HomeMy WebLinkAbout1999-011588 - tearoff/reroof , ERMIT
` CITY OF ORONO PERMIT TYPE:
275� Kelley Parkway- P.O. Box 66 �_�_}:;.,.�.:��;=�wi;
Permit Number:
Crpstal�Bay, Minnesota 55323 Date Issued: `'''� !'"'"�'
(612)473-7357 ��i�.;''z:=;,f�_;�=
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY: �
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CONTRACTOR: — ra����1 i!_.=�-�T. — � . . _.� .OWNER:
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A LICANT/PEFMITEE SIGNATURE ISSUED BY:SIGNATURE
� Date Received: � �d3�9 S
Total Fee: $ �
Enter�d By:• Permit#: //58 � � �
CITY OF ORONO - BUII.DING PERMIT APPLICATION � �
A,ll information must be submitted in full before plan review will be started. .
� (please prira all information) . .
THE APPLICA1ti'T IS: � � - (circle one) . O�NER O CONTRACTOR . � � �
JOB SITE ADDRESS: .3C9�S � � '� ✓'�� �G �ve- , ZIP: �
I�'A1�iE OF Oti��R: �"�e�e. (�o �� �l PHONE: (home) �7� — 7 7�1 �
(work) �
M A B,I�i T G ADDT•ESS: 3 C� l S L�,�� +� 14�� crrY: t,J�. ��. � znP:__�SS�g�
co�.A.c�coR: c�a k� ����f cld c� �Pro�� Pxorr�: ��a-��3-a��o
CONTACT PERSON: MOBILE/PAGER:
MAII., .�i'G ADDRESS: g�S S l�l4c.(c �'yic�o le (�/', CITY:�'•...►re�, �(�'+o�G�� ZIP: S.y'3`f
STATE LICEI�TSE: �# abOU 3�?I �
ARCHITECT�ENGIIVEER: . PHOti'E: ��
1�IAILING ADDRESS: __ CITY: ZIP:
� NAME: REGISTRATION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration_
PROPOSED tiYORK(describe in detai�: ��q ci r��� C'r v►� i!'�iiD���� V'oo�� �!'l 9
�� S— ��t�(� � � e
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALIS: ATT. DET. � � � . .
ESTII�i IA.TED CO�TSTRUCTION YALUATION(excluding lanc�: $ �� � �� ' O0 .
I hereby apply for a building permit and I acknowledge that the i.nformation above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Build�n� Code; that I understand this is not a permit and work is not to starc without a
permit; and th�c the work wi11 be in accordance with the approved plan.
APPLICANT'S SIGNAT'URE: ��1Y�1� D�'TE: �'o� 3— 99
NOTE! �arade Homes events require separate permit approval by Police Department and
� City Council 60 days prior to tke event. Non permitted events will not be allowed.
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See.13.04 RIGATS OF S[JBJECTS OF DA?A '
Subd. 1. Type of data. The righcs o!iadividual oa whom the data is swced or�o be sca�ed shall be u sec focch ia this seetion.
� Subd.2. IntocmaGoa nqi3red to be givm individual. An iadividuaI uYed to supply pcivate or conFidendal dan conceraing himself shaIl
be iafocmed o`: (a)the purpose aad inreaded use oE the cequesud dan withia the collecdag Eta�e agenry.polidaI subdivisioa,or sntewide rysum;
� (b)whe�er he caay refuse or u,legalty requir_d�o suppty.�he mtuesred dara:(cj aay tmowa coosequeace arisi.cg from his siipplyiag or re[using to syppty
privac�or con.�ider.dsi dara;arid(d)the idendry of ochupersoas or enrides auchacized by snce or federal law to rn:eive ehe dara. This requiremeac shali
aoc appty w�en ari ie.dividuaI is uked to supply iavesdgadve dan,pursuaat ro seedon 13.82,subdivisioa S,oo a law entoccemdac officer. .� . �
The eec:tmissioner of rcvenua mav oTace the aace- rauir-d und���is subdivision in the individual income eaz or orooem raz refund
insc�vcaons inscesd of on those fomu. •
Subd.3. Aecas to data by iadiv[dual. Upon request w a responsible auchoriry,an'mdividual shaIl be informed whether he is�he subjecc
o!stor:d daa on individuats.and whecher ic is dassiGed u public,privat�or conF.deaoal. Upoa his furcher requesc.an iedividual who is�he subjr.c
of stoced private or public dara an tndividuals shall be shown ehe dam wirhout any charge to him aad;it he duiru.shall be infocmed of the eonteac
and meaniag o[d�at data. Afur an individual has beea shown the pcivare dan aad inforaied o[ics meaaing,che daa nead not be disclosed oo hua for
six months thereahet unless a d'�spute or aecon punvanc to this secdon is pending oc addidoeal dara on the iadividual has beea eoUected or erea�.d.
The cespaasible aurhoriry shall'provide eopia ol the pdvu-or pub[ic dara upon request by rhe individual subject of�he daa. The responsi'ble auehociry
may require�he cequesdng peaon W pay che accual eoses oF inaking,cecdfying,usd comp�ing the copia.
The responsible aurhoriry shall compiy immediacety.if Qossible,wieh aay tequac made pursuuu w�his su6division,or wi�hin five days of
the dace o[the requesc,exctuding Saturdays.Sundays and legal hotidays,lf immediace compGaace is not possible. Ithe cannoc comply with the request
wi�hin thac dme.he shail so inform the iadividual.and may have an addidoaaI five days wirhin which to comply wich the cequac.exctudia'g Saturdays,
Sandays and legal holtdays. . .
Subd.4. Procedure when data Ls not acearate or complete. M iadividual may eontest the acc�nry or completeaess of pubtie orpriva[e
dam coacuning fiimseif. To execcise this right,an individuaI shaIl aodfy ia wridag ehe cespoosibie aud�odry desen'bing the nanue of the d'wgreemeac. .
The respoasible auehoriry shall wichia 30 days eicher: (a)correct rhe dara tound ro be inaccunte or iacomptete and atumpc to nodfy pasc recipients of
inaccucace or incompiece data,including recipieacs named by che individual;or(b)nodfy the individual thac he betieves the dara to be cocrect Dat�
Ia dispua shall be d'uclosed only if the individual's staeemenc of d'uagreement is inciuded wich the d'ucloud daa.
The de�ecminadon of the responsible auchoriry may be appealed pursuant to the provisions of the adminismave pcocedure act retating to
eontesced eases. ' - •
DATA PRIVACY ADYISORY �
In accordance wich M.S. 13.04,Subd.2, "Ri�hts of subjects of data",we would like to inform you that your request
for a permit or license from the Ciry of Orono or any of iu deparcmenu 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 qualihcation for the pecmit or license requated.
2. You may refuse to supply daca, but refusal may require that the Ciry deay the permic or license. �
3. The informatioa may be shazed with ocher local,stac�or federal agencies to the exceac necessary to process
the permit or license. �
4. If your requested permit or license requires Council action to approve� some iaformation may become
. public. ' � � . . . . , . .
S. You have certain rights under M.S. 13.04�(available upon requesc) to review privace data on.younolf. . .
6. Your full name is required to process this applicacion or permic.
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Ciry Scite Zip Ptiaee
I understaad my ri;hts as stated above.
Signacure
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DATE TIME
CITY OF ORONO CALLED IN ��Q���i�
INSPECTION NOTICE SCHEDULED // '• ;3D
PERMIT N0. � `� � �� COMPLETED
ADDRESS �S � —�V�`%
OWNER CONTR.__':��/r` .r,-�,
TELEPHONE NO. _% '`�3 - �(�;d
� DESCRIPTION /f OJi�,a�
� 01 FO 11 MEC ICAL RI 18 EXCAV/GRADING/FILLING
2 FRAMING ^ 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
J 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
� COMMENT . .
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ CORRECT WORK 8 PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
L CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
L INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advanc 473-7357
Owner/Cont r on site:
Inspect .
ite Copyllnspector's File Canary CopylSite Notice
CITY OF ORONO CALLED IN �"��'�� T�M U�
INSPECTION NO I E SCHEDULED �_��—. / 3 �
PERMIT NO. �g COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO. 9�3 — 2�(�!
� DESCRIPTION
� 01 FOOTING 11 ME ANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 ME HANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 12 WATER HOOK-UP 17 SITE INSPECTION
OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� O-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
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITAT�ON ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next' " n 24 hours in advanc .473-7357
OwnerlContra on s te•
Inspector.
White Copyllnspector's File Canary CopylSite Notice