HomeMy WebLinkAbout1998-010971 - roof repair damage � � _ . PERMIT
•�TY OF ORONO PERMIT TYPE:
' 2750 Kelley Parkway- P.O. Box 66 Permit Number: -�' `-�-" �`'``=`
Crystal Bay, Minnesota 55323 Date Issued: �`S�'`-''�'`
(612)473-7357 + �.:�:"j''=:�_:
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APP ICANT/PERMITEE SIGN ��-- ISSUED BY:SIGNATURE � f �
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. Total Fee: $ � ' � - -���� Date Received:
Entered By: Permit#: (;�� �;' �
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER CONTRACTOR _.�
JOB SITE ADDRESS: /S7� �o r�� .��►`�� � ��v�� ZIP: �5�.5 3 5�,
NAME OF OWNER: �r=,�,�/ (��Ci4,� /� PHONE: home G
� ( ) /73 G���
� (work)
� MAILING ADDRESS: ��-�'✓�"�' CITY: ZIP:
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`r' CONTRACTOR: ���C',��/ ���, �7"- PHONE: ��� J�.2.S�
� CONTACT PERSON: jo,� �/2,ec/ MOBILE/PAGER: _.��.�-� a 3 y
� MAILING ADDRESS: 3 � ,CPy,� S"T CITY: �,Pp�tl� ZIP: SS�.���
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� STATE LICENSE: # ��'/
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ARCHITECT/ENGINEER `�-- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detai�: /��py�/� ��c�r�� �i9�1���`= �'/ic-�Sc�
� '�'c" ,�i i�l v° .� /_�2 � X /3 � �o ,
STORIES: l SQ. FEET OF EACH FLOOR: �5� }�,�',��'�
NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ C,��?G �
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 acc�e with the a roved plan.
APPLICAI�IT'S SIGNATURE: ����c-� �� (��—�._ DAT'E: ��� � ���
.i �--
NOTE! Parade o�'Homes events require separate per�r�a�pproval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sea 13.04 RIGHTS OF SLBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqwred to be given individual. An individual asked to supply private or confidential data concerning himsetf
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide
sysum;(b)whether he may rzfuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or
refusing[o supply private or confidendal dara;and(d)the idenary of odier persons or enrides authorized by sta[e or federal law to receive the data.
This requirement shall noc appl}• when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement o�cer.
The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or orocertv tax refund
instrucrions instead of on chose forms.
Subd. 3. Access to data b}•individual. Upon request to a responsible authoriry,an individual shall be infortned whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his fucther request,an individual who
is the subject of stored privacz or public data on individua(s 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. Afrer an individual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six mon[hs thereafcer unless a dispute or action pursuant to this secuon is pending or addirional data on the individual has been
collecud or created. The responsible au[horiry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible au[horiry may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply itnmediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that dme. he shall so inform[he individuai,and may have an additional five days within which to comply with the request,
excluding Saturdays,Sunda}s and te¢al holidays.
Subd.4. Procedure when data is not accurate or compiete. An individual may contest the accuracy or completeness of public or
private data conceming himself. To ezzrcise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible au�horin shall wirhin 30 days either: (a)correct the data found to be inaccurate or utcomplete and attempt to notify
past recipients of inaccurate or incomplzte data,including recipienu named by the individual;or(b)noNfy the individual that he believes the dara
to be correct. Data in dispu[e shall lx disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible aurhoriry 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 fumish 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
public.
5. You ha�•e certain righu 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 Middte 1-ast
Address
Ciry State Zip Phone
I understand m r' as scated above.
�ignature `
6
DATE �IME
CITY OF ORONO CALLED IN �.f_ a3 Q `c�
INSPECTION NOTI E SCHEDULED �j' � �9� '
PERMIT NO. � COMPLETED
ADDRESS 1��5r
OWNER � CONTR.
TELEPHONE NO. ���-S�IciCi
� DESCRIPTION
� NG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANOS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 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
Q OWNERICONTRACTOH TO MEET YOU:_YES_NO
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
�INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance.473-7357
OwnerlContractor o
Inspector. -
White Copylinspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO � � CALLED IN �—��.,
INSPECTION NOTICE �i(}� SCHEDULED ��� ��va
PERMIT NO. COMPLETED
ADDRESS I��S �'�� Cd��' �LU�7
OWNER CONTR. '"���%�+� '���
TELEPHONE NO.
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 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
� 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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W ❑WORKSATISFACTORY:PROCEED i=1 PROJECTCOMPLETE
� �RRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�' CITATION ISSUED
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice