The URL can be used to link to this page

Home My WebLink About2005-P08675 - re-roof . � CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Pos6�s Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: si3i2oos SITE ADDRESS: 3sss Lyric Ave Wayzata,MN 55391 P I D: 17-117-23-43-0106 �_" DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 29.60 Valuation: $ 640.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 30.60 APPLICANT: Owner/Self OWNER: Tom Haugan MN 3585 Lyric Ave Wayzata, MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION 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. --^� > : /\ /// .._,......�� '7 4' `/ �V J .../"�' � �- �'�/1' ,��"' ��-� A ANT PE IGNATURE ISSUED BY SIGNATURE / ,. Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1 . � Total Fee: $ Date Received: Entered By: Permit#: CITY OF OI20N0 - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be stai�ted. (please print all i�rformation) ----------------------------------------------------------------------------------------------------------------------- THE APPLICANT iS: (circle one) WNE OR CONTRACTOR JOB SITE ADDRESS: �c� �� - �` �' e '`i� ZZp: S S s`�l ( Will this be a Pa�•ade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a special event per-rnit is reqa�ired with Police Depnr-tme��t and City Council approval 60 days prior to the event. Slzzrttle bus seivice will be reqt�ired a�nless applicant demonstrates strfficient on-site parking is available. Non permrtted events will not be allowed. NAME OF OWNER �1`'l. �i4��=��R� PHONE: (home)�7SZ ��Q�� (work) MAI�ING ADDRESS: ��'�� '7 ��- ►�� CITY: ��'� ZIP: SS 39/ CONTRACTOR: ��- � PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: ti �,A PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home RemodeUAlteration � PROPOSEDWORK(desct�ibein detai�: �-��J� ��l�c�- ��c�� sr-►�^�� S STORIES: Z. SQ.FEET OF EACH FLOOR: y �� NO. OF BEDROOMS: Z. GARAGE STALLS: ATTACHED DETACHED r/ ESTIMATED CONSTRUCTION VALUATION(excluding land): $ (a�� ,��" 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 accordance with the approved plan. APPLICANT'S SIGNATURE: --� �' DATE: � �S, �..5� �-- 31 e . Sec.13.04 RIGHTS OF SUBJECTS 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.Z. Information required to be given individuai.An individual asked to supplyprivate or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data�vithin the collecting state agency,political subdivision,or statewide syste; ,(':;� whether he may re£use or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall not apply when an individual is asked to supply inves[igative data,pursuant to section 13.32,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is the su6ject of stored data on individuals,and whether it is classified as public,private or confidentiai. Upon his further request,an individual who is the subject of stored private or public data on individuals sha11 be shown the data widlout any charge to him and,if he desires,shall be infomted of[he content and meaning of that data. Afcer an individua]has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereaRer unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the priva[e or public data upon reques[by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,ceRifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this sttbdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if imtnediate compliance is not possible. If he cannot compty with the reques[ within that time,he shalt so infoi�n the individual,and may have an additional five days within which to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete.An individual may contesc the accuracy or completeness of public or private data conceming himsel£ To exercise tltis right,an individuai shall notify in wiiting the responsible authoiity describing the nature of the disagi-eement.The responsible authority shall within 30 days either. (a)con-ect the data found to be inaccurate or incomplete and attempt to notify past recipienis oi inaceurate or incomplete data,including recipients named by the individual;or(b)notify[he individual that he believes the data to be wrrect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disdosed data. The deteiTnination of the responsible authority 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 subj ects of data",we would like to inform you that your request for a pemlit 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 pernlit 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 infornlation may become public. 5. You have certain rights under M.S. 13.04(available upon renuest) to review private data on yourself. 6. Your full name is required to process this application or permit, First Middle Last Address City State Zip Phone I understand my rights as stated above. �� Signature 32 � � DATE TIME CITY OF ORONO CALLED IN S '�� `/'��'-`� INSPECTION NOTI�E ' SCHEDULED "�S G� ;�?v��<''�7 PERMIT NO. �� `5�� COMPLETED ADDRESS �J t� j �.(/r;� r _ .l��L�� - �,: OWNER� /M. �r;v'�i_�c CONTR. ��/rc�i'l�r,r` TELEPHONE NO. �_S_� �� _�D � CJ � DESCRIPTION ��f L%��` � �C�-F' � �� 01 FOOTING 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 � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 t 36 FOUNDATION/REMOVAL OWNE CONTRACTOR TO MEET YOU: ES_NO �' {t ��. '�f-�`�,r;L � COMMENTS: � � � W C � J O � � O � W -- + � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContrac s' e: Inspector. White Copyllnspector's F'e Canary Copy/Site Notice � DATE TIME � ITY OF ORONO cn�� INSPECTION N CE �SCHEDULED ��/]?� PERMIT NO. COMPLETED � ADDRESS �S gJ� �- �r/ C � OWNER� �--/i� i.t rt?l�, CONTR. TELEPHONE N0. � � �� DESCRIPTION '7 � T��Y�. � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIG FINAL 35 HARD COVER REMOVAL J 10 PIUMBING FINAL `�/` 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � a W WORKSAT{SFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY W O ❑�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL O ARRANGE ACCESS. Ca11 for th ex 'n pection 24 hours in advance. (JSZ� 24J-46�0 OwnerlContract ' n sit : Inspector. White Copyllnspector's File Canary CopylSite Notice