HomeMy WebLinkAbout1996-008351 - re-roof/tear-off � PERMIT
�1 CIT�Y OF ORONO PERMIT TYPE:
2?50 Kelley Parkway- P.O. Box 66 ���1 I�C3I P�i�
Crystal Bay, Minnesota 55323 Permit Number: - i�-
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(612) 473-7357 Date Issued: t�A����,�f_��,
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ � ,,� (� . � � Date Received:
Entered By: _��; _ _ Pernut#: �> 5�/
CITY OF ORONO - BUILDING PERIVIIT 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 O ONTRACTO�~
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JOB SITE ADDRESS: ZZ-�1 � ���-{�n ��o�r Q- Q C . ZIP�
NAME OF OWNER: \'��rrt�`�� C'��•-�o r�c- /� t`�5 PHONE: (home)
(work)
MAILING ADDRESS: Z2�C� � • ��o�rL �f , CITY: U7�y a��-� ZIP:
CONTRACTOR: n '-,/-� 1 � o o�j,�• PHONE: � �~%- ��-� S �
CONTACT PERSON: j3� �( �- o v� MOBILE/PAGER:
MAILING ADDRESS: 7c`� C-�a•ti.� l�va— CITY: S��• ��� \ Z�: S 10
STATE LICENSE: # � `�� j
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED WORK(describe in detai�: ���� �- a � � � � � �'�- �' �� �
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 5 3� �-2-�
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 permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: C� �,�-��''�-�(" DAT`E: �- Q 1 �l CG
NOTE! Parade qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SiIB.TECTS OF D�T?.
Subd. 1. Type of data. 'Ihe rights of individual oa whom the data is scored or to be stored shall be as set forth in this secuon.
Subd.2. Information required to be given individual. .an individual asked to supply private or confidenrial data concerning himself shall
be infortned of: (a)the purpose and intended use of the requested dara wi[hin the collecting'state agency, poliacal subdivision,or sratewide 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)che iden[icy of o[her persons or enoties auchorized by state or fedeial taw to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve dara, pursuant to secdon 13.82, subdivision�, to a law enforcement officer.
The commissioner of re�enue mav place the notice reauired under this subdivision in the individual income tax or prope_rtv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whe[her he is the subject
of stored data on individuals, and whecher it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data wirhout any charge to him and, if he desires, shall be informed of the content
and meaning of�hat data. After an individual has been shown the private data and informed of its meaning, che data need no[be disclosed to hun for
six months thereafter unless a dispute or acrion pursuan[to this secaon is pending or addiaonal data on[he individuai has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible authoriry
may require [he requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authoriry shall compiy immediatefy, if possible, with any request made pursuant to this subdivision, or within five days of
the date of the request,exctuding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform[he individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal hotidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pm�ate
data concerning himself. To exercise rhis right,an individual shall norify in writing che responsible authority describing the nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt[o�odfy past recipienu of
inaccurate or incompiete data, inciuding recipients named by [he individual; or(b)notify the individual tha[he believes the data to be correct. Data
ut dispute shall be disdosed oniy if the individual's statemen[of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riahts of subjects of data", we would like to inform you that your request
for a permi[ 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 a�encies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
j. 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 my rights as stated above.
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Signature
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DATE TIME
CITY OF ORONO CALLED IN �� /-%��
INSPECTION NOTICE,.,r SCHEDULED `f' t/ �
PERMIT NO. %�5��� COMPLETED � il
ADDRESS ��`�� �� �-1'��- �'•�
OWNER /�')�/�Ci �4_,�" C��ii.�'r CONTR. � �^=
TELEPHONE NO. ��7 ^ ��s �
7
� DESCRIPTION �� - .:-��-�`-`
� Oi F 11 MECHANI (il 18IXCAV/GRADINCi/F�WNd
y FRAMING _� 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 WqLL B0. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UO O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
J 70 PLUMBINO FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �CNORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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WL CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �-'CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in�pection 24 hours in advance.473-7357
OwnerlContract te
Inspector. ���
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