HomeMy WebLinkAbout1996-007307 - tear-off/remodel j PERMIT
� Y OF ORONO PERMIT TYPE:
', 2750 Kelley Parkway- P.O. Box 66 - - -_
`�Crystal Bay, Minnesota 55323 Permit Number:
(612)473-7357 Date Issued: Y;-. ;; � ,,-:w.
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SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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AP T�PER ITE SIGNATURE ISSUED BY:SIGNATURE �,
� �Total Fee: � DateReceived:
DateApproved:
Entered By: ^�� Permit#: J� ; 7
CITY OF ORONO - BUII..DING PERMIT APPLICATION
ALL I�i'FORiti1ATION��ITST BE SLB1�iITTED P1 FULL BEFORE PLAN REV�W WILL
BE STARTED
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THE APPLIC�u'vT IS: (circle one) OWivER 0 CONTRACTOR,
JOB SIT'E ADDRESS: G' ��
ZIP: J�J�S�
NAME OF O��'NER:
! PHOivE: (home)–�� ,_���zS
work)
I�IAILINGADDRESS: �� , CITY: _� ZIP: �S�S,6
� _; PHOivE: � ����1�_��'� �313
CONTRACTOR: �'� '
MOBILE PHONE/PA ER:
MAILINGADDRESS: ���'a .P .'��'� �� , CITY: ZIP:__���
STATE LICENSE: # ��� ��� �G6"°�Q �
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ARCHTI'ECT/ENG�V�ER: –.___....._--,___.__. _.--�
N1AII..INGADDRESS: ^''�"�=------C�'��-..------- --. ZIP:
NAivIE: REGIST'RATION # � --'_—_
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TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration I.and Alteration
PROPOSED`VORK(describe indetail): � ���– ����
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDR O�IS: G�GE STALLS: ATT. DET.
ESTTVi IATED CONSTRUCTION VALUATION(escludingland): $ �^,��G
I hereby apply for a building permit and I acknowledge that the information above is complete
and accurate; that the work will be i.n conformance with the ordinances and codes of the City
and with the State BuildinQ Code; that I understand this is not a permit and work is not to start
without a permit; and that the work will,, e in accor ance with the approved plan.
� N�, � ` ��'�4,1�'Q� DATE: ��'�
APPLICANT S SIG • �
NOTE! Parade of Homes events require sepa ate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
� �
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righu of individual on whom the data is stoced or to be stored shaq be as set forrh in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself shall
be informed of: (a)the purpose and intended use of the reques[ed data within the collecting 3tate agency,political subdivision,or statewide system;
(b)whether he may refuse or is legaily required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idendry of other persons or entides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve dara,pursuant to section 13.82, subdivision 5,to a law enforcement of6cer.
The commissioner of revenue mav nlace the nodce reQuired under this subdivision in the individual income taz or propertv taz refund
instructions instead 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 whether it is classified as public,priva[e or confidendal. Upon his further 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 shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal 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 authoriry
may require the requesting person to pay the actual cosu of making,cerdfying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with 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 compiy with the request
within that time,he shatl 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 dus right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to notify past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminisuative 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 fumish certain private or
confidential information.
You are notified that:
1. The information you fumish 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.
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DATE TIME
CITY OF ORONO CALLED IN `%�`��%J
INSPECTION NOTICE SCHEDULED �-� ��`i2�
PERMIT NO. 30'7 OMPLETED � �
ADDRESS �C� '
OWNE
6���.— �° CONTR. � •� �
TELEPHONE NO. '`�`{� ' ��1�
� DESCRIPTION ./Z,C,��-�
l� 01 FOOTING 11 CHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAAMM 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ," pHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for th xt i pection 24 hours in advance.473-7357
OwnerlContra t on si :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED W 9' �J' 9S
INSPECTION NOTICE SCHEDULED Q-i � ���
PERMIT NO. ���� COMPLETED � �r
ADDRESS 4�� O ' � �
OWNER �/� CONTR. /d�.t11�-tc.�Ct'L- �Q��
TELEPHONE NO.
� DESCRIPTION
l� 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 0 ^,BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 0 MO-SITE 27 SEPTIC MAINT. 21 COMPlA1NT
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED �OJECT COMPLETE
WC CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN _' CITATION ISSUED
C STOP ORDER POSTED.CALLINSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next i pection 24 hours in advance.473-7357
OwnedCont a on si e:
Inspector. -
White Copyllnspector's File Canary CopylSite Notice