HomeMy WebLinkAbout1999-011924 - reside t ��• PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 E;,_f 7 4 t`si;
Crystal Bay, Minnesota 55323 Permit Number: ^ _�:y:=,F
(612) 249-4600 Date Issued: �- - - - - -
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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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PLICANT/PERMITEE SI ATURE ISSUED BY:SIGNATURE
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�'otal Fee: $ '��•�� Date Received: Q/ � �
�ntered By: .,. . Pemut#: 1 �.g �.� -
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CITY OF ORONO - BUILDING PERM�r APPLICA.TION '� � �
- _ � . _ . ;
� .All information must be submitted in full before plan review a'ill be started. . � �
� . . (please prini all information) ,- . . ' -
T'HE APPLICAIr"T IS: '��� � (circle one)�.� OSYNER OR. ONTRACTOR �� � • ` � . . � . . . �. . .
JOB SiTE ADDRESS: � a��7.� �L"onov:��:� e�rcJc�: �3-S`� !
. , ... �-.-.- .- - - _ _-.- �'vchl►oJz _ �
' PHONE: (home) �7.�_a$o S�
NAlti� OF O��R: S-�-e..� .
. . � (work) ' _
NIAILP�G ADDl�ESS: ��►..Q, CITY: ZIP: �
. CTOR: .� PHONE: 7��'Co�o `� g �� �
CO�RA
CO�►'TACT PERSO�I: MOBILE/PAGER:
�VIA.LLIti G ADDRFSS: CITY: Z7P: 5�4�a�
STATE LICE�'SE: � �I 7 9 � •
� A.RCHIT'ECTlEhTGI1�TEER:� . . . � r � . PHONE:.� � -
�Il�TG ADD�tESS: � . CTTY: � � ZIP:
. hAME: gEGISTRATIO�T#
T'S�E OF tiYORK: New Addition_, Accessory Structure
Move � RemodeUAlteration _ Land Alteration _ .
P OPOSED ti�ORK(describe in detai�: Q e-�� �� l ��'� 4"c� ' —
, � � � .�o���/
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STORIES: SQ.T'EET OF EACH FLOOR: . .
I�O. OF BEDROOII�..S: � GARAGE STALIS: ATT. _. DET._ . . . � .
FST1.I�IAZ'ED COVSTRUCTIO�I YALUATIO�i(excludina lanc�: $ 17, ��`j •
I hereby apply for a building permit and I acknowledge chat the information above is complete and
accurate;that the work�will�be in conformance with the ordinances aad codes of the Ciry and with
the State Build:.*►� Code; that I understand this is not a permit and work is not to start without a -
permit; and thac the work will be in accordance with tlie approved plan. -
PLICA�ti'T'S SIGNAZ'URE: DATE: 9'07 9- 9�
AP
NOTE! Parade of Homes events require separa ,ermit approval by Police Departrrcent and.
' City Counci160 days prior to tke event. Non permitted events Knil not be allox�ed
.
� . . - _ . .
Sec.13.04 RIGATS OF SVBJECIS OF DATA - -- , _� - - • • .
Satd. i. ?ype oI data. ?he righct of[ndividual aa whom dte data is stacsd or w be snoc:d sbalI be u sec tocih m chis secdcn, �
Subd.2. Iatormation nquired to be yivm iadlvidual. ,+�n sdividual uksd to supP1Y Pcivac:or eoafidendal dara coaceraiag himsetf sh�U
be iafocm:d o.: (a)the purpase acd inc:nded use oE the cequac�daa wichia the eoUecdng 3tire ageary.polidai subdivision,or sa�wide rystem•
� ••(b)whe�e:he r.ay rFiise oY u legatly requ'ir:d m supply che mqaesc:d data:(c)zay I�owa eaasequecca ar�tiag fmm his sicppiyiag ot refusiag to suppi�
: privac�orcoa::deaEsl daa;and(�t�e idendry o[a�:rpe�soas arearides auciariz:d by mie o�f-�e='L-�:i�r.c:ive r�e daa. Tttis cequire�ent s.�.11 . .
�not apply w;;ea art i.dividuaI is uked to supply iavesagadve daa,pacsuaet oo secdac 13.8L.subdivision 5,oo a!aw eafactemeat ofticea .r� :. :- , .
The eeaimissioner of reveaue mav otsc••che nadr_ rauir-d urtd-r this sutdivuion in the individual irtcome tu or omoem taz retbrd
Inmuetions L�suad of on those faetns.
