HomeMy WebLinkAbout2001-P04399 - re-roof • �
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po4399
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600
Date Issued: 9i2v2oo�
SITE ADDRESS: 2570 Lydiard Ave
EXCELSIOR,MN 55331
PID: 2t-�i�-23-22-ooti
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Permit Class: Building Census Code O/S- Building
Permit Type: Minor Alterations Permit Sub-type(s): Building- Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 167.25
Valuation: $ 8,215.00
State Surcharge Fee: $ 4.15
TOTAL FEE: $ 171.40
APPLICANT: Allstar OWNER: �NDY,CHRISTINA&ANGELA PETERSO
8401 73rd Ave N 2570 LYDIARD AVE
Minneapolis, MN 55428 EXCELSIOR, MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERIvIISSION 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.
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/ ICANT--f' RMITEE SI NATURE SSUED BY SIGNATURE
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Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1
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Total Fee: $ 1 7 � � y d Date Received: �;� 7-�� �1
Entered By: ;f�Vl=�� Permit#: /�U `�' C y�
CITY OF ORONO - BUILDING PERNIIT 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 O�L[TRACTO�.
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JOB SITE ADDRESS: � �j ��� �. `I �'� Lr� i'��A ZIP:
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NAME OF OW�1ER: �,��i'I �� �'7�G�,-S��'�� PHONE: (home)��I ��J �J�
(work)
MAILLITG ADDRESS: �.,��.�v L�,�;�%� '>".�.". CITY:.!v'4�%y r,�� ZIP:
CONTRACTOR: �j;�.`�% ��,:;�. - , PHONE: �� -� ��S J ���J -
CONTACT PERSON: MOBILE/PAGER:
MAILINGADDRESS: ' c�� 7��`2`�:�,',t� ,�J;. , CITY: I�����1 ;;�' ZIP: °_,-y � '.
STATE LICENSE: # ` M�_�
ARCHITECT/ENGINEER: PHONE:
MAILll\G ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: ' -�f� - � �-��� �_ � �;S<` �'�•1t• �'
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ,�j � i�>
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 Buildin� 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.
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APPLICANT'S SIGNATURE: - �,,,,,,,='"�� DATE: ��=-..-��-��/ _
NOTE! Parade of Homes events require separate pernzit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGH'TS OF SUB.TECTS OF DAT�
Subd. 1. Type of data. The ri¢hts of individual on whom the data is stored or to be stored shall be as set forth in this secrion.
Subd.2. Information reqtared to be given individual. .�n individual asked to supply private or confidenrial data concecning himself shali
be informed of: (a)the purpose and intended use of the requested data within the collecang'stace agency,poliacal subdivision,or sratewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply
private or confidencial data;and(d)the idenriry of ocher persons or enndes authorized by state or federal law to receive che data. This requiremenc shall
not apply when an individual is asked to supply invesaeaave data, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the noace reauired under this subdivision in the individual u:come tax or propem tax refund
instructions ins2ad of on those forms.
Subd. 3. Access to data by individual. Upon reques[to a responsible au[horiry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public, private or confidential. Upon his further request, an individual who is the subject
of scored private or public data on individuals shall be shown the data wirhout any charge to him and, if he desires, shall be informed of[he contenc
and meaning of that data. Ahzr an individual has been shown the private data and informed of its meaning,the daci azed not be disclosed to hirn for
six months thereafter unless a dispute or acaon pursuant to this secdon is oending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of rhe dara. The responsible authoriry
may require the requesting person to pay the acrual costs of makine,cerafying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, wi[h any request made pursuant to[his subdivision,or within five days of
the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply wi[h the request,excluding Samrdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pricate
data conceming himself. To exercise rhis right,an individual shall nonfy in wri[ing the responsible authori[y describing rhe nature of the disagreement.
The responsibte authoriry shall within 30 days either: (a)correct the data found to be inaccunte or incomp(ete and a[z.:mpt to norify past recipienu of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes rhe data to be correct. Data
in dispute shall be disclosed only if the individual's sta[ement of disagreement is included wi[h the disclosed data.
The de[ermination of the responsible authoriry may be appealed pursuant to the provisions of the admuustrarive 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 o[her local, state or federal a�encies to the e�tent necessary to process
the pernut or license.
4. If your requested pernut or license requires Council action to approve, some information may become
pubiic.
5, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION OTI �- SCHEDULED J�#,e�,/� -rL�'
PERMIT N0. ��� COMPLETED � � � .� �-�
ADDRESS ��7� - �-��
OWNER� �' ' CONTR.G�.C2•�-�z-�. ��
TELEPHONE N0. ' ��� �5.� � �`�`��
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� DESCRIPTION /ti,�,
� 01 FOOTWG G 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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
� OWNERfCONTRACTOR TO MEET YOU:_YES NO
� COMMENTS:
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W ❑ ORKSATISFACTORY:PROCEED f�g�OJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTfFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
Inspector. ����_ �� � G�
White Copyllnspector's File Ca�ary Copy/Site Notfce