HomeMy WebLinkAbout2001-P04147 - re-roof PERMIT
CITY �F ORONO Permit Number:
275C't Kelley Parkway - PO Box 66 P04147
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: sil�2oot
SITE ADDRESS: 2640 Kelty Avenue
Excelsior,MN 55331
PID: 20-117-23-14-0006
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Census Code 43,� ���� ����
Permit Class: Building /
Permit Type: Minor Alterations Permit Sub-type(s): Building- Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 9�25 Vatuation: � 3,800.00
State Surcharge Fee: $ 1.90
TOTAL FEE: $ 99.15
APPLICANT: 7ohn Volkmar OWNER: John Volkmar
MN 2640 Kelly Avenue
Excelsior MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURG ISS DBYSIGNATURE
Coaies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reborts, 1-Assessin�, 1-Finance Page 1
Total Fee: $ Date Received:
Entered By: Pemut#:
.
CITY OF ORONO - BUILDING PERNIIT 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 CONTRACTOR
JOB SITE ADDRESS: �ZI( lJ ZIP: -S s.�3'
J t/4 ��w�.ai ✓ PHONE: (home) SvZ"`f 7/-g7�F
NAME OF OWNER: c7�� �'i �/
(work) S�1-.-�,c.
MAILINGADDRESS: aL(e �-(C� rLl�� � CITY: � x��S��r ZIP: SS33i
CONTRACTOR: ��I PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAII..ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGI5TRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detain: ��71►,,�T���S �e,D� �J�—� ��l4C�i
STORIES: � SQ.FEET OF EACH FLOOR �3 OJ
NO. OF BED OOMS: � GARAGE STALLS: ATT. � DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $��� �00• �
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 pemut and work is not to start without a
permit; and that the work will be i accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: � 1
NOTE! ParadeQf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed. �
Sec.13.04 RIGH'TS OF SUB.TECTS OF DATa �
Subd. 1. Type of data. The righ[s of individual on whom the data is scored or to be scored shall be as set forth in this section.
Subd.2. Information reqirired to be given individnal. An individual asked to supply private or confidendal dara canceming himself shall
be informed of: (a)the purpose and inunded use of the requesred data within the collecting�ta[e agency,poliacal subdivision,or statewide sysum;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from 6is supplying or refusing to supply
priva�e or confidendal data;and(d)[he idendty of orher persons or enuaes authorized by state or federal law to receive the data. This requ'uemenc shall
not apply when an individual is asked to supply invesrigadve data,pursuant co section 13.82, subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income tax or provertv tax refund
inscruccions instead of on chose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whe�er 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[he data wirhout any charge to him and,-if he desires,shall be infomied of the content
and meaning of[hat data. Aher an individua!has been shown the private data and informed of its meaning,the data need not be disclosed to hicn for
six months thereafter unless a dispute or action pursuanc to this secdon is pending or addidonal data on the individual has been collected oc created.
The responsible authoriry shatl provide copies of the private or public data upon request by the individual subject of che data. The responsible authority
may require the requesring person to pay the actual costs of making,ceroifying,and compiling the copies.
The responsible authoriry shal(comply immediately,if possible,wich any request made pursuant to this subdivision,or within five days 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 concerning himself. To exercise chis right,an individual shall nodfy in wriang the responsible authoriry describing�he nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccucate or incompiete and attempt to nodfq past recipients of
inaccurate or incomplete data, inciuding recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data
in dispu[e shail be disclosed only if the individual's statement of disagreemenc is included with rhe disclosed data.
The decerminarion of the rzsponsible authoriry may be appealed pursuant to the provisions of the administiarive procedure act reladng to
contested cases.
DATA PRNACY 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 fumish 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 pemut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pemut 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.
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City State Zip Phone
I understand y rights as stated above.
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D,6�iE� TIM E
CITY OF ORONO CALLED IN �
INSPECTION NOTICE C� �/y SCHEDULED ������� �����
PERMIT NO. � /` / COMPLETED �
ADDRESS � � ��-�--� �
OWNER • CONTR.
TELEPHONE NO. ���� '�����v �
� DESCRIPTION �Q ah' G � �
lL 01 FOOTING 11 MECHANICAL RI 1 EXCAV/GRADING/ LLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
C]CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContra t r on site:
Inspector. ���-T
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN � : o
INSPECTION NOTICE SCHEDULED „ �
PERMIT NO. PD �l�-17 COMPLETED
ADDRESS �Ci yU �p -��'--�- '�"�`�� �
OWNER CONTR.f�-�-� -�-�'–�— -
TELEPHONE NO. ��� ��� ���� �r
� DESCRIPTION �i '�� ��
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O C; CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN
INSPECTOR WILL RETURN CITATION ISSUED
C;STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor ite:
Inspector.
White Copyllnspector's File Canary CopylSite Notice