Subd.3. Aceess to data bY indivZdual, Upon requesc co a�espaasible au�hodry.aa individ�al shaIl be infoaaed whe�her he is�he subjecc
of stord daa on iadividu3ls.aad whecha it Is elassifi:d u pablic,privar or eanF.deadal. Upoa his fucsher rques�aa iadividwl wito is th-,subjea
of siocrd priva::or public daa on Iadividuals shaIi be showa the daca w��tsout any charge to him uid;if he des'ues�sha11 be iaCocmed o[the coatenc
aad meaaing o[dut daa. Aher aa individual has beea shown cbe privatb daa arsd Iatormed ol ics maaing.che dan ne.-d noc be ditclosed to him tor
six moachs thereafuc ac�l:ss a d'upuce oc actioa puesuanc w this secdon Is peading or addidooal daca on the iadividual hu beea eotIecc:d or ereated.
The cesponsibie anthociry shatlpcovide eop'ies o(the pcivau o�public dan apan request by the iadividual subjecc o[the daa. �e respoos4bie aurhoriry
may requir:rhe csquesdng person to pay che acaca!cosu aF nsakiag�eecdfyin�.aad eomp�liag the eopia. • �
Ttse cesQonsbie authoriry shall eompiy immediatety�i!peuibie.wi�h aay request mad:pursuant to thi.s subdivisioa,oc wichin five days of '
the dax o[the requesc.excluding Saardays.Sundays and tegal holidays.if icsuaediate eompliaace is not pouible. If he eanaoc eompty wirh ti�e requesc �
withia dut ti�ae,he shall to hiform�he individuaI.aad may have an addidooaI t►ve days wichin which to compiy wich the cequu�ezcIuding Saturdays. '
Sandays utd(egal hol'idays. � . . _ . , .
Subd.4. Proeedure whm dzta Ls not aeeunte or eomplete. An iadividual may eonc:st the ace�rary or eomple�eaess olpubtic or privace
dzn eonceming h'uasel! To acetcise chis righ�an trtdiv�ual shatl nodfy ia wridng dte respoos�Ie auchoriry daenbiag the naeure ef die d'uagreemeac '
The tesporuible auchodry shall wichia 30 days ei�:er. (a)eotrect the dara fouad m be inaccunte or iacomptete aad uump�w nodCy past raipieats of
tnaceucate oc incomplece dara.lacluding recipiea�s naresed by the individuaI;or(b)ttadty the iadividual that he believes the d�to be correct Dati
In dispace shall be d'uclosed onIy it the individual's satecaenc o!disagreeac:ac Is iaeluded winc�he d'ucloud dam.
The daecminadon of ehe respoasible aurhoriry may be appealed pursuaac to the provisions of the admtnisaadve proceduce ace teladag to
eontescd casas. ' . . . . . .
. DATA PRTVACY ADYISORY . . . � � ;
In accordance with M.S. 13.04�Subd.Z, "Ri�.Phu of subjects of data",we would like to inform you t&at your nquat
for a peraut or Iicecue from the Ciry of Orono or any of ics deparcments may require you to furnish cerca.i.n private or
confideatial information.
You are notified that:
1. The informatioa you furnish will be used to determine your qualifcadon for the permit orlicense requested.
2. You may refuse to suppty data, but refusal may require tlzat the Ciry deny the perm.it or license. ' �
3. The information may be shared vsrith o�her local,scace or federal a;eacia to the euenc necusary to pmcess
the permit or license. '
4. If your requested pecmit or license requires Couacil actioa to approve, some iaformation may become � ;�
. public, � • _ �. . . . . . . � . - �:
. .'S. � You.have certaia righcs under M.S. I3.04�(available upon requat) to review private data on,yourself. . . '
6. Your full name is required to process this application or permic.
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Ciry Sate Zip Phone
I understaad my rights as stated above.
Signacure . •
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED �-� �—
PERMIT NO. COMPLETED ( �
ADDRESS � � � � G C��
OWNER CONTR. �qv�. ��- ��
TELEPHONE NO. � �-1� a'g�
� DESCRIPTION�7> g�lY1 G)
ty 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FI A 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
�C ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �:_ PHOTO TAKEN
INSPECTOR WILL RETURN f CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContrac on sit .
inspector.
White Copyllnspector's File Canary CopylSite Notice