTOR �._._..._T� JOB SITE IADDRESS: '�� 5 5 �(� ��'�'1�',V�i�U1 �� ZIP: � Will this be a P rade of Homes,Remodelers Showcase Home or other Display Hom ? ❑ Yes !�NO !f yes, a special event permit is requi��ed with Police Department and City Cozrnci approval ! 60 days prior to the event. Shuttle bzcs service tivill be r•eqzcired unless applicant de onstrates si ff cient on-site parking is available. Non-permitted events will not be allowed.I _.-- / NAME OF OWNER:.�1-��1-Z a �.c�Y� 1�7��.�[5u 5-�, PHONE: (home) ' - U y �U�(a. � (work) MAILIN(�ADDRESS: �I��J �Y11�tS�"lM�i'1 '�C�CITY: �� ZIP: 5 CONTRACTOR: 11 � PHONE: '� CONTACT PERSON: � MOBILE/PAGER: (�I 2.- Z c�• - � � �. MAILING ADDRESS: r� CITY: �r ZIP: � STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: 1 MAILING ADDRESS: CITY: ZIP:j NAME: REGISTRATION: # � TYPE OI�WORK: New Addition _._...._.. ssory Structur Move Home Remod�j%Alteration � �� `_---� - PROPOSiED WORK(describe in detain: �i.w �'LG � ; � STORIE�: � _ SQ.FEET OF EACH FLOOR: �� NO. OF �EDROOMS: � GARAGE STALLS: ATTACHED� DETA HED� � ESTIMAII'ED CONSTRUCTION VALUATION(excluding land): $= �� I hereby apply for a building permit and I acknowledge that the information above is complete an accurate; that the work will be in conformance with the ordinances and codes of the City and with the Sta e Building Code;that�I understand this is not a pennit and work is not to start without a permit;and that the ork will be in accordance with the approved plan. ' f�� .� I � APPLIC,ANT'S SIGNATURE: DATE: � � '� l,� 31 \ . Scc.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. Intiormation required to be given individual. An individual asked to supply private or confidential data concerning 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.T'his 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. Tlte commissioner of revenue may place the notice reauired under this suUdivision in the individual income tax or proce 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 infotmed whether he is the subject of stored data on individuals,and whether it is classified as pub(ic,private or confidential, Upon his fufther 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. After an individual has been sho�vn 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 oP 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 wmplete. An individual may contest the accuracy or completeness of public or private data concerning himself To exercise this right,an individual shall notify in writing 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 wrrect. 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 tl�e provisions of the administrative 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 confidentiat information. You are notified that: l. 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 reyuested permit or license requires Council action to approve,some information may become public. 5. You have certain rights under M.S. l�.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. �� I�2. �`-��hc,�� First � ' Middle Last �� 5 5 �)�a r��s ��w►� 12 c'�� Address � /"' ' ,.J �-.. Citv State Zip Phone I understand my rights as^ted above. ;°`� � v ._ �--`�� JZ- � ' 1�.. i � Signature ;' ; v ;� .� / �,�-��- �/ D TE TIME CITY OF ORONO ��iN / � ��5 INSPECTION NO CE SCHEDULED �` PERMIT NO. � COMPLETED �� iX�t'C.� S / � ADDRESS � �S� �-��-�-; �l OWNER CONTR. �.�1�: .E� TELEPHONE NO. � v `� � � DESCRIPTION lV 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 OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT I J 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/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a o I, -- � 7 /' � — � � ' o _. � �L.-c.J � lC� S lt 1� Q ti o '2c�-�- ��r�S`��.�. �11� z ' � �'. G� s — � � �'i N� � w � W � � � d � WORKSATISFACTORY:PROCEED f_l PROJECTCOMPLETE W ❑ RRECT WORK R PROCEED CJ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT � ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 24Q-46QQ Owner/Contractor on site: Inspector. �� Vl�hite Copyllnspector's File Canary CopylSite Notice