HomeMy WebLinkAbout2008-00387 - roofing CITY OF ORONO PERMIT NO.: 200&00387
� w \ 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE �SSUEn: 1U13/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 659 MINNETONKA HGLD LA
PIN : 06-117-23-44-0006
LEGAL DESC : MINNETONKA HIGHLANDS ESTATES
: LOT 002 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING -UNDEFINED
VALUATION : $ 3,500.00
NOTE: GARAGE
APPLICANT PERMIT FEE SCHEDULE 103.25
TWO TEACHER CONSTRUCTION STATE SURCHARGE(VALUATION) 1.75
2586 ARON DR TOTAL 105.00
MOUND, MN 55364
(612)598-2191
Minnesota State License#: 20073200
OWNER
SPEETER, RICHARD
659 MINNETONKA HGLD LA
LONG LAKE, MN 55356
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 the work described and does
not grant permission for additional or related work which requires separate
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 consVuction 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 �:n
revoked a y[i e or e cause. `
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Applicant ermitee Signature Date Issued By Sig ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All informaYion must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: , � � � , ZIP: �� �j
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Will this be a P rade of Homes, Remo�et�rs Showcase Home or other Display Home?
❑ Z'es 1�0 If yes, a special event permit is required with Police Department and City Council approva/
60 days prior to the event. Shuttle bus service 1vi11 be required unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER: _�� (J�y,,,-� �-2�-�-e�^ PHONE: (home) Gj�Z -�/�S_ ��, �/ y
(work)
MAILING ADDRESS: �j.�`� �r�,����-,,�� CITY: ��y��� ZIP: _4��� (O
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CONTRACTOR: �
�w� '���e..- Co•1��-�-�`'rl�-� PHONE: _�/2-�q�, -Z l�'t /
CONTACT PERSON: �����-N �,,g ,�J MOBILE/PAGER: 7)
MAILING ADDRESS: 25,��, f�v,�1 �7 J' CITY: �o,,�.S� ZIP: ��;3,��/
STATE LICENSE: # �?�� ,���� EXPIRATION DATE: ,�r-t�,�tr � � ��
ARCHITECT/ GINEER: PHONE:
MAILING ADDRE . CITY: ZIP:
NAME: " REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure �
Move Home Remodel/Alteration (ie: Siding, Windows) ��
Any earth movement may re re MCW review d p rmits!
PROPOSED WORK(describe in detai�: �� �,r. ��� •��� '� �,��-, �C i-� - -�
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STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
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ESTIMATED CONSTRUCTION VALUATION(excluding land): $ )
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the wark 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.
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APPLICANT'S SIGNATURE: DATE: � -�
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righu 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 col lecting state agency,pol itical 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 oYher 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 a law enforcement officer. �
The commissioner of revenue may 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 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 charge to him and,if he desires,shall be informed of the content and
meaning of that data. Afrer 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. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
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 of the request,excluding Sat�rdays,Sundays and]egal holidays,if immediate compliance is not possible. If he 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 lega]holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The
responsible authority shall within 30 days eithec (a)correct the data found to be inaceurate 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 correcL Data in
dispute shall be disclosed only if the individual's statement of disagreement is induded 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 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.
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I understand m ts as d above.
Signature
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Reset Form 32
� I� `�(�'�'"' '' TE TIME �
CITY OF ORONO �CALLED IN �
INSPECTION NOTI g-7 SCHEDULED � �
PERMIT NO. COMP ET€D
ADDRESS /
OWNER CONTR.
TELEPHONENO. � � � ��-5��' �
� DESCRIPTION ��
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q�WAL ❑ SEWER HOOK-UP � PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. p COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL Y ❑ FOUNDATION/REMOVAL
� OWN ONTRACTOR ET YOU:L]YES_NO
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W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
�NSPECTOR WILL RETURN ❑CITATION ISSUED
l�TED.CALLINSPECTOR
❑ INSPECTION RE4Ut1�iED.CALLTOARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OwnedContractor on site:
Inspector. ��
White Copyllnspectw's Ftle Canary CopylSite Notice