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Home My WebLink About2008-00240 - roofing ` � CITY OF ORONO PERMIT NO.: 2008-00240 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �SSUED: 09/22/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 3650 LYWC AVE PIN : 17-117-23-34-0035 LEGAL DESC : NAVARRO : LOT 003 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 4,150.00 NOTE: REROOF TEAR-0FF HOUSE AND GARAGE. APPLICANT pERMIT FEE SCHEDULE 118.00 MIDWEST ROOFING STATE SURCHARGE VALUATION 2.08 3 Li JEFFERSON HWY � � CHAMPLIN,MN 55316 TOTAL 120.08 (763)427-9696 Minnesota State License#:20010277 OWNER TOLEDO, LLOYD&CAROLYN 3650 LYRIC AVE WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only[he work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming 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 consuuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revok at any time for due cause. ` / ��/ D$ / � � � � pplicant Permitee S�gnature Date I��y Signature ��Q Date / � SEPARATE PERMITS REQUIRED FOR WORIti OTHER THAN DESCRIBED ABOVE. � . Total Fee: $ �O�-/. � � Date Received: // � , Entered By: � Permit#: - CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all informatiort) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: J�SD G-Vr�'C �I/� ZIP: �S�`�, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yes �NO If yes, a special event permit is requi�ed with Police Department and City Council approval 60 days prior to the event. Shuttle bus service luill be required unless applicant demonstrates sufficient on-site pa��king is available. Norr permitted events will not be allowed. NAME OF OWNER: �� To/-ep(0 PHONE: (home)��eZ `�IZO �6S`� (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR:/�'li��s� �c,o1�'jh` d- S,dih� PHONE: �3 y�-�-�696 CONTACT PERSON:,�`.eo� Bud ziak' MOBILE/PAGER: MAILING ADDRESS: ,3/3 .7'r r��rrs d+-� fi��Y CITY: eG-j4-s�.. �-�' ZIP:.SS3 6 STATE LICENSE: # �ov�B�'�3 � EXPIRATION DATE: 3�3/�vq 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 ct ��,�oa Gjeu.s Qq,.a�e ��Oss STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ y� ��5� 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. , c� APPLICANT'S SIGNATURE: ��. DATE: l v�s? Q 8 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,political 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 authorized by state or federal law to receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to alaw enforcement officer. The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or property tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shal I 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 charge to him and,if he desires,shall be informed 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[o 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. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require 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 ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within that time,he shall so inform 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 accurate or complete. An individual may contest the accuracy or completeness of publ ic or private data conceming himself. To exercise this right,an individual shal l notify in NTiting the responsible authoriry 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,incl uding 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 ln 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 furnish 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. 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 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. � `7-�'1 C`� L• �QC� First Middle Last 3�3 ��e�� ,v Address �Lra"�1�'�, SS3/� �3-.�YS�D3� City State Zip Phone I understand my rights as stated above. � ignature Reset Forn� 32 CITY OF ORONO �� v° TIME ✓ CALLEDIN � INSPECTION NOTI E DDa p SCHEDULED ln 1p BR PERMIT N0. �� COMPLETED ADDRESS J'�O r� OWNER CONTR. � TELEPHONE NO. � DESCRIPTION �Q�/ �n�- � ❑ 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 _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J � PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a o � ;G -l�-v rC S —T� c�-�1�' � � 0 � W � Q � 2 W � W � � � ❑WORKSATiSFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED 7 ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-46�� Owner/Contractor on site: Inspector. _rI` � White Copyllnspector's File Canary CopylSite Notice