HomeMy WebLinkAbout1997-009491 - re-roof/tear-off PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Crystal,8ay, Minnesota 55323 Permit Number:
�Ei12)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLIC T/PERMITEE SI ATURE ISSUED BY:SIGNATURE
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Total Fee: $ �'� `-� ' � Date Received:
Entered By: �f, Permit#: -� `'�
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CITY OF ORONO - BUII,DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWIVER OR CONTR.ACTOR
Jos si� �nxEss: _����� 1-��1C�t�i�� �It/���-�.�� z�: �'J��J�JS�
rr� oF ow1vER: U SQ ��C� PxorrE: �nome� �`�(�-� �'Q�
( (work) �-{ ��- ���-{�'�
MAILING ADDRESS: 1-1��� I-�'�(���� i l�i'�L� CITY: ���'!'�` ��,r.'� ZIP: �jJ
COi�1'TRACTOR: PHONE:
C01�1'I'ACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGIST'RATION#
TYPE OF WORK: New Addition Accessory Structure
Move � RemodeUAlteration Land Alteration
PROPOSED WORK(describe in detai�: �,� ' ��i✓!; ����' ,�,,��11��� Y L�� �
STORIES: �" SQ.FEET OF EACH FLOOR: � (���i��1� ��` � �'�'��''
NO. OF BEDROOMS: � GARAGE STALLS: ATT. ,�_ DET. ^�)
ESTIlvIATED CONSTRUCTION VALUATION (exclud.ing land): $
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.
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APPLICANT'S SIGNATLTRE: � � � �� , DATE: �D� �� C 7
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NOTE! Parade o,f Homes events require separate permit approval by Police Department and
� City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGIiTS OF SLJB.TECTS OF D�►TA
Subd. 1. Type of data. The righcs of individual on whom the dara is scored or to be scored shall be as set forth in this section.
Subd.2. Information reqirired to be givea individual. An individual asked to supply private or confidendal dara concerning himself shail
be informed of: (a)the purpose and inteaded use of the requested data within the collecdng�tarc agency,polidcal subdivision,or statewide rystem;
(b)whether he may refuse oY is legally required to supply the requested dara;(c)any known coasequence arising from his supplying or refusing to supply
privace or confidendal data;and(d)[he idendry of o[her persoas or endaes authorized by stato or federal law to receive the dara. 'Ihis requiremeat shall
not apply when an individual is asked to supply invesdgadve dard,punuant to secrion 13.82,subdivuion 5, to a law enforcemen[officer.
The commissioner of revenue mav place the noace rQuirzd under chis subdivision in the individual income taz or vrooem raz refuad
insciucdons inscead of on those forms.
Subd.3. Access to data by individual. Upon request to a respoasibla authority,an individual shall be informed whether he is the subject '
of scored data on individuals,and whether it is classified as public, private or confidenaal. Upoo his further request,an iadividual who is the subjecc
of stored private or public data on individuals shall be shown the data wichouc any charge to him and,'if he das'ues,shall be iaformed of the content
and meaning of that data. Afrer an individual has been shown the privare data and informed of its meaning,the data need not be disclosed to him for
six monchs thereafrer unless a dispute or acrion pursuanc to this secdon is pending or addiaonal data on the individual 6as been collected or created.
The tesponsible authoriry shail provide copies of the private or public data upon request by the individual subject of the dara. The responsible authority
may require the requesdng person to pay the acaial cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or wichin five days of
the dace of the request,excluding Saeurdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply with the request
within that dme,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Satutdays,
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�his righc,an individual shall nodfy in wriung the responsible authoriry describing ihe nature of the disagreemeac
The responsible authoriry shall within 30 days either: (a)correct the data found[o be inaccucate or incomplece and attempt to noafy past recipients of
inaccurate or incomplete data, inciuding recipiencs named by che individual;or(b)nodfy the individual that he believes the dara to be correct Data
in dispute shall be disciosed only if che individual's statemenc of disagreemenc is included with the disciosed data.
The decerminadon of the responsible authoriry may be appealed pursuanc to the provisions of the adminiscradve procedure act reladng 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 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 wich other local, state or federal a;encies to the eztent necessary to process
the permi[ or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain ri�h.ts 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.
�S� f'ti�1� ✓1� �-�'��C�`�
First � ; ' Middle Last
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Address �,r
_L�,� �;���_� �ti1 k'1 ��� � - (��, �����J �
Ciry Srace Zip Phone
I understand my rights as stated above.
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Signa re
DATE TIME
CITY OF ORONO CALLED IN �� '��'y �
INSPECTION NOTICE'/�y SCHEDULED �4 �� � 'S
PERMIT NO. �7 / � CQMPLETED �_ '�
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ADDRESS ��G �2_�t�.�� '�-�
OWNER� �:. �1Jc�L�-c. CONTR. �
TELEPHONE NO. ���' � ��
� DESCRIPTION � '/�L�'-r' �
11 MECHANICA I 18 EXCAV/GRADING/FIWNG
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PlUM81NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 2$CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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�d ORK SATISFACTORY:PROCEED
PROJECT COMPLETE
W I CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O �; CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ,_- pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance.473-73rJ7
OwnerlConiract r 't :
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice