HomeMy WebLinkAbout1999-011577 - tearoff/reroof PERMIT
rITY, OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: ��-''�-••`-''#"�=
Crystal Bay, Minnesota 55323 �=��� �.�.'?
(612)473-7357 Date Issued: _
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: ��- :':�=�-1 _�_n��:. - °r�; _ �_��_: . OWNER:
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/ PLIC ERMITE IGNATURE ISSUED BY:SIGNATURE
Tot�i Fee: $ ���, $� Date Received: �/���- �
Entered By: Permit#: �
CITY OF ORONO - BUII�DING PERMIT APPLICATION �
. ,
A.11 information must be submitted in full before plan review will be started. .
� . . (please print all information . .
� �� A.PPLICAh'T IS: � - (circle one) .� Oti�NER O CONTRACTOR � � . � � �
JOB SITE ADDRESS: /I��� t i'vo%�if �.•� `� ZIP: ��� � il i j
NA,11�� OF Otii7��R: -5����.•���r PHONE: (home) G iZ �7/- B'�6 z.
. (WOIk� � !i« S/7 3 7 77 6
lr1t�■.. 1�G ri7J1JAriL7.S: I��� /�/!� 'T/.«� Cli l.: d!'e.ti a 7..r1.0: ��S^?� �/
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CONTRACTOR: ��a s s ���s.� PHONE: (�lz 5f7� �`��G s' ,,
COI�►TT'ACTPERSON: ���.�� z�-������ MOBILEIPAGER: Q'/f'-7f'g7
MAII� .]�i'G ADDRESS:�L�_-���o, 'e j� CITY: ,�.c�c�/S�m� ZIl': ��3 3,r i
STATE LICENSE: # 3.�0� �
ARCHITECTlE11TGI1`TEER: " PHOti'E: .-
1�IAILI�'G ADDRESS: CITY: ZIP:
� NAME: REGISTRATION#
TYPE OF ti�ORK: New Addition Accessory S�ucture
Move Remodel/Alteration Land Alteration _
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PROP SED ti'YORK(desc/ribe in detai�: Q�oa � v�� �/ �'� �`��
lc� �4�a�� � '
C d� /'�/Jl �( ' � Cz'S G�-i� Gc/ � ;
STORIES: _______ SQ.FEE'T OF EACH FLOOR: . .
NO. OF BEDROOMS: GARAGE STAI..LS: ATT. DET. � . . �
ESTI.I�IA.TED CO�ISTRUCI'ION VALUATION(excluding lancn: $ `�2 o D� — �
I hereby apply for a building permit a.nd I acknowledge that the infonnation above is complete and
accurate; that the work will be in corrformance with the ordinances and codes of the Ciry and with
the State Build:.n� Code; that I understand this is not a permit and work is not to starc without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: � "Z Z -f�
NOTE! Parade o�Homes events require separate permit approval by Police Department and
� Cily Council 60 days prior to the event. Non permitted events wili not be allowed.
. � �
See.13.04 RIGATS OF StlSJECIS OF DATA '
Sabd. 1. Trpe o[data. ?he righcs o!individuai on whom the data is smced or oo be scored shall be as sec focth in this secdon.
� Subd.2. Information nqirired to be�irm individual. An individuaI ulced to suppty prirate or coahdendal daa concerning himsetf shall
be iaformed of: (a)the purpose and iarended use of che requuud dan wichia the collecang 3nre ageary.politial subdivisian.or samwide sysLm;
(b)whe�e:he taay roEuse oti u legaUy requ'u:d co suppty_che requesred daa:(e)any I�owa caasequence uisiag frvm dis sizpplying or rettesiag to suppty
privace or eon.�tdar.ca!daa;u:d(�the ideariry of oc�er ptrsoas or eaddes auchocized by st3ce er fedenl law ta rtceive cio�a. ihis requiremenc sha1I
aot appiy wEen aa iGdividaal is uked w supply iavesrigadve dan,punvaac oo seedon 13.82.subdivisioa 5,w a law eafocoemeac officec. • . •
'[he eoc�missione�of revenue mav olaca the nodc- rauird und-�this subdivision in the individual ineome ax ot orooectv taz refund
inscsucdons inscexd of on chose forms. •
Subd.3. Accas to data bv lndirtdual. Upon request oo a respacuible aurhodry.an'mdividual sball be intormed whutserhe is rhe subjecc
o[stor.d daa on iadtviduals.aad whechcr ic is class�ed u public,pdva�s or conF.deadal. Upon his tlu�her request,ae jedividaal who Is che subje:t
of swred pcivace or public daa on iudividuals shal!be showa the daa wi�hauc any eharge to him aad;if he des'ues,ehall be infocmed of du eoacenc
and meaaiag of that daa. Afcec an individuai has been showa the priva�e dara and iafocmed o[iet meaning.the dam ne:d not be discloud oo hua to�
six monrhs thereahec uniess a d'upute or acdon pursuant to this secdon is pending or addidonal daca on the individuai has beea eoUeued or erea�d.
