HomeMy WebLinkAbout1996-008392 - grading/berm � PERMIT
. � CITY OF ORONO PERMIT TYPE:
- 2750 Kelley Parkway- P.O. Box 66 t�:.��.h ���FI;�E:Cr
Crystal Bay, Minnesota 55323 Permit Number: ;;i z;_:�;_�•�
(612)473-7357
Date Issued: #f,����_<<,��;�
Sl1�� ADDRESS:
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� CONTRACTOR: — ����1 i�.�y��• — OWNER:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� Total Fee: $ �C � �� Date Received:
Entered By: ,Q� Permit#: ' 3 �j z
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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: � � ✓� ��Y`��p�/'��j�J'�t/� ZIP: ��2j 2�
NAME OF OWNER: 1�� V� PHONE: (home) �7� -��Z�
2 / (work)
MAILING ADDRESS: ;�)j ��N`�1-�sl�t..v✓e CITY: ��p�/(� ZIP: