HomeMy WebLinkAbout2001-P03750 - re-roof � -
PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po3�so
Crystal Bay, Minnesota 55323 Permit Type: lvtinorAlterations
(952) 249-4600 Date Issued: siii2ooi
SITE ADDRESS: 1453 North Arm Dr
MOUND,MN 55364
P ID: 07-117-23-44-0071
DESCRIPTION:
Proposed Use: lcesicientiai
Census Code 434
Permit Class: Building
Permit Sub-type(s): Building Re-Roof
Permit Type: Minor Alterations
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 9�•25 Valuation: $ 3,200.00
State Surcharge Fee: $ 1.60
TOTAL FEE: $ 98.85
APPLICANT: W F. SMITH CONST OWNER: GINA M ZINGSHEIM
5975 LYNWOOD BLVD 1453 NORTH ARM DR
MOiJND,MN 55364 MOLTND MN 55364
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII.DING CODE REQUIREMENTS.
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ISSUED BY SIGNA
Copies: City,Applicant,Assessor,Finance Page 1
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII.DING PERMIT A►PPLICATION
All information must be submitted in full before plan review will be started.
' (please print all information) .
'THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR �
JOB SITE ADDRESS: � �' � � �� �}�,1'"\ �(L. ZIP: �
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NAME OF OWNER:J��r-'r��'. �s°�'�1�� PHONE: (home)
(work)
1�IAIL�G ADDRESS: . CTTY: ZIP:
CONTRA.CTOR: '�'' � S�, � PHO�TE:
CON'TACT PERSON: '��� ��IOBILE/PAGER:
MAILING ADDRESS: S� 7 S- �`r'U�wc�� .���TY: P�\,o ,�w� ZIP: SS�� �/
STATE LICENSE: # S.�o �
ARCHITECT/ENG iNEER: PHO\'E:
1VIA.IL'Pi TG ADDRESS: CITY: ZIP:
NAME; REGISTRATION# •
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�� Land Alteration
� �
PROPOSED WORK(describe in detai�: j-�"/��L.. � v�' ��-����r`'� '� -
STORIES: SQ.FEET OF EACH F'LOOR: _
NO. OF BIEDROOMS:� GARA.GE STALLS: ATT: � DET. -.m � ,-:. -< __-. : -
EST iMA'I'ED CONSTRUCTION VALUATIO\ (excludi.ng land): � -�� � �
I hereby apply for a building permit and I acknowled�e that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with
the State Building Code; that I understand this is not a perm.it and work is not to start without a
permit; and that the work will be in accordan i e approved plan. .
APPLICAN'I''S SIGNATURE: DATE: �� —� )
1VOTE! �Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
� �
Sec.13.0-1 RIGEiTS OF SVBJECTS OF DaTa
Subd. 1. Type of data. The righcs of individual on whom the dara is stor.3 or co be scorcd shall be as set for[h in this secaon.
Subd.2. Information requdred to be givm iadividual. An ir.di�ldual asYd W supPly privace or confidendal data conce�ning himself shall
be informed of: (a)�he purpose and inrended use of che requesud dam wi�in the collecring state agency,polidcal subdivision,or sratewide rystem;
(b)whec'�er he may refuse oY is legaliy required�o supply ehe requested dan:(c)any lmowa eonsequence arising from his supplying oc refusing to supply
private ar conndenaal daca;and(d)the idendry of ocher persoas or enddes a�chorized by stat�or fedecal law to rrceive the daca..This requiremenc shall
not apply whan an individual is asked to supply invesdgarive dara,pursu+:t to secaoa 13.82,subdivision 5,to a.law enforcement o�cer.
The commissioner of re�enuo mav place the nodce reauircd crd-r chis subdivision in ihe individual income tax or prooem taz refund
inscructions instead of on chose forms.
Subd.3. ?,ccess to data by indi�idual. Upon requesc to a r.s�onsible auchoriry,an individual shall be informed whe[her he is ehe subject
of s�ored data on individuals,and whe[her it is classified as public,privac�or con6deerial. Upon his further requesc,an individual who is the subjecc
of scorr3 privace or pubtic dara on individuals shall be shown[he dara wi^ouc any e'c�rge to him and,-if he desires,shall be informed of che concenc
and meaning of chac data. Aftor an indiiidual has been shown ehe privam Caa and i�:onned of i�s meaning,che data need not be disclosed ro ti�n for
six monchs�heceaiter unless a dispute or acdon pursuane to ehis secdon is�:nding or addidonal data on the individual has been collected or creaced.
The responsib(e authoriry shali provide copies of the privace or public dac�L�on requ�:by the individual subject of�he daca. The responsible authoriry
may rquir_the requesring person to pay che acmal cosu of making,ce_.;•ing,and compiling the copies.
The responsible au�horiry shall comply immediacety,if possible,wi�h any r_quest made punuant to this subdivision,o�wichin five days of
the dace of che request,excluding Saturdays,Sundays and legal holidays,ii ir•.mediac-comptiance is not possible. If he canaot comply wirh the requesc
wi�hin thac cime,he shal!so inform�he individual,and may have an addi�eral five days wichin which to comply wich 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 public orpri�ate
daca concerning tiimself. To exercise chis righc,an individual shall nodfy ia wridng ce responsible authoriry describing che nacure of the disagnemeac.
The responsible auchoriry sh�ll within 30 days ei�her: (a)correct[he dac�fcund to be inaccurate or incomplete and aaempc to noafy past recipienrs of
inaccur�e or incomplece data, including recipiencs named by che individi:al:or(b)coufy the individual that he believes the data to be correct Data
in dispuce shall be disclosed only if[he individual's statemenc of disagree�en�is i.cl•.idad wieh che disclosed daca.
The decerminarion of the responsible au�horiry may be appea:e3 pursuaac to the provisions of the administrarive procedure acc relaang to
conta.ed cases. . �
DATA PRIV:�CY AD�ZSORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects ot c�ata",we would like to inform you that your reauest
for a permit or license from the City of Orono or any of ia depar�ents may require you to furnish certain private or
confidential information.
You aze notifced that:
1, 'Ihe information you fumish will be used to de:ermine rour qualification for the permit or license requested.
?, You may refuse to supply data, but refusal nay require that the City deny the permit or license.
3, The information may be shared wich other local, scate or federal agencies to the excent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
. , public.
�. You have certain rights under M:S. 13.04 (a�ailable Lpon request) to review private data on yourself.
6, Your full name is required to process this aoplicacion or permic.
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P�6 ��/vD r . 6 �_.
Ciry State Zip Phone
I understand my ri�hts as s ted above.
Signamre
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E �y SCHEDULED '� 3� 0�'�'�
PERMIT NO. /�O COMPLETED �' � ��+
ADDRESS�S�5 3 N , .t /�r�--�
OWNER CONTR. �� �`• S/Li r f�t Co�`�;
TELEPHONE NO._ � I c�- �CO� ;�I I 7
� DESCRIPTION /� �'�/t�� ���i
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTIOfV '-
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 OEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 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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� �IORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W �O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� 249-46Q�
OwnerlContrac on site:
Inspector. �2 �
White Copy/lnspector's File Canary Copy/Slte Notice