HomeMy WebLinkAbout1998-010633 - repair roof , . �- PERMIT
CI�Y OF ORONO PERMIT TYPE: .
� �750 Kelley Parkway- P.O. Box 66 �_��-'!'`-`t�`�°=`
Crystal Bay, Minnesota 55323 Permit Number: ._,� s,;;_,:�;:_,
(612)473-7357 Date Issued: t;;^;;��`;;;•_�;_;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
CONTRACTOR: — �,�s��� ; �;�,�t. — OWNER:
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APPLI ANT,PERMITEE SIGNATURE ISSUED BY:SIGNATURE �.
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. Total Fee: $ % %`� - -`1 Date Received: �'C_ /!- J
Entered By: � Permit#: ��) � ?, "l�, _
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CIT OF ORONO - BUILDING PERMIT 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) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��1`�G �,`�,�- l'j�K�,,,v3�(, ZIP: `�'� 3 Z 3
NAME OF OWNER: C, i i`( �;� L����r��;. PHONE: (home)
(work) `'�113 • ��> �
MAILING ADDRESS: Z�1`j�% �``��a.� �' r'�.(��� CITY: �:��,�,v�;• ZIP: `.�`S 3 z'�
t, �
CONTRACTOR: �r���`C2:��;;�°,;�ti,c,;l��ry PHONE: '�i u-1�;`t���.
CONTACT PERSON: �_1� :n �r�SM,�t,_;�-� MOBILE/PAGER: �?I�:c:: Z t�1 J
MAILII�TG ADDRESS: z'�7,`;t} C�,��.:�.�, ��: CITY: �i,;,,:�<sv2,��.► ZIP: �5�:�)
STATE LICENSE: # ^��,�
ARCHITECT/ENGINEER: �l� r`� - PHONE:
MAILING ADDRESS: CITY: ZIP:
N:LME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�,� Land Alteration
�� ,
PROPOSED WORK(describe in detai�: �`��?'���,Z, ������ �'����r����L�z�» ������ `=��Z��l��
STQRIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOM5: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ll�,�,���
I hereby apply for a building pernut 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: �� � 4�`��
\
NOTE! Parade of Homes eve ts re ire separate permit approval by Police Department and
City Council 60 days prior to t ev nt. Non permitted events will not be allowed.
5
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 srored shall be as set forth in this section.
Subd.2. Information required to be given individual. M individual asked to supply private or confidential data conceming himself
shall 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 confidenual data;and(d)the identiry 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 olace the notice reauired under this subdivision in the individual income tax or oronertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is the t
subject of stored data on individuals,and whether it is dassified as public,private or confidential. Upon his further request,an individual who I
is the subject of stored private or pubfic 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 shown the private data and informed of iu 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 authoriry shall provide copies of the private or public data upon request by the individual subject of the data. ,
The responsible authority may require the requesring person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days i
of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he 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 of the
disagreement. The responsib(e authority shall within 30 days either: (a)conect 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 individua]that he believes the data I
to be correct. Data in dispute shall be disdosed only if the individual's statement of disagreement is included with the disclosed data. I
The determinaaon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating �
to contested cases.
DATA PRIVACY ADVISORY �
I
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 �ity of Orono or any of its departments may require you to furnish certain I
private or confidential information.
You are notified that:
I
l. The information you furnish will be used to determine your qualification for the permit or license II
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 pernut 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 pe�it.
��,�v�'-,� ��'W Ft,1 ; ���`��'���`�cv
First Middle Last
Z'��`�C �-�:�, � !G
Address
•- `,.� ���v�-� >L., �(
�Ci�C i��l'/Yl,� �'1�'v �.�� �J �-;�-� ,
City State Zip Phone
I understand my rights as stated above.
