HomeMy WebLinkAbout1999-011587 - tearoff/reroof PERMIT
�CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - ; ���;�v,-;
Crystal Bay, Minnesota 55323 Permit Number: :._{`��_,':T:.+f
(612) 473-7357 Date Issued: _ ._
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY: I'
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Tofal Fe�: $ 7�o-�b Date Received:_ �v-��—y
Entered By: Permit#: �
CIT'Y OF ORONO - BUII.DING PERMIT APPLICATION � �
- �
All information must be submitted in full before plan review will be started. .
� (please print all information) , .
THE APPLICANT IS: � � (circle one) .� O�NER CONTRACTOR . �
JOB SITE A1�DRESS: .�Cp� �f �-�'1 �''� fG �U�. , ZIP: �
1�'Alb� OF O��fi'ER: �'� ��h PHONE: (home) �-� 797U
(work) � v O
MAILIYG ADDF•ESS: ��.2`�� CTTY: ZIP: _
CO�RACTOR: �/J ��1e�oS PFiONE: Ce�.a— 9��3-a��d
CON'TACT PERSON: � MOBILE/PAGER:
MAILTtii'G ADDRESS: �(�g� �61�G� i'Lictdl� ,�r, CITY:.���� �/'4��'i� ZIP: S�
STATE LICElti'SE: # a6o 0 3 a �/ �
ARCHITECTlEi�'GINEER: . PHOti'E:. �
17.ATLPi TG ADDRFSS: CIT'Y: ZIP:
. NAME: gEGISTRATION#
TYPE OF tiYORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration_______
PROPOSED ti'YORK(describe in detain: lP�✓ 4'�� ��C� ��11��— �'�o��r4
.
STORIES: _______ SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GA.RAGE STALLS: ATT. DET. � _ .
EST .Jl�i IATED CONSTRUCTION VALUATION(excluding land): $? � �U . 0 � .
I hereby apply for a buildino 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 Ciry and with
the State Build�n� Code; that I understand this is not a pemut and work is not to start without a
permit; and thGc the work will be in accordance with the approved plan.
� ��u'C�� DATE: t� a�I�R
APPLICANT S SIGNATURE:
NOTE! Parade q�'Home� events requir separate permit approval by Police Department and
� City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.Q4 RIGKTS OF SUSJECTS OF DATA ' �
Subd. 1. Type o[data. The righcs of iadividual on wham the data is scoced or to be scoced shalI be u sec focsh ia this secdoa
� Subd.2. IntormaCoc req�rired to be givm individual. An iadividua!uked to suppiy private or confideadal daa coaceming himself sbaIl
be informed oE: (a)the purpose and iateaded use of the requessed daa wichia the collecang�nm ageary.polidal subdivision,or satswide system;
(b}whe�tec he tnay reCuse oY is legally ceqti�r:d to supply:the requesud data:(c)acy faiown caauquence arising from his supplyiag or refusiag to suppty
p;ivsr_or co:.�daadaI dara;and(��e ideadry of och:r penoas or eaddes auchociz:d by scare oc fedenl law to rnceive the daa. Tbis requ'uemeac shall
aot apply when an individual is uked to supply invurigacve daa,pursuaat to secdoa 13.82.subdivision S.oo a faw eafoc¢emeac officer. .- . •
The eecnmissioner of rcvenu:mav olacr the nocce r_�uir:d und:�this subdivision in the individual income ax or orooem taa teFund
insciucaons instexd of on those forms. •
Subd.3. Acceu to data bv iad[vidual. Upon requesc to a tespansible auchoriry.an individual shall be info�ned whecher he is�he subject
o[stor.d daa on iadividuals.and whechec it is ctassifud as pubGc,privac�or conF.deadal. Upon his lurcher tequesc�an icdividual who is the subjeu
o!siored private or public daca on iadividuaIs shall be shown the dara wichout any chacge to him and;if he desires,shal!be infocmed of the eoaceac
aad meaning of d�u data. Aher an individual has beea shown the priva�e dan and iatocmed o!In meauing,the dam ne:d not be disclosed oo him for
six mondu thereaher unless a dispute or aeaon pursuanc w this secdon is pending or addidoaat dara on the iadividuaI bas beea eoUec�d or erea�d.
The�espons3ie authociry shallprovide eopia of the priva�or public dam upon�equesc by the iadividual subject oE che daa. The respoasi'ble auchoriry
may requics rhe nquating pecson to pay the accual eoses of makis�z,eecafying,and eomp�ing the copia.
The cesponsib(e auchoriry shall comply imraedis�ety,if passible.wi�h aay cequac cude pursuant to chis subdivision,oc wichia five days of
the dare ot the ceques�ezcluding Satucdays.Sundays and legal hoiidays.if inuned'uce compliaace is not pouible. If he eaaaot comply with the requesc
wiehin duc dme.he shall sa inform the individuaI�and may have an addidoaaI five days within which to eomply wirh the requat,exctuding Saturdays,
Sundays aad legal holidays. . .
Subd.4. Ptocedure when data is not accurate or complete. M individual may eon�est dce accunry a�eompleteaess otpubiic oc pri��ace
daa wneeming tiaaself. To ezeccise this right,an iadiv[dual shall aoaFy ta wtioag the tespons�ble auchoriry descdbiag dze nature of the diaagreemeat .
The respa�uibte au�horiry shall wichia 30 days eieteer. (a)comecc tha daa found to be inaccuate or incomplete aad atcempc co nodfy past recipien�s of
Inaccucue or incomplece data,inctuding cecipieacs named by che individuaI;or(b)nod[y rhe indtvidual thac he betieves the daa to be corcect Data
in dispuce shall be disclosed only It the individual's statemenc of d'tsagreemenc is included with the d'udosed daa.
. The de�emunaaon of ehe responsible auchociry may be appealed pursuant�the provisions of the adminiscaave procedure aet miadng to
contemd cases. ' • •
DATA PRTVACY ADYISORY �
In accordance with M.S. 13.04,Subd.2, "Rights of subjecu of data",we would like to inform you that your request
for a permic or license from the City of Orono or any of its deparcments may require you to furnish certaia private or
confidential information.
You aze notified thar.
1. The information you furnish will be used to detecmine your qualification for the permit or license requated.
2. You may refuse to supply data� but refusal may require that the Ciry deny the permic or license. � �
3. The information may be shazed wich other local,state or federal agencies to the excenc necessary to process
the permit or license. �
4. If your requested pecmit or license requires Couacil action to appmve, some information may become
public. � . . . _ . ' .
5. You have certain rights under M.S. 13.04�(available upon request) to review private data on.yourself.
6. Your full name is required to process this applieation or permic.
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Ciry Sate Zip P�oae
I understaad rights as stated abova
Signaare
DAT f T�ME„
CITY OF ORONO CALLED IN -J �"O v
INSPECTION NOTICE SCHEDULED �/2 " � �
PERMIT NO. �/.S�8 7 COMPLETED
—� � /'
ADDRESS -3 �' a� (�G�✓`'�-��
OWNER �"v CONTR. �'�L fr�ZG
TELEPHONE N . ��f 3 —� � ��
� DESCRIPTION �'1�'_�vd-��
l� 01 FOOTING 11 MECHA AL RI 18 EXCAV/GRADING/FILLING
��A�MING � 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
Q—Q3' � N ~ 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� /dJp10RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W �❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r- pHOTO TAKEN
INSPECTOfl WILL RETURN `
— CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance.473-73 'rJ7
OwnerlContr r o si
Inspector.
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