HomeMy WebLinkAbout1999-011328 - remove/reroof �'ERMIT
CITY OF ORONO PERMIT TYPE:
2�50 Kelley Parkway- P.O. Box 66 Permit Number: - - ` '- `�°� '`"`�'
Crystal Bay, Minnesota 55323 Date Issued: -'` ���'`��`=
(612)473-7357 " �'''
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SITE ADDRESS:
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DESCRIPTION
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REMARKS:
FEE SUMMARY:
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APP�ICANT�PERMITEE SIGNATU ISSUED BY:SIGNATURE �
Total Fee: $ ���� �� Date Received: `'�—��l� � � _
• Eurered By: `�� Permit#: �/��
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CITY OF ORONO - BLTII�DING PERNIIT APPLICATION
All i..°ormation must be submitted in full before plan revie�v will be started.
(please print all information)
-------------------------------------- -------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR
JOB SITE ADDRESS: r � z 7 �- � ►'''� � L. 1 �cl� �'✓�IP: �" S 3 6 �
NA1�iE OF Oti�TER: � o�"`'1. � ��o.,v e_ _ PHONE: (home) `-/ �7 2 - S .S L( �'
(work)
iV1A1LI�i 1G ADDhESS: % / �Z 7 L���ti L���i c� c. CITY: U r c�.�� ZIP: S S 3 6 �/
COl�i'I'RACTOR: ; in� c�. PHO�TE: �0 12. - �S S � a6 Y`�
CONTACT PERSO�': � � MOBILE/PAGER:
� 1�IAILI�i'G ADDRESS: /Zoo C' �`! '`' S T CITY: oom ;�, t-u�.ZIP: S�y z S
STATE LICENSE: # Qb0 3��l�I'
ARCHITECT/ENGIlVEER: PHO�tE:
IZAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_� Land Alteration
PROPOSED`VORK(describe in detain: R e,✓v�o�-�. �. � ���� �.r � � �°° �' `y�``�
d-- r-e. �r v v �
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
EST�IATED CONSTRUCTION VALUATION (exclud.ing land): $ �l Q S 7
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 SIGl�'ATURE:��.ww.��( ( —I , DATE: t-� - I L� ` � �
NOTE! Parade of Homes events require separate pe it approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
� ,
. Sea13.04 RIGFiTS OF S[18JECTS OF DaTA '
Subd. i. Type o[data. 'Ihe righcs of individuai on whom the data is scoced or to be stored shall be u sec focch in this section.
Subd.2. In[ormation required to be pvw indiridual. An iadividual uked w suppiy private o�confidendal daa conceraing himself shali
be infocmed o(: (a)the purpose aad iatended use oE che requared dara wichia the collecang Ytate agenry,poGdcai subdivision.or satewide rystem:
(b)whethen c�tnay reft�se oti is.legally tequited to supply che ctquesud data:(c)aay lmown coasequence arising from his supplying or refuswg w supply
privace or confidendal data;and(d)che idendry of ocher persoas o�earides au�horized by snce orlederal law m ceceive che dara. This iequiremeac shall
not appty when an individual is uked to supply iavesdgadve dam,pursuanc ro secdoa 13.82,subdivisioa S,w a taw enfac�emeat officer.
The commissioner of revenu-mav vlaca the nodc- reauired under dtis subdiv�ision in the individual income tax or orooem taa refund
insccucaons inscead o!on rhose forms.
Subd.3. Access to data br individual. Upon request to a responsible aurhoriqr„an individual shall be informed whether he is che subjecc
of swced dan on individuals,and whecher it is classified u public,private or confidenaal. Upon his tt�riher reQuesc,aa individual who is�he subjecc
of saoced private o�pubtic daa on individuals shall be shown che dara wichout any charge to him and;if he desires,shall be informed of the content
and meaning o[that data. Afte�an individual has been shown the privare daca and inforaud ot iu meaniag,the data need noc be d'uclosed oo hicn for
six moadu thereaher unless a dispute o�acaon pursuant w this secdon is pending or addidonal data on the individual has beea collected or croared.
The tesponsible au�horiry shall pcovide copies of the privare o�public dara upon cequest by the iadividual subjecc of rhe daa. The responsible suthociry
may nquire[he raquesdng person to pay the actual cosu of makin$,cerdfying,and compiling che copia.
The cesponsible suthoriry shall comply immediately,if possible,wich any cequest made putsuant w this subdivision,or wirhin five days of
the dace of the nquesc,excluding Satucdays,Sundays and legal holidays,if immediace comQliance is not possible. If he canaot comply with die requesc
within that dme,he shatl w inform the individual,and may have an addidonal five days within which to comply wich the request,excluding Saturdays,
Surtdays uid legat holidays.
Subd.4. Ptocedure whea data ts not aceurate or complete. An individuat may contest the accuraey or completeness of pubtic or private
dan concerning liimsetf. To exercise chis right,an individua!shall noafy in wriring dte respoagibte authoriry describing the nature o[die disagreemenG
'I�e responsible authoriry shall within 30 days eithe�: (a)correcc rhe data fouad to be inaccurdte o�incomplete and atumpc to nodfy past mipients of
inaccurace or incomplece data,including cecipien�t named by ehe individual;or(b)noafy the individual that he believes che data to be correcG Data
in dispuce shall be disclosed only if the individual's statement of disagreement is included wirh the d'uclosed data.
The determinadon of the responsibie au�horiry may be appealed puauanc to the provisions of the adminisaarive procedure act telaang to
contesud cases. •
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04�Subd.2, "Rights of subjecu 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 furaish certain private or
coafidencial information.
You aze notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. '��ou may refuse to supply data, but refusal may require that the Ciry deny the permit or license.
3. �'he information may be shazed wich ocher local, stace or federal agencies to the excenc 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.
A.� � V� o w.� 1^ l ►"
First �fiddle 1��
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Aaa� �c� v�-� �`v� o S S�12 �S S 3 -v C�� q
�iiy Snce Zip Phoae
I understand my rights as stated above.
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Signature
D�������r G���� DATE TIME
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CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED 't- -o �
PERMIT NO. 3 �' COMPLETED � j
ADDRESS � 2�1 w�A
OWNER ��- CONTR. R�t�wa,..t (?•�a rnrG
TELEPHONE N0. �� � ��� �� 7� 7
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� DESCRIPTION ���� ����^--
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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�ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR I CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContra tor on site:
Inspector {
White Copyllnspector's File Canary CopylSite Notice
DATE l TIME
CITY OF ORONO CALLED IN � -�� / a O
INSPECTION TI���� � SCHEDULED .3-0� �. '�"a
PERMIT NO. COMPLETED
ADDRESS �� �
OWNER CONTR.
TELEPHONE NO. �� � 0 �
� DESCRIPTION dl,�LlPr �/72'SS� S iz �
l� 01 FOOTING 11 MECHANI I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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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
J 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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INSPECTOR WILL RETURN
I CITATION ISSUED
❑ STOP ORDER POSTED.CALL INSPECTOR
[; INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector.�///l/`-� -�C 4�f�/ �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �r� � ��_ 1�`����
INSPECTION NOTICE SCHEDULED -���CY' :
PERMIT NO. �-'� � 3 z--� COMPLETED �' ��� �{ �
ADDRESS / / Z� � r�rl�`�� � � n�-%r� i�_�'-
,. OWNER /�� /�"' ��'�fh CONTR. I ���-����1� �-lC���1 �oCF�,ar
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TELEPHONE NO. ��� 3 - C-�G � ��
� DESCRIPTION ��'C��` `���
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lL 01 FOOTING 11 MECHANICAL R 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
��05 FINAL � 14 SEWER HOOK-UP 06 PROGRESS
� 0� 7�EAf6--SITE 27 SEPTIC MAWT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
4Q.i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTO T MEET YOU:_YES_NO
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V BEFORECOVERING PERMANENT
CCORRECTUNSAFECONDITIONWITHIN HOURS. : pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
OwnerlContra tor on site:
Inspector CL �-�/�1
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED S -�'�v p�
PERMIT NO. ���Z—g COMPLETED �
ADDRESS `� 2-? Z�1�14- �L��ii'�ot-
OWNER CONTR. �Y/��� ��j'
TELEPHONE NO. ��3"-�y`r
� DESCRIPTION��'1a � 0��1���
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� �cORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V( BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector. �.�-�
White Copyllnspector's File Canary CopylSite Notice