,/�_
�`�"l�--y-� '�
Signature �
� / 6
��
' � CHECK OFF LIST FOR ISSUANCE OF PERMITS
` FOR OFFICE USE ONLY
ADDRESSORLEGAL: Z�SC7 �o_��y p�(ZK.W�4�I
PID: =�-� ,��� �� _.� �3 , ,� �+�,�� �
�
DESCRIPTION OF WORK: '�TQ2W�. Q��C�C� dLt;�'��(L
------------------------------------�----------------------------------------------------------:---�-i-------�---
ZONING REVIEW BY: DATE APPROVED. r�- 9
BUILDING REVIEW BY: DATE APPROVED: ffi- t�-�$
FEES TO BE CHARGED: Misc. Fees Calculated By: ;
PERMIT Yes c/ No
PLAN REVIEW Yes No v- SEWER CONNECTION I
STATE SURCHARGE Yes �/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: /�1�v Gt�A-�tIC�C:�
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: �
Front (Lake): Right de:
Reaz (Street): Left Si e:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt. !
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By: • -
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Set ack: I.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes N Date of Council Approval:
REl�ZARKS (in house):
7
. ' .
BUII�DING REVIEW CHECK LIST � .
UBC: tJ '( CONSTRUCTION TYPE: 'y,(V
- Sq Footage $Per Sq Ftg
Basement x =
l st Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ �(`��(�'�?(�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_QC Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
�Final Grading/Filling Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMII�:
8
. � 23350 County Road 10 • P.O. Box 97 • Corcoran f Loretto, MN 55357
� O � � � � � � � � � � Phone (612)498-7844 • 1-800-627-1669 • Fax (612)498-9951
PROPOSAL � �
CITY OF ORO�dO
BJILDING M PLAN REVIEW
Date: July 28, l 998 !NSPECTOR ---
DAT=_ � 7� PEAMIT NO.
�'r/�Pp(?OVED f:S St,�?MITTED
To: Greg Gappa `� qpr��U��p�'�!7,-1 GUF�RFCTIONS AS NOTEO
City of Orono �� ;�rj��1Pp;?p���U---CCRnrCT&RE�UBPAIT
2750 Kelley Parkway Tnese commer.t"s are far your informa?ior.Ail v:ork shail be done
Orono MN in fu!I c�m�!�anca w':h c!1 apGlicrb,e baiidirg and zening code.
� F1�;quraments including i,ar,s not specifcallynoted in this r�view.
KCEP THIS PIAN ut=T OIV S1TE AT ALL TIMES
We hereby submit specifications and estimates for: Storm Damage Repair on 40'Section
of Bui/din
• Remove and dispose of existing roofing, sheathing and trusses.
� lnstall new LVL header on sidewall.
• Install new trusses spaced at 24" on center with 40-7-10 loading at a 4:12 pitch.
• Install Certainteed Sealdon 25 shingles and asphalt felt on '/2" CDX sheathing.
• lnstali 12" "Rollex" soffit system on endwall and "Rollex" fascia system on endwall and
sidewali.
• Install 29 gauge Pro-Panel I1 steel on 80 LF of sidewall with necessary trim.
We hereby propose to furnish material and labor- compiete in accordance with above specifications, for the sum of:
Ten thousand seventv dollars * * * * * * * * * * '� * * * * * $10,070.00
Payment to be made as follows: 30% Downpavment, Balance Upon Completion
This proposal may be withdrawn by us if not accepted within 10 days.
Authorized signature
All material is ;uaranteed to be as specified. All work to be completed in a workmanlike manner according to
standard practices. Any alteration or deviation from above specifications involving extra cosu will be executed
only upon written orders, and will become an extra charge over and above the estimate. Ail agreemenu
contingent upon strikes, accidenu or delays beyond our control. Owner to carry fire, tornado and other necessary
insurance. Our workers are Fully covered by Workers' Compensation Insurance.
Acceptance of Proposal - Tne above prices, specifications and conditions are satisfactory and are hereby
accepted. You are authorized to do the work as specified. Payment will be made as outlined above.
Signature: Date:
Signature: Date:
Gappa