The respoeuible auehociry shallprovide eopies ot�he pciva�or public daa upon requuc by�he iadi�idua!subject o[�he daca. The nspoasi'ble auchoriry
may requir: the tequadng person to pay[he accual coscs of maki�g,cecritying,and eemp'�ling the copia.
The responsible authoriry shall compiy imraediacety.if possible.wich any request made pursuant to this subdivision.or wichiu hve days of
the dace of the teqaes4 eactuding Suucdays,Sundays and legal holidays,if irsunediate compliaace is noc possible. If he cannot eompiy wich the�equest
wi�hin that dme,he shatl so infocm the individual.and may have an addiaooaI fve days wirhia which oo eomply wi�h the requesc,excludiag Satuidays,
Sundays aad kgal holidays. . .
Subd.4. Procedure when data is not accurate or eomplete. M iadividual may eoncest the accunry or completeaeu of publIc or private
daa concecning htmself. To execcise this right,an indivtdual shaIl aoaFy in wridag dse nesponsibie authoriry desctibing the nawre of die d"uagreemeac
The respoasiblo authoriry shall wi�hin 30 days ei�:er. (a)correcc che data[ound to be inaccunte or iacomptete and atcempc to norify past recipierus of
inaecucdte or Ineomptece daea.jnetuding recipien�s named by�he individuat:or(b)aoafy rt►e individual thac he believes the data to be cocceet Dati
ia dispuce shall be disclosed only If the tndividnal's statemenc o[d'�sagreemeac is included wirh the disclosed data.
The decerrninaaon of the responsible aurhoriry may be appealed pursuanc to the provisions of�he adminisaadve pcocedu�e aet relaaag to
eantesced ea�as. � . . �
DATA PRIVACY ADVISORY �
In accordance with M.S. 13.04,Subd.2, "Ri�Q.hcs of subjecu of data",we would like to iaform you that your request
for a permit or license from the Ciry of Orono or any of iu departments may require you to furnish certain private or
confdential information.
You aze notified that:
1. The informatioa you furaish will be used to detormine your qualification for the permit or license requated.
2.. You may refuse to suppiy data, but rafusal may require that the Ciry deny the permit or license. � �
3. The information may be shazed with other local,stace or federal agencies to the ettent necessary to process
the permit or license. �
4. If your requested permit or license requira Council action to approve, some iaformation may become
. public, . . . . . . . �
�5. You have certain rights under M.S. I3.04�(availabie upon request) to review private data on.yourself. . .
6. Your full name is required to process this application or permi[.
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Ciry Scue Zip Phoae
I undetstand rights state abdve.
Signacur
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CITY OF ORONO CALLED IN /. D/jT� �� TIME��
�F ..t
INSPECTION NOTICE SCHEDULED � -` 3.3 'b
PERMIT NO. 7 COMPLETED
ADDRESS �.3 S� ��ti� ����� 'J
OWNER CONTR.�,.t% ���i�uZ���-
TELEPHONE NO. � 7� — �S �' ��
� DESCRIPTION
l� 01 FOOT 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRA G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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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W ❑WORK SATfSFACTORY:PROCEED C PROJECT COMPLETE
� ❑ CORRECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY
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� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
��EFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, pHOTOTAKEN
INSPECTOR WILL RETURN
STOP ORDER POSTED.CALL INSPECTOR ! CITATION ISSUED
NSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Noiice