HomeMy WebLinkAbout1999-011653 - tearoff/reroof PERMIT
CITY OF ORONO PERMIT TYPE:
2?50 Kelley Parkway- P.O. Box 66 _ . _,
� Crystal Bay, Minnesota 55323 Permit Number: - � �,:;�
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(612) 473-7357 Date Issued: i_?1 ;�i�,'`�;:=i��
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: _ �`,�,, ; ,_^��� _ ;�� �*� OWNER:
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APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE C��
Total Fee: $ `j��o�� Date Received: �/�-�y
�ntered By: Permit#: /l!O�.3
CIT`Y OF ORONO - BUILDING PERMIT APPLICATION � ;
;
A.11 information must be submitted in full before plan revie�v w-ill be started. .
(please print all information) .
- - . . �—=�� --- .
Z'HE A.PPLICAIr'T IS: � (circle one) OtiVNER O CONTRACTOR ��
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JOB SITE AUDRESS: ���� �Gl�� �' < ' . ` ZIP: �5�,5 � �
�c� �_�- ����l�c� ,�%r�"
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I�'A11�iE OF Oti��R: ��-��� �n��-�C�IZ �E'�� PHONE: (home) 7���C�
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I1�IAII.I�i tG ADDFESS: � "U � (�C� ��l-C�' -�'�-�� �'�� ��'�CTTY: �,v��` ZIP: �S"�- -- ,
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CONTRACTOR: ! J��" �J O(, �� �L�� ��-�� PHONE: �7� 3��1 �
COl�t'I'ACT PERSOti': ' �� (" e MOBILE/PAGER: � �:l - S�Y��'�%
MAII,I�'G ADDRESS: ,�7-��� C f.� /�-c� �� CITY: � L � � ZIP: �-5-4'Y
STATE LICE�'SE: # 5�,��`�' �
ARCHITECT�ENGII`'EER: PHO�'E: .
1�A_II�Itii TG ADDRESS: CITY: ZIP:
�•AME; REGISTRATION#
TYPE OF ti�ORh': New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
" � � C�
�ROPOSED ti'YORK(describe in detai : ,�- = ��f�-���� �Y� ��- �1 ��- �t �
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STORIES: SQ.k'EET OF EACH FLOOR:
�'O. OF BEDROOII�IS: GARA.GE STALLS: ATT. DET. �
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FST .Il�i IA.TED CONSTRUCTION VALUATION (exciuding land): $ j�� -
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 wich the ordinances and codes of the City and with
the State Buildi.n� Code; that I understand this is not a permit and work is not to start without a
pernut; and thac the work will be acc d nce wi ` proved plan.
► �,A � �i � i I DATE: / �5� C' ,
APrLICA.i�r'T S SIGNATURE:
NOTE! Parade of Homes events require separate perntit approval by Police Department and
� City Council 60 days prior to tke event. Non permitted events will not be allowed. �
� �
Sec.13.Q4 RIGFiTS OF SLJBJECTS OF DATA '
Sutd. 1. Type o[data. The righ�s of iadividual on whom[he data is scored or ro be storad shall be u set focch in this setaon.
Subd.2. Intormation reqinred to be givea iadiridual. �1n individual uk:d w supply priva�e or coafidendal daca concerning himself sbaIl
be iafora:ed of: (a)the purgose and inrendcd use of the requcsted dara wichin the collecting�ate ageuty,polidcaI subdivision,or scatewide rysc-m;
(b)whec�er he may reFuse oc u,legalIy requir:d to suppty.che rquesud data:(c)aay Imawn coasequcnce arisiag from his supplyiag or reCusing to supply
privace or co:i.=�der.ria.1 data;and(d)the ideadry of o�her pecsoas or ead¢es auchorizcd by st�te or fedecal law to rnceive the dara. This requirement zha1I
nat apply when an ir.dividua!is asked to supply iaves¢garive dam,pursuaac ro secdon 13.82,subdivuioa 5, co a law enfaccemeat oE,lcar. . �
'T�a cenmiszioner of rovenve mav D1ace �he nodr rauird und-r this subdivision in the individual income taz or orooem eaz refund
inscrucdons tinstead of on chose Corm.s.
