HomeMy WebLinkAbout1998-010336 - tearoff/reroof -* PERMIT
E CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 t�'_�i��.7���t�
Crystal Bay, Minnesota 55323 Permit Number: ;}�;;:Y;;_�,
(612) 473-7357 Date Issued: ;:}�=,J;1:j�,����;=�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: — ��=�l �f�:t-��. -- `�:�?" . �i�: . OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE �e'�C�
� Total Fee: $ Date Received:
Entered By: Permit#:
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) OWNER OR CONTRACTOR
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JOB SITE ADDRESS: ��� S L i ;�(���L� � �� ZIP: �� >�
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NAME OF O�VNER: :I�� � ` ,nc �� �-/�o r':�Pxo�: (home) �C�-�—� � � /
(work)
MAILING ADDRESS• I G�� L��r 1 G�f`� C-�� CI'TY: � �'� � 1 G ZIP: ?``>'��C.
C0�ITRACTOR: P -+�,-�1 ��CC ti �' PHO�TE: �L �'�'�C��
CONi'ACT PERSON: J� ��,' Cc� C MOBILE/PAGER: �
MAILI�i 1G ADDRESS: C-S � " I ��j CITY: i,��l v���ti ZIP:_�f
STAT'E LICENSE: # �.C ���
A.RCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRA.TION#
TYPE OF `VORb': New Addition Accessory Structure
Move � Remodel/Alteration�. Land Alteration
PROPOSED WORK(describe in detai�: ���� - �l�c���- �� 'v;t S � _
STORIES: SQ.FEET OF EACH FLOOR: �
NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET.
ESTI�l�1ATED CONSTRUCTION VALUATION (excluding land): $ �, ���r _
I hereby apply for a buildin�pernut 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 Ciry and with
the State Buildin� 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.
�_�y- � �
APPLICANT'S SIGNATURE����'��������� DATE: � �S�`���
NOTE! �Parade of Homes events require separate permit approval by Police Department arad
City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS OF D�Ta
Subd. 1. Type ot'data. The righ�s of individual on whom the data is stored or to be stor�d shalI be as sec forth in this secrion.
Subd.2. Information reqiared to be given individual. An individual uked to supply private or confideadal dam concerning himself shall
be informed of: (a)the purpose aad inrended use of the reques�dara within the collecdng�tate ageocy, polirical subdivision,or sracewide rystem;
(b)whether he may refuse or is legally required co suppiy the r.quested data;(c)any Fmown coasequcnce arising from his supplying or refusing to supply
privace or eonfidenaal data;and(d)che idendry of other persons or enarias auchorized by state or federdl law to receive ch�data. This requiremeat sfia11
noc apply when an individual is asked to supply invesdgadve dara, pursuan�[o secdon 13.82,subdivision 5, to a law enforcement offccer. -
The commissioner of revenu� r-iav place che noace rauired und�r this subdivision in the individual income tsx or oropem tax refund
instrucdons insczad of on�hose forms.
Subd. 3. Access to data by indir-idual. lipon requesc to a responsible auchority,an individual shall be inforaed whecher tie is[he subjecc
of scored dara on individuals,and whecher it is classified as public, private or confcdenrial. Upon his further request,an individual who is the subjecc
of s[ored privace or public daca on individuals shall be shown the dara wichouc any charge to him and,�if he desires, shall be informed of the concenc
and meaning of chac data. Afcer an individu�l has bzen shown the privac�data and informed of ic�meaning,the dara need noc be disclosed to him for
six monchs chzreafter uriless a dispute or acdon pursuan�to chis secaon is pznding or addiaonal data on the individual has beea co(Iecced or creaced.
The responsible authoriry shall provide copies of the privace or public data upon request by the individual subjecc of[he data. The responsible aurhoriry
may require the requesring person to pay the ac�ual cos�s of m3king,cerdfying,and compiling the copies.
The responsible auchoriry shall comply immediacely,if possiblz,wi�h any request made pursuant to this subdivision,or wi�hin five days of
the dace of[he request,exciuding Sanirdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply wich the requesc
within[ha�time,he shail so inform[he individual,and may have an addiaonal Five days within which to comply wi[h the request,e�cluding 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 ri¢h�,an individual shall noa"ry in wriang[he responsible authoriry d�scribing che nature of the disagreement.
'Ihe responsible authoriry shall wichin 30 days eicher: (a)correcc chz data found to be inaccurate or incomple�e and attempc to nodfy pasc recipients of
inaccurate or incomplece dara, including recipiencs named by che individual;or(b)nodfy the individual thac he believes �he data to be coaect. Data
in dispute shall be disclosed only if the individual's sc3cemenc of disagreement is included wich che disclosed da�a.
The determinarion of the responsible authoriry may be appealed pursuant to the provisions of[he adminiscrarive procedure act relaan� to
contcsced cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "RiQhts of subjects of data", we would like to inform you that your request
for a pernut or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified that:�
1. T'he information you furnish will be used to determine your qualification fo;the permit or license requested.
2. You may refuse to supply data, bu� refusal may require that the City deny the perm.it or license.
3. The information may be shared with other local, state or federal agencies to the ex�ent necessary to process
the permit or license.
4. If your reques[ed pernut or license requires Council action to approve, some information may become
public.
5. You have certain ri;hts 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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I understand y ri;hts as stated above. j:� �
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�DATE / TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �- �
PERMIT NO. � � �'�3-� OMPLETED ti1�
ADDRESS � �� �-�� �-'�'�-�
OWNER �1/Y�G CONTR. �fZ �,-
TELEPHONE NO. 7 � g J � � �
� DESCRIPTION .�1_.c�
� 01 FOOTING 11 M HANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q FIN 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
r09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ; PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the t inspection 24 hours in advance.473-7357
OwnerlCon a o s te:
Inspector.
White Copylinspector's File Canary CopylSite Notice