HomeMy WebLinkAbout1991-003766 - re-roof ' PERMIT
�ITY OF ORONO PERMIT TYPE: E T �
1335 Brown Rd. South • P.O. Box 66 �"<�''"�`��`r��'
Permit Number: �_E;?;;����,
Crystal Bay, Minnesota 55323 Date Issued: 4 y�•i a:=��''�f
(612) 473-7357
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
1 ''• CITY OF ORONO - BDILDING PSRMIT APPLICATION
Tota'1. Fee: $ Date Received:
Date Approved:
Entered By:
Permit#:
ALL INFORMATION MIIST BE SIIBMITTED IN FOLL BEFORE PLAN REVI�nI ieTIIS. B$ STARTED
(See Check-off List Enclosed)
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THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITS ADDR$SS: / 130 �.... o �A- �trJAA ��C. � a � �D� N�. ZIP: �5 3 � �
(work)
NAI� OF OWNER: � ►''l. � . l� o C 1<<"� R ►� ►�1 PHONS: (home) `+� a- � a 7 3
MAILING ADDRESS: 1 l 3 0 �.o �-t�( -c-� nl D A A J c . CITY: K o �1 tS D o�n� _ ZIP: � � 3 b `�'
CONTRACTOR: S � �--- C- . PHONE:
�MAILING ADDRESS: CITY: ZIP:
TYP$ OF WORR: New Addition Accessory Structure Move
Demo Remo�e�/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : R � - R e o �= -� � � �� 1 � G
� Qo� E � D 1� 2cS-S.
STORIES: o a � SQ. FEET OF EACH FLOOR: � `� '� o
NO. OF BBDROOMS: GARAGE STALLS: ATT. DET. ,
BSTIMAT$D CONSTRDCTION VALIIATION (escluding land) : $ I o o. o
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 SIGNAZ'ORE: �-,.-.. � �- ���"�~-�-"'�"`— DATE: C� -� ] - `�/
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CITY of ORONO
Post Office Box 66•Crystal Bay,Minneaota 55323•Municipal Officea
•
s - � � On the North Shore of Lake Minnetonka
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 confidentia]. information.
You are notified that:
1. The information you furnish will be used to determine your
qualification for the permit or Iicense 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 Iicense requires Council. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�e
data on yourself.
6. Your full name is required to process this application or
permit.
�.I � � L� Ar'1 ADo � � H 1� �C1< P'\ A � t�
First Middle Last .
ii 30 �o +� A t�� ►� D � AJt '
Address
r� a J,.(�� r-► o.l. _ 5 S 3 6 '�
City State Zip
4� a - 3a� 73
Phone
I understand my rights as stated above.
�—.-s-- C,t'_ �d'C�c�,-.—,.1
�
Signature .
BUILDING&ZONING-473-735 i � ADMIIVISTRATION�&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING -
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573.04 RIGflTS OF SIIBJECTS OF DATA
gubdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored she]l be as set forth in this section.
gubd, 2, Information required
to be given in����" An.individual asked to
� su ly private or confidentiel data concernina amWi�n� collecting state agency,
PP
purpose and intended use of the req t med �b� Whether he may refuse or is legally
po litical subdivision, or statewide sys �oWn consequence arising from his
required to supply the requested date; (�) �Y �d (d) the identity of
supplying or refusing to supply private or con fidentiel data;
other persons or entities authorized by state or�e�ke lto s pplyeu►vest g ave data
requirement shall not apply when an indrvidual
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma le�t t8X re°una u�structio uinsteadh°S
subdivision in the individuel income tax or r�
on those orms. . - --- - " .
. Ac� to �� � ����y Upon request to e responsible
Subd. 3.
authority, an individusl sha]1 be inYormed w�b�� h r vateeor eonfidential.e IIPcn his
individuels, an d w he t h e r i t i s c l a s s i f i e d a s p � P u b l i c d a t a o n
ta �m and, if he desires, shall
further request, en individual who is the subject of stored priva te o r�du� � been
individuels shaII be shoWn the date witho of�hat datae. After an ind�
�e informed of the content snd meaning t� �� need not be disclosed to
shown the private data snd informed of its meariinB� ursuant to this section is
him for six months thereafter unless e dfspute or action p
� rivate or public data upon request by
ending or additional data on the individuh has been eollected or created. e
{ p rovide copies of P require the
responsible authority shall p on,sible authority maY �in the
the individual subject oft�e actual.cos h of malcing, certifying, and comp g
requesting person to pay -
copies. if ssible, with anY request
The responsible authority shall comply immediately, po
ursuant to this subdivision, or within five days of the date of the request,
made p �d le holidays, if immediate compliance is not
excluding Saturdays, Bur►daYs � with the �
ossible. If he cannot comply with the request within that time, he shall so inform the
p have en additionel five daYS Within which to comply
individuel, and m S t���� S��� �d Iegal holidays-
request, excluding
te or complete. An individuel m8Y
Subd. 4. Proced�u'e when data is ublic o�p ivate data concerning himself. To
contest the accuracy or completeness of p ln �� �e �po�ible authority
exercise this right, an ind�v�du�°1 she�. notify �ible suthority shall within 30
describing the nature of the disagreement. Z'1�e resP°
days either: (s) correct the data found to be inae��8e��u�ng Qee�ipl��namedt by
notify past recipients of inaccurate or in�n►Pl
the individuel; or (b) notify the individual t�vidual'sistatement cf disag�'eement is
tf the m
Data in dispute shall be disclosed only '
• included with the disclosed date• � 8ppealed pursuar►t to the
' The determination of the responsible authority m o contested cases.
p r o v i s i o n s of the administrative procedure act relating
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC. ��(� SCHEDULEO G�Zk'�1� 2:3�
PERMIT N0. � COMPLETED n �
ADDRESS ��3� ��� uNflA"
OWNER Q� I I ��-�w�� CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
O031NSULATION 24125;WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REM01/AL
Q 05 FINAL 13'METER SEfITURN ON E I O
� 07 DEMO—SITE 14 SEWER HOOK-UP OB PHOCRESS
� 07 DEMO—FINAL 27'SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOYN-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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q ' WORKSATISFACTORY:PROCEED O PROJECTCOMPLETE
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w CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOMERING PERMANENT
❑CORRECTUNSAFECONDITI0NWI7HIN HOURS. c PHOTOTAKEN
INSPECTOR WILL RETURN c CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIONREWIRED.CALLTOARRANGEACCESS.
Cali for the next inspection 24 hours in advance.473-7357
Owner/Con site:
Inspector: �
wnne coPynn or's Rk Canary Copy/SIM Nodcs