Subd.3. Accas to data by individual. Upon requesc ro a rzspansible authoriry,an individaal shall be informed wharher he is the subjecc
of stnr:d dsn on individuaIs,and whe�her it is c(ass�ed as public,privac�or conEdenaal. Upon his furchec r_quest,an iadividual who is ehe subjecc
of s:or.d privace ar pubiic data on individuals sha1l be shawn the daci wichout any charge to him and;if he desira,shall be infocmed oE the eontanc
ar.d meaning oE chat dara. Aher an individual has been shown�he privare dan and infocmed oC ie�meaaing,the daea aeed not be disclosed to him far
su mancfu thereafter unlas a dispuce or acaon purruanc to this se:aon is pending oc addiaoaal daca on the individuat bas been eollecc�d or crear_d.
The respocuible aud:ariry shall�provide copies of che privac�or public data upon request by[he individual subject of che dara. Tha respocuible auchoriry
may requir.rhe requesdng person ro pay the accual coses or making,eecrifying,and eompiling che capia.
The responsible auchoriry shalI compiy immediataly, if possible,wi�h any requesc made pursuanc to�his subdivision,or wi�hin five days of ,
the date of che reqaesc,ezcluding Sacucdays,Sundays and leg�l holidays,if immediace compliance is not possible. If he cannot comply with the reques� �
wichin d�ac drrse,he shall so inform che individual,and may have an addirioaat five days wichin which ro comply wich the request,excluding Sacurdays, !
Sundays and legat holidays. . .
Subd.4. Pracedure whea data ts not accurate or eomplete. An udividual may eonGsc ehe accurncy ar eompiec�ness oFpublic orprivace
dara conceming himself. To exercise chis right,an individual shaIl nodfy in wridag�he responsibie auctioriry describing the nacure of the d'isagreemeac
The respoasibic authoriry shall within 30 days ei�:cr: (a)cocrec�che data found to be inaccurdte or incomplece and attempt to nodfy past recipiencs of
inaccurdce or incomptece data, including recipien�s named by the individual;or(b)naaFy[he individual that he believes the data to be correcc. Dat�
in dispuce shali be disclosed only iF the individual's statemenc of disagrcement is induded with the d'uclosed data.
The decerminadon of the responsibte auchoriry may be appealed pursuanc to the p�ovisions of the adminisaarive procedure act relating to
contesud tases. •
DATA PRIVACY ADYISORY �
In accordance wich M.S. 13.04, Subd.2, "Ri�bts of subjecu of data", we would like to inform you tha[your request
for a pennit or license from the City of Orono or any of its depanments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to detemune your qualification for che pecm.it or license requested.
2. You may refuse to suppty da[a, but refusal may require that the Ciry deny the permit or license.
3. The information may be shazed wich other local, stace or federal a�encies to the etcent necessary to process
the permit or license.
4. If your requested permic or licease requires Council action to approve, some information may become
public. �
5. You have certai.n rights under M.S. 13.04�(availabte upon request) to review private data on yourself.
6. Your full name is required to process this applicacion or permic.
_' J�i�,�C� C�����'LJ �� � ��f-' ���(-'�
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I u rsi�d my ' hts as stated above. �
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Signacure '
DATE q IME
CITY OF ORONO CALLED IN ��-'�� / �
INSPECTION NOTICE SCHEDULED �--�y�9 �. '�n
PERMIT NO. �/�p.�3 COMPLETED
ADDRESS � S � a`�'�- ����
OWNER CONTR. �
TELEPHONE NO. � � —' 3 � �7
� DESCRIPTION
l� 01 FO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECT�ON
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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next i pe ion urs in advance.47 -7357
OwnerlContra r o si : �
Inspector.
White Copyllnspec 's Fil anar ite Notice