HomeMy WebLinkAbout2000-P02849 - re-side PERMIT
CITY OF ORONO
2?50 I�Qlley Parkway - PO Box 66 Permit Number: Po2sa9
Crystal Bay, Minnesota 55323 Pe►'mit Type: Minor Alterations
(612) 249-4600 Date Issued: s�2i�2oo
SITE ADDRESS: 1127 LomaLindaAve
MOUND,MN 55364
PID: 08-117-23-23-0020
DESCRIPTION:
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Side
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 4,920.00
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 113.75
APPLICANT: COTY CONSTRUCTION INC OWNER: DALE F ROTH
1001 6TH St S 1127 LOMA LINDA AVE
HOPKINS,MN 55434 MOUND MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECLFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI ANT P M TEE 1 NATURE d�SL1ED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
Total Fee: $ Date Received: � '�� "�� �
�ntered By: ��_�;�;��,� � Permit#: `� �' - '�y
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: � �Z 7 L1��i�1,r3 ��i✓ia,,9 f}vt ZIP: `� 5-.3��
NAME OF OWNER: ���/L �O]"// PHONE: (home) �' Z- 5 `�3
(work)
MAILING ADDRESS: 11z 7 ��Jw�i� �i.�c/i?.g. /g�ITY: �/'<O/Jp ZIP: 5 5�36�
CONTRACTOR: �Ty CGit/S�- �/GT7O�/ PHONE: �3,3 - 3 `-� ,3 G
CONTACT PERSON:� /G '/�SU�✓MOBILE/PAGER: ��G-Z// /
MAILING ADDRESS: /CyJ/ „�n ST .S CITY: �ip,�i.vS ZIP: SS .� `f3
STATE LICENSE: # �3 5"6
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration j� Land Alteration
PROPOSED WORK(describe in detai�: ��,� � ��-'�5�/JE _
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ���Z�,—
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 pernut 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 SIGNATURE: G��� � '� -,% � DATE: � �l O('I
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
.
Sec.13.04 RIGHTS OF SiJB.TECTS OF DaTA •
Subd. 1. Type of data. The righcc of individual on whom che data is stored or co be stored shall be as set for[h in this secrion.
Subd.2. Informatioa reqirired to be given individual. An individual asked to suppiy priva[e or confidenaai dara concerning himself shall
be informed of: (a)the pucpose and inunded use of the requesce�data within the collecting�tate agency,political subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the mquested data;(c)any irnown consequence arising from his suppiying or refusing to supply
priva[e or confidendal data;and(d)[he idenury of other persons or enrides auchorized by state or federel law to receive the data. This requirement s6a11
not apply when an individual is asked to supply invesrigadve dara, pursuant to secdon 13.82,subdivision 5, to a law enforcemenc officer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or prooem taz refund
instructions ins[ead 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 whe[her it is classified as public,private or confidendai. Upon his further request,an individuai who is the subject
of stored private or public dara on individuals shall be shown che dara without any charge to him and,-if he desires, shall be informed of the 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
siz months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authority
may require the requesting person to pay the accual coscs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the requesi,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuncy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in wricing the responsible authority describing[he nature of the disagreement.
The responsible au[horiry shall within 30 days ei[he�: (a)correct the data found to be inaccurate or incomplete and aaempt to nodfy past recipienu of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual thac he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dara.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the adatinistradve 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 pemut or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified that:
1, The information you furnish will be used to detemune 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 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
public.
5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(, Your full name is required to process this application or permit.
First Middle Last
Address
C�� S[ate Zip P6one
_... .
I understand my rights as "atstive:
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Signature
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �`� z��'—
PERMIT NO. �'��� COMPLETED �
ADDRESS I a ��'�'lcc- G�nG7CC.. �}"U�
OWNER CONTR. ��� ��S �
TELEPHONE NO. ��-���'��
� DESCRIPTION S lc�(�t�
l� 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 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNEHICONTRACTOR TO MEET YOU:_YES_NO
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O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. i: PHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor on site:
Inspector. i��/_Gcv� �0..�S
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
Gi —29-C�C% `•'3Z
INSPECTION NOTICE SCHEDULED %�� 2�-�=G 9• .� ,�ry,
PERMIT NO. �1? �� ��C1 COMPLETED �Z�C� •q .30
ADDRESS 11�`7 L c.:n��c� L. �i�cYa �'}-��
OWNER I� �-�'''�-f"1 CONTR. �.C�-� �� C`���S
TELEPHONE NO. C� 3 �3 " 35 ��
� DESCRIPTION � �C) � r��� _ � ; I�c�1
�
ty� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q� FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTAL�. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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GW �ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
� CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. - pHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REDUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContract r on site:
Inspector. � Z �
White Copyllnspector's File Canary CopylSite Notice