HomeMy WebLinkAbout1998-010490 - re-roof/tear-op PERMIT
CITY OF ORONO PERMIT TYPE:
2750�ielley Parkway- P.O. Box 66 `�'•j��-#�.���t�`
Permit Number: {��;F���.;�_t
.G�rystal Bay, Minnesota 55323 _
(612) 473-7357 Date Issued: i;;:f�;«;�'�;;�;
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/PEFMITEE SIG URE ISSUED BY:SIGNATURE
,� s.;�otal Fee: $ Date Received:
' T'atef�d By: Permit#:
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CITY OF ORONO - BUILDING PERMIT A)PPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) .
THE APPLICAI�TT' IS: (circle one) OWNER OR CONTRACTOR � � .
JOB SiTE ADDRESS: j ,-�. .�-��:_� � �� � ' '� `— ZIP: �� �=.��'-'� 1
L-`�- 17��t�"`-' 1--�-�� �t�
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� NAME OF OWNER: ��r" �:f�:;-:.'� � '=`Y n�ni t,,�i� L_l , PHONE: (home) � � '� � � s� ,,
(work)
MAILING ADDRESS: � 1-��c� L�r rri�F f�-r`z� CTTY: r�`fUs� ZIP:S�.;�=
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CO�"TRACTOR: �i�: �.�}�� �� �� C�-� I�-�S'� , PHOivE: �� � ,`� ,�_S I
CONT'ACT PERSON: �?vr MOBILE/PAGER: 's�C.� — 3 i/ ��
MAILING ADDRESS: ��� i <-- �s��N+.u�r� ��r�!,�ITY: �'1��.�,�:•]:; ZIP: c-�``;�; �
STATE LICENSE: # `'J'">��
A.F.CHIT'ECT�EI�'GINEER: PHOiVE:
;YIA ILTiYG ADDRESS: CITY: ZIP:
I�,TAME: REGISTR.ATION#
TYPE OF tiVORb'.: New Addition Accessory Structure
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Move � Remodel/Alteration s Land Alteration
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PROPOSED tiVORK(describe in detai�:
STORIES: SQ.k'EET OF EACH�'LO�R: � -
NO. OF BEDROOiYIS: GARAGE STALIS: ATT. DET.
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EST�VIATED CONSTRUCTION VALUATION (excludi.ng land): $
I hereby apply for a buildin�permit and I aclmowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry 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 i.n accordance wit�h t�e approved plan.
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APPLICANT'S SIGNATURE:��� �`���� ���-�_.'~�-, DATE: 1 .` ��� I ��
NO?'E! �Parade o Home events require separate permit approval by Police Departmerat ca�td
� City Counci160 days prior to the event. Non permiited events will not be allowed.
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Sec.13.Oh RIGHTS OF SUBJECTS OF D�TA
Subd. 1. Type of data. The rizhcs of individual on whom the data is store3 or to be scnr:d shaIl be as set for[h in this secdoa. =
Subd.2. Information reqtrired to be given indicidual. An individual azked to suppiy privare or confideoaai dara concerning himsetf shall
bz informed of: (a) [he purpose and inr:aded use of tho r.quuc.3 data wi�hin the colle:dng Star�ageacy,polidcal subdivisioo,or sratewide system;
(b)whecher he may refuse or is le3al[y requir_d to supply the r_quested dac3;(c)any Imown coasequence arising from his supplying or refusing to supply
privace orcoruidendaI data;ar.d(d)the idanary of otherparsoas or enoaes auchoriz=d by sca�e or federal law ro receive the dara. Zhis requiremeat sha11
not app[y whan an individual is asked to supply invesri�adve daca,pursuanc to secdon 13.82,subdivision 5, to a law enforcement ofFccer. -
The comr,ussioner of revenue mav olace �he noece r_ouird und=r[his subdivision in the individual income tax or orooem az refued
insrrucdons insccad oE on chose forms.
Subd.3. Access to data by iadivzdual. lipon request to a responsible auchoriry,an individual shall be inFormed whethec he is the subject �
of scord dati on individuals,and whether it is classified�s pubiic,private or conFdendal. Upon[vs furcher reques�,an individual who is the subjec�
of s[ored privace or public daca on individuais shall bt shown che dat�wichout any char3e to}iim and,-if he desires, shalI be informed of the conten�
and meaning of chat data. Aher an individual h�s been shown[he privare data and informed of iu meaning, the data need not be disclosed to him for
six monchs cf:ereaiter unless a dispute or acaon pursuzn�to chis secaon is prnding or addidoaal data on the individual has been collecc�d or creared.
Tht rsponsibl�atcthoriry shall provide copies of the private or public data upon reques�by the individual subjecc of thc data. Thz responsible aucfiority
may requir the requesdng ptrson to pay the accual cosu of rt�king,cerafying,and compiling the copies.
'Ihe responsible auchoriry shall eonpty immediately,if possible,wich any tzquest made pursuant to this subdivision,or wichin five days of
the date of�he requesc,exciuding Sacurdays,Sundays and legal holidays,iF immediate compliance is not possible. If he cannot compty with the request
within chat time,he shall so inform[he individual,and may have an addiaonal five days wicfiin which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or compleee. An individual may contest tho accuracy or completeness of public orprivate
data conceming hiriself. To exercise�his ri¢hc,an individual shall noa"ry in wriring[he responsible auchoriry dtscribing the nacure of the disagreemeat.
The responsible authoriry shall wichin 30 days eicher: (a)corrcc che dam found to be inaccura�e or incomplece and attemp[to nodfy past recipien�of
inaccunte or incomplece dara, including recipien�s named by che individual; ar(b)noafy the individaal that he betieves che data ro be coaecc. Data
in dispute shaii be disclosed only if the individual's sc3�emeat of disagr:ement is included wich the disclosed daca.
Th�decerminadon of the responsible authoriry may be appealed Pursuant to the provisions of che administradve procedure act re(adng to
conta�ed eases
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�hts of subjects of data", we would li.ke to inform you tha[your request
for a pernut or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified thar.�
1. The information you fumish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require tha[ the City deny the perm.it or license.
3. The information may be shared with ocher local, state or federal a�encies 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 have certain rishts 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.
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First �iiddla /,� Las�
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Address `� �'
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Ciry Smte Zip Phane r
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I understan my ri;hts as,�tated�above:
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Signan:re
D� TIME
CITY OF ORONO CALLED IN 0- V U
INSPECTION NOTICE � b SCHEDULED �b 9� �� 3 �
PERMIT NO. U � COMPLETED _�_ 1�
ADDRESS v v �'�^-�
OWNER �Z�G��NTR. �
TELEPHONE NO. �'F73 -- S l�
� DESCRIPTION
ly� 01 FOOTING 11 MECH AL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECH ICAL FINAL 19 LAKESHORE/WETLANDS
ti
Q 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
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:
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W� RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. n pHOTO TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR r� CITATION ISSUED
❑ INSPECTIOtJ REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac�srey si •
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Inspector. ��
White Copyllnspector's File Canary CopylSite Notice