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Home My WebLink About2008-00241 - roofing � �, CITY OF ORONO PERMIT NO.: 2oos-oo24� 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 09/22/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 3640 LYRIC AVE PIN : 17-117-23-34-0036 LEGAL DESC : NAVARRO : LOT 004 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 4,150.00 NOTE: REROOF TEAR-OFF HOUSE AND GARAGE. APPLICANT PERMIT FEE SCHEDULE 118.00 MIDWEST ROOFING 313 JEFFERSON HWY STATE SURCHARGE(VALUATION) 2.08 CHAMPLIN,MN 55316 TOTAL 120.08 (763)427-9696 Minnesota State License#: 20010277 OWNER SIMONSON,GERALD 3640 LYRIC AVE WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shail be performed according to the approved plans and specifications,applicable City approvals,and the S[ate Building Code. This permit is for only the work described and does not grant permission for addi[ional or rela[ed work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. `��C� .�� l 4�j u�� ''/l �� d� pplicant Permitee`S g ature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � �'�9 � � Total Fee: $ �02l• � � Date Received: �/��-/O$� Entered By: Permit#: -- oZ-� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print alt information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOBSITEADDRESS: ��p �� VrJ'C 15`�i ZIP: �S�`�, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yes �lvo If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service ku.ill be required unless applicant demonstrates su�cient on-site parking is available. Non permitted events will not be allowed. � NAME OF OWNER� �v�y �ly�OhSDJ� PHONE: (home)1'�S� Y�( 33!$ (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR:/�'lidit,�s� �a,�'�i,s �- S,d�h� PHONE: �'os y��-�696 CONTACT PERSON:�`.00� Bu��i�k' MOBILE/PAGER: MAILING ADDRESS: ;j13 ,7'�t��r-s�+-� l�uv CITY: e.Lj�ss.. �' ZIP:.�s3 6 STATE LICENSE: #_�o��B�� EXPIRATION DAT : � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) x` Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detai�: O v` �,�ro Gieusr�q�e e ��Os STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED COI�TSTRUCTION VALUATION(excluding land): $ y, f�S� I hereby apply far a building permit and I acknowledge that the information above is complete and accurate; that the work will be in confarmance 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 accardance with the approved plan. � �/� q APPLICANT'S SIGNATURE: G%Z'( DATE: ( v�� Dg 31 � � 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.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,pol itica]subdivision,or statewide system;(b) . whether he may refuse 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 authoriud by state or fedetal Iaw to receive the data.This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may nlace the notice renuired under this subdivision in the individual income tax orprooerty tax refund instructions instead of on those fortns. Subd.3. Access to data by individual. Upon request to a responsible authority,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 stored private or public data on individuals shall be shown the data without any chazge to him and,if he desires,shall be infortned ofthe content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. 'Ihe responsible suthority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may requiro the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within ihat time,he shal I so infarm the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accivate or complete.An individual may contestthe accuracy or wmpleteness ofpublic or privale data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement'The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination 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 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 fumish 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. Ttie information may be shared with other local, state or federal agencies to the extent necessary to pmcess the permrt or license. 4. If your requested permit or license requires Council action to approve,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 application or permit. -��-1 c� L� ./�I��,� First Middle Last 3/3 ,�e�.�, �v Address �G��ol��, .�s3/b r�`3-�Y.�-o3�9 City State Zip Phone I understand my rights as stated above. � ignature 32 �'� D TIME V CITY OF ORONO ' ca,��Eo iN ��' INSPECTION NOT�CE�� SCHEDULED - PERMIT NO.a� COMPLETED ADDRESS 3�a�D LA/�/C �� OWNER CONTR. /�'r�a�Lll�d.-7' /�- � TELEPHONE NO. ��2 �7 � 3�� DESCRIPTION /�00� �7 �2QQ� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � � DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBiNG FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO c� COMMENTS: � W a o - C-�`�� . � 0 � W � Q � z W � W � � d W ❑WORKSATISFACTORY:PROCEED OJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOH REINSPECTIOIJ TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. �. � White CopyMspector's File Canary CopylSite Notfce