HomeMy WebLinkAbout2008-00302 - roofing � �
CITY OF ORONO PERMIT NO.: 200�-00302
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 10/15/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 360 LEAF ST
PIN : 04-117-23-23-0009
LEGAL DESC : AUDITOR'S SUBD.NO.230
: LOT 029 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-LJNDEFINED
VALUATION : $ 3,600.00
NOTE:
TEAR OFF SHINGELS AND REPLACE.
APPLICANT
MUNDEN,KEVIN PERMIT FEE SCHEDULE 103.25
360 LEAF ST STATE SURCHARGE(VALUATION) 1.80
LONG LAKE,MN 55356 TOTAL 105.05
PAID WITH CASH 105.05
OWNER
MUNDEN,KEVIN
360 LEAF ST
LONG LAKE,MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if consWction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
rev ed at any time for due cause. r
��...�� �„�,�,.d.�i�►� 15 / a$
i i /Di �,5 i D�'`
Applicant Permitee Signature Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� �
Total Fee: $ �°Jr. ��� DateReceived: �� ��/�
Entered By: Permit#• apYJ�'— oU,.3o�—
CITY OF ORONO - BUILDING PERMIT 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: 3�� �-t-�� S� ZIP: �'�3'S�
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes Q'�10 If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed.
NAME OF O WNER: �t v � C� �J�'l v.�t�C 1�� PHONE: (home) �o�Z--� —�3��
(work) �e Z �`t c - 3 SQ 1
MAILINGADDRESS:3�U ��.�� S�, CITY• � c��� ZIP• ��35�
CONTRACTOR: S�-� PHONEc
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration(ie: Siding, Windows)
Any earth movement may require MCWD review �nd permits!
PROPOSED WORK(describe in detain: �1 E C1 2 0��- S�:�c� F,S Zt.�.�.�aC�
_St�'<���5 ,
STORIES: �.— SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: Z- GARAGE STALLS: ATTACHED DETACHED �C
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 3 i��� .�b
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 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: �-�°^'"`�" v"` DATE: ��I t 5 Z��
31
I �
Sec.13.04 RIGHTS OF SUBJECI'S OF DATA
Subd.1. Type of data. The righu of individual on whom the data is stored or to be stored shal]be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming 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 azising 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.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 may nlace the notice reauired under this subdivision in the individual income tax or property 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 informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private 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 chazge to him and,ifhe desires,shall be informed ofthe 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 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 reqaest 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. 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 SaYurdays,
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
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 recipienu 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 individuaPs statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the adminisVative 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
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 shazed with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve,some information may become
publia
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.
First Middle Last
I����"5� � . ��lJ 1���-e
Address
���� cNl� • 5�3'�� ���— ZG( —'�33-1
C��Y State Zip Phone
I un erstand my rights as stated above.
� � .
Signature
e r„
` 32
.� � � �� ✓
�O D � TIME
CITY OF ORONO CALIED IN d�
INSPECTION NOTI E SCHEDULED � �
PERMIT NO.��a�OG�3�� COMPLETED
ADDRESS � �
OWNER ONTR.
TELEPHONE NO. �l� — v�Ol—" �"33 7
� DESCRIPTION ��� � �L��
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q �FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
v�, COMMENTS:
�
W
a
O ' 1 �'+'lf 1 � � � �U V r��
�
�
O
�
W
�
Q
�
2
W
�
W
�
�
d
W ❑WORK SATISFACTORY:PROCEED JECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WlLL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
inspector. � � ��;If C �
White Copyllnspector's Ffle Canary Copy/Site Notice