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Home My WebLink About2006-P09843 - re-roof PERMIT CITY C�F ORONO Permit Number: 2750 Keliey Parkway- PO Box 66 P09843 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/8/2006 SITE ADDRESS: 1155 Loma Linda Ave Unit# Mound,MN 55364 PID: 07-117-23-14-0013 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Pernvt Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 139.25 Valuatioa: $ 6,980.00 State Surcharge Fee: $ 3.50 TOTAL FEE: $ 142.75 APPLICANT: Huepenbecker Construcrion OWNER: Eugene Geyen ETAL 205 W.3 1/2 St. 1155 Loma Linda Ave Waconia,MN 55387 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. P P T SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print a[l information) ----------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR � /� JOB SITE ADDRESS: 1��s r�� ,�- ��/bl20 ZIP: c=z��T Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 10 If yes, a special event permit is required with Police Department and Ciry Councid approval � ' 60 days prior to the event. Shuttle bus service will be reqa�ired unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: C.��E' ��_P�' PHONE: (home)�6� ��•�-a�o� / /�'� (work) MAILING ADDRESS: �/�� LD�'�'4 �� /7vc.CITY: �l�'out� ZIP: �� CONTRACTOR: P � ph (�G1�, PHONE: 6 �`��- �6/y CONTACT PERSON: o U e MOBILE/PAGER: �a oz3a- � MAILING ADDRESS: � �l� �- CITY: 2��1�4 ZIP: c�3� STATE LICENSE: # aZ�O EXPIRATION DATE: 3 p ARCHITECT/ENGINEER: NE: MAILING ADDRESS: CITY: ZIP: NAME: REG N: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and ermits! PROPOSED WORK(describe in detuin: f�Q� �°l^ �� Q S' �s STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED o� ESTIMATED CONSTRUCTION VALUATION(excluding 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 ofthe 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 SIGNA RE: DATE: � d� 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to suppiy private or contidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data.This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�v enforcement o�cer. The rommissioner of revenue mav olace the notice re�uired under this subdivision in the individual income tax or oro�ertv tax refund �nstructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infortned whether he is the subject of stored data on individuals,and�vhether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data 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 iu meaning,the da�a need not be disclosed to him for six months thereatter unless a dispute or action pursuant to this section is pending or additional data on the individual has been col lected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [Fhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional 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 accuracx or completeness of public or private data concerning himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;o�(b)notify the individual that 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 data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 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 furnish 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 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 publia 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. First Middle Last Address Citv State Zip Phone I understand y right sta d above. . Signa e Reset Form �? �v/��F � S�AT TIME ITY OF ORONO ca�� INSPECTION N TIC SCHEDULED S- � -�� PERMIT NO. �8 .3 COMPLETED ADDRESS ��SS .L.oma Lind�t�¢� OWNER CONTR.l�i�� 7'` TELEPHONE NO. �p� Z , a3a - �'f �{S L� � DESCRIPTION �e� � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 v 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � �l�i -- �� -t�C,�c-� � � O � � l � �t t� T��9 �c�Ff 0 � W � Q � Z W � W � � d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑C RRECT WORK&PROCEED _n_ ISSUE CERTIFICATE OF OCCUPANCY Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDIT�ON WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�7 CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Cal{for the next inspection 24 hours in advance. �95Z� 249-46QQ OwnerlContractor on site: Inspector. LJC/ .� White Copyllnspector's File Canary Copy/Site Notice