HomeMy WebLinkAbout1999-011455 - tearoff/reroof PERMIT
CITY O� ORONO PERMIT TYPE:
2750`Kelley Parkway- P.O. Box 66 `�t-1�'[,.,I�f T t�jiz
Crystal Bay, Minnesota 55323 Permit Number: ;�;� ���c�
(612) 473-7357 Date Issued: : _ _w
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICA /PERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: y $ 7�� � � Date Received: ,S- �-�--97
Entered By: /!�avL Permit#: /`�
CITY OF ORONO - BLTII,DING PERMIT APPLICATION
A.11 information must be submitted in full before plan review w�ill be started. .
(please print all information)
THE APPLICAi`'T IS: (circle one) OtiVNER OR CONTRACTOR
, � , ,. � � � ;.
JOB SITE ADDRESS: ' '�C_f�l �'V � t����}��1 /.% .1_T_ ZIP: ���G ,�
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NA,I�TE OF Otii��R: ��'���1 �� V'� ( �l� PFiONE: (home) �r���- S�; 7 �
(work) � l%'� -�.� ?�
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NiAILPi 1G ADDFESS• CI'I'Y: ,;����)�'��� ��L C� ZIP: . , � ��,,_;._,
CO�ACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MALLTtii'G ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECTlENGI1�TEER: PHO`'E:
MA.IL�'G ADDRESS: CITY: ZIP:
�TAME: REGISTRATIO�t#
TYPE OF '4VORK: New Addition Accessory Structure
Move Remodel/Alteration �' Land Alteration
ED'��ORK describe in detai : �'l_��+�-��<" �c Y'% �"' �' -� ��--'
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STORIES: � SQ.�F'EET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. �_ DET., ��-- �
ESTIi�IATED CONSTRUCTION VALUATION (excluding land): $ �> � � � � � -�'�� �
I hereby apply for a buildina 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 Build�n� 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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A.PPLICAi��''S SIGNATURE:�� , ���l f � DAT'E: �
NOTE! Parade of Homes events require ,separate permit approval by Police Department and
City Counci160 days prior to tke event. Non permitted events will not be allowed.
�
Sec.13.04 RIGI�iTS OF SUBJECTS OF DATA '
Subd. 1. Type o[daca. 'Ihe righcs of individual on whom[he dara is scored or co be swred shalI be as set forch ia this secuon.
Subd.2. Intormation reqlrired to he given indivfdual. �n individual asked to supply private or caafidendal dam concerning himself shail
be infora:ed o�: (a)the purpase and incended use of the requested dan wichin the eollecang sratt agenty,goliacal subdivision,or smmwide rysum;
(b)whe�er he raay refuse oY is_legally requir.d to supply che rquesud data;(c}any Iatown coascquence arisiag from his supplying or refusing tn supply
privace or conndenoal daa;and(d)che ideadry of oeher per�oas or enodes au�orized by seace ar fedecal law[o rnceive che data. This requ'uemeac sha!I
not apply when an ir.dividual is asked to supply invesdgarive daa,pursuan�ro secdon 13.82,subdivision 5,co a law enforaemenc o�cec
'Che eec�missioner of revenue mav DI3CC ih� nodc- rauird und-r this subdivision in the individuai income tax or orooem taz refund
inscrucdons inscezd of on chose forms.
Subd. 3. Access to data by individual. Upon requcsc co a responsible authoriry,an individual shall be informed whtther he u che subject
of scor.d dan on individuais,and whecher it is class�:d as public,private or conhdenaal. Upon his funher request,aa indi�idual who is the subje:c
of scored privace or public daa on individuals shall be shown che dam wichout any charge to him and;if he desires,shall be infocmed of the eoocanc
and m�aning af that dara. After an individual has been shown the privare dac�and informtd of ics meaaing,the data need not be d'uclosed ro him for
six mon[hs theceafrer uniess a dispuce or acdon pursuant to ttus secdon is pending or addidooal data on the individual has becn collecced or created.
The cespacuibla auehoriry shall provida eopies of the privac�or public data upon request by the individual subjece oF che dara. The responsible auchoriry
may require the requesdng person to pay che accual coscs oi makinz,cerdfying,and compiling the copies.
'Ihe responsible authoriry shal!comply immediattly,if possible,wich aay teques[made pursuant co this subdivision,or wi[hin five days of
the dace of the requesc,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliacce is not possible. If he canaot comply with the tequcsc
wichin chat ame,he shall so inform the individual,and may have an addirioaal five days wi�hin which to comply wich the request,ezcluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public oc private
data conceming himself. To exercise chis righc,an individual shail noafy in wridng che responsibie au�horiry describing the natuce of the disagreemeac
The responsible auchoriry shall wi[hin 30 days eithet: (a)comct[ha da[a found to be inaccucat^or incomplece and aaempc co nadfy past recipiencs of
inaccurnte oc incomplete data, including recipien�s named by the individuai;or(b)noafy the individual that he betieves the dara to be correct Data
in dispuce shall be disclosed only if the individual's scacerr.enc of disagreement is included with the disdosed data.
The decerminadon of the responsiblt auchoriry may be appealed pursuanc to the provisions of the adminisaarive procedure act rela[ing to
contesced cases. �
DATA PRIVACY ADVISORY
In accordance wich 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 che permit or license requested.
2. You may refuse to suppty data, but refusal may require that the City deny the permit or license.
3. The information may be shared wich ocher local, state or federal a;encies to the ettent necessary to process i
the permit or license.
4. If your requested perm.it or licease requires Council action to approve, some information may become i
public. j
5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. '
6. Your full name is required to process this applicacion or permi�.
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Ciry Sate Zip Phone i
I underst y ri;hts as stated above.
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signa[ure
DATE TIME
CITY OF ORONO CALLED IN S-2b y 9 �
INSPECTION NO IC SCHEDULED S= — ;3 a
PERMIT NO. COMPLETED °��
ADDRESS v • �Z�J��Y/
OWNER 6�'t- �� CONTR.
TELEPHONE NO. �7 7�--S.3 ��
� DESCRIPTION �1_P- ./�
4� � 11 M ANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULA N 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
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
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��RK SATISFACTORY_PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
C CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor si -
Inspector.
White Copyllnspector's File Canary Copy/Site Notice