HomeMy WebLinkAbout2000-P02605 - re-roof t • PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po26os
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(612) 249-4600 Date Issued: 6i2sioo
SITE ADDRESS: 458 Linden Ave
LONG LAKE,MN 55356
P I D: 06-117-23-41-0100
DESCRIPTION:
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Minor��terations Permit Sub-type(s): Build'mg Re-Roof
i
_ �
DETAILS: -
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 9�•25 Valuation: $ 3,700.00
State Surcharge Fee: $ 1.85
TOTAL FEE: $ 99.10
APPLICANT: �CLINE ENTERPRISES INC OWNER: M D DIETRICK-BLOCKER ET AL
26175 BIRCH BLUFF RD 458 LINDEN AVE
SHOREWOOD,MN 55331 LONG LAKE MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TF�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMI'LIANCE WITH ALL CITY OF ORONO ORDINANCFS AND
STATE OF MINNESOTA B DING CODE REQUIREMENTS.
/� �
I SUED BY SIGNATURE _ /
C�h
Copies:City,Applicant,Assessor,Finance Page 1
, • Date Received:
Total Fee: $
Entered By: Permit#:
CITY OF ORONO - BU�.DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please prirEt all information)
TSE APPLICANT IS: (circle one) OWNER OR CONTRACTOR �
JOB STTE ADDRESS:
`-�.�� C,�-b, �� z�:
lh'AME OF OWNER: /" ��'��7' ����e� PHO�IE: (home)
(work)
1�IA]LIti'G ADDRESS: CTTY: Z�:
CONT'R4CTOR: �inc)�h� �-n�,� �'i��' �'nL PHONE: ''171-9`l�"��
CONZ'ACT PERSON: �71 S� n MOBILE/PAGER: .
1�IAILIYG ADDRESS�?6i�s' B�r�� ��. CTTY: :s��� ZIP: SS� 3 ..
STATE LICENSE: # �d/ 6 �3�
ARCHITECT/ENGI�YEER: PA���
ZLAILl�'G ADDRESS: CITY: ZIP:
N��,�: REGISTRATION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �'� d�� � �^��
STOR�S: SQ.F'EET OF EACH FLOOR: ___
NO. OF BEDR001�iS: GARAGE STALLS: ATT. DET.
ES'Tll�i IATED CONSTRUCI'ION VALUATION (excluding lancn: $ 3��
I hereby aoply for a buildin�permit and I acknowledge that the information above is complete and
accurate; chat the work will be in conformance with ihe 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.acc danc with e pproved plan.
APPLICANT'S SIGNATURE: DATE: (9��7��
� NOT'E! Parade qf Flomes events require separate permii approval by Police Department and
� Cily Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.0�i RIGHTS OF SUBJECTS OF DAT�
Subd. 1. Type of data. The righ�oi iadividuai on whom the dact is sor.d or m bc scnrsd shall be as set for�h ia chis secaan.
Subd.2. Informatian reqirired to be�rm iadividual. An iadividual uked to sugply private or coafidendal data coaceraing himsalf shalI
be informed of: (a)�he purpose and inL.aded use of�he«quested dam wichia�he collecdag 3u�.agenry,polidcsl subdivuiaa,or sntewide rystem;
�b)whe�er he taay rfuse or is legally tequited m supply the cequesud data:(c)any l�own coatequeace arisiag from his suQplyi:g or cefiuing to supply
privace or conr.dendaI data;and(d)[he idendty af octer persaas or earides auchariz�by star_or fed�rsl law co re�eive rhe daa. This requiremeac shall
aot apply when an individual is uked to suppiy iar•arigadve dam,punuan�to se:aaa 13.82.subdivision S, co a law enfocc:Weac officer:
The eommissioner of rtvenue mav Ia:e the nodce crauired under ehis subdivision in the individual income es or orooem az tefur.d
inscivcdans ins.exd of an�hose forms.
Subd.3. Access to data br•iadividuaI. Upan requesc m a respansible auchoriry,aa individual shall be informed whaher he is che subjecc
of stnr_d data an individuals,and whe:her it it ciusified as public,privace or con:.d=nriai• L,"Fan his further cequest,an indiv;�uai who is�he subjecc
of smr:d private or public dae�on individuals shall be stiown ehe dan wi�hauc any ciuge rn him and:if he desires,shall be iafocmed of ihe concenc
and meaning of chat data. Aher an individuai h:is been shown che privare dara and informed of ia meaniag,che dan need eoc be disclosed ou hirn for
siz manehs dsemafuc unleu a dispute o�acdon pursuanc rn �his secrion is pending ac addidoa�l daet on che individual has beea collectrl or creamd.
'Ihe responsible au[hority shall provide copies of die privaee or pu6lic data upon reGuesc by the iadividual subject of che daei. T::e mspoasible auchoriry
may require che�equesdng person ro pay the acaial cosu oF inafcing,cerdfying,u:d campiliag the copies. .
The respansible aurhoriry shall compty iaunediacety,if pouible,wich a:y�quesc a�ade pursuanc to chis subdivision,or wichin five days of
the da�.of che requesG excluding Saturdays.Sundays and legai holidays,iF immed'uc�compliaac�is noc possible. If he canaoc comply widi rhe requesc
wi�hin d�ac titne,he shall so inform rhe individual,and may have an addidonal five days wichin which to comply wic4�he requ:s:,ezcludiag Saturdays.
Sundays and legsl holidays.
Subd.4. Procedure when data is not accurate or compiete. An ir.div':dual may contest the accuracy or comple`aess of publie or pri�ate'
dara coctcerning himself. To exeroise�is righc,an individual shall nodfy in wridng cl:=respaasbie aurhoriry describing�tte na��::of[he disagreemaac. .,
The responsibte auchoricy shall wichin 30 days eir.�er. (a)correcc rhe daca found ro 6e inacec:rac_or incomplece and aaempc to r.odfy past recipiencs of
inaccura�e o�incomplece dars, inciuding mcipiena named by[he individual:or(b)eodfy d:e individual chac he believes the daca to be coctecc Dan
in dispuce shsll be disc:osed only if ehe individual's sracemenc of d'uagreement is�:luded wic.h[he disclosed dan.
'Ihe dece.�minadon of che responsible auchoriry may be appealed pucsu�:.c co the provisions of che sdminisaarive p;o:edure act reladng ro
conmsced cases.
DATA PRIVACY aDVISORY
In accordance wich M.S. 13.04,Subd.2, "Righcs of subjeccs oi data",we would like to inform you that yaur reauest
for a permit or license from the Ciry of Orono or any of its depz�ments may require you to furnisa certain private or
confidencial information.
You are notified that: .
1, The information you furnish will be used to determine your qualification for the permit or license requested.
? You may refuse to supply data, buc refusal may require that the Ciry deny the perm.it or license.
;. The information may be shared wich ocher local, scac�or federal a�encies to the excenc necessary to process
the permit or license.
:�, If your requested perm.it or license requires Council action to approve, some infor^L.acion may become
public.
�, You have cenain ri�hts under M.S. 13.04 (available upon request) to review privace daca on yourself.
6, Your full nazne is required to process this applicacion or perm.ic.
�� ��l � �j` � � �� �
1,.� � 1
��t �� �t
Fusc��� l!>>1�
Address� � ,� ^ � � �C'7�� / % �/�v��
)•J Z1�) -
Cicy Sar� Zip Phc.._
I understand my ri;hts ace ove. .
Signamre
DATE TIME
;ITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED `� ^�� l0 : 3 0
PERMIT NO. � J COMPLETED � /O; 3�
ADDRESS
OWNER CONTR.
TELEPHONE NO. '�'J/ — �l OCa�
� DESCRIPTION_/��t�-�S
lL 01 FOOTING 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FIN L 14 SEWER HOOK-UP O6 PROGRESS
h 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL P 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEEf YOU:_YES_NO
Z
� COMMENTS:
�
W
a
� �� - � ���
>.
�
O
�
W
�
Q
�
Z
W
�
W
�
� (�^
d �WORKSATISFACTORY:PROCEED J9�PROJECTCOMPLETE
� CORRECT WORK 8 PROCEED / O ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector.����CL���
White Copy/lnspector's File Canary CopylSite Notice