HomeMy WebLinkAbout1999-012106 - tearoff/reroof � PERMIT
t C�TY-�OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 ��:�: :.;t:��":��
Permit Number: � .;T,;4
Crystal Bay, Minnesota 55323 - �-'�-`='
(612) 249-4600 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMIT E SIGNATURE ISSUED BY:SIGNATURE . �+' -��
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Total Fee: $ //3 • '7� Date Received:
Entered By: �',� Permit#: / �/C��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information 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 OR CONTRACTOR
JOB SITE ADDRESS: � <� `� `� I `'�r2� '�' �-m� ��� i2 ZIP:
NAME OF OWNER:��`� �– (� �V��"�-1�-'rJ PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
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CONTRACTOR: , � �� PHONE: �-� � �I I �
CONTACT PERSON: � �� MOBILE/PAGER:
MAILING ADDRESS: =� `) � S L;-��.�t,:7, , h/r,CITY: ��} b„�,, �� ZIP: SS��;�
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STATE LICENSE: #�3�-T
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
l�JAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
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PROPOSED WORK(describe in detai�: ( ��lfi; �� ,.�,
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �% 7 S —
,
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 ermit and work is not to start without a
permit; and that the work will be in accordance'�vith e approved plan.
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APPLICANT'S SIGNATURE: DATE: I I -- � ^ �
NOTE! Parade Qf Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
i • •
Sec.13.04 RIGHTS OF SUB.TECTS OF DaTA
Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqtirired to be given individual. An individual asked to supply private or co�denaal data concerning hicnself shall
be informed of: (a)the purpose and intended use of the requesced data within the collecang'state agency,poliacal subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising fmm his supplying or refusing to suppty
priva[e or confidendal data;and(d)[he identiry of other persons or enrities auchorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigadve dara, pursuant to secdon 13.82, subdivision�, to a law enforcement ofFicer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or proper[v tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon reques[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[hat data. Afrer an individual has been shown the private data and informed of ics meaning,ihe data need not be disclosed to him for
six months thereafrer unless a dispute or acrion pursuan[to this secdon is p�nding or additional data on the individual has been collected or created.
The responsible authoriry 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 cosu of making, certifying, and compiling the copies.
The responsible authoriry shall compty immediately, if possible, with any request made pursuant to this subdivision,or within five days oi
the date of the request,excluding Samrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comp(y 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 o�completeness of public or pri�•ate
data conceming himself. To exercise this right,an individual shall notify in wridng the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found co be inaccunte or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplece data, inciuding recipients named by the individual; or(b)notify the individual tha[he believes the data to be correct. Data
in dispu[e shall be disclosed only if the individual's statemeat of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the admuvstrarive procedure act reladng 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 reauest
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 pemut or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pemut 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.
(. Your full name is required to process this application or permit.
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Signamre �
DATE TIME
CITY OF ORONO CALLED IN �`
INSPECTION NOTICE SCHEDULED fi . • P c��'E�'�
PERMIT NO. �oZ_�C� Co COMPLETED � � �b�
ADDRESS /
OWNER CONTR.
TELEPHONE NO. �7�(�S�5
� DESCRIPTION __ ....JL_.C��t rr-�
lL 01 FOOTIN 11 MECHANICAL RI 18 EXCAV/GRAD�NG/FILLING
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13 MECHANiCAL FINAL 19 LAKESHORE/WETLANDS
�
Q TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
� 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 ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
��RRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnedContractor on site:
Inspecto���i 4z-�-c ���-�f�
White Copyllnspector's File Canary CopylSite Notice
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I �4TE `� T��
CITY OF ORONO CALLED IN (� �V
INSPECTION NOTICE �SCHEDULED � l� 1��
PERMIT N0. coMP�ETE / ' l 'S
ADDRESS ���� Y�O�{�l �� 1-�,
OWNER T CONTR._1.cJ. I- �°�F Cc
TELEPHONE NO. __��v^�- �/ 1�]
� DESCRIPTION ���
� 01 FOOTING 11 MEC CAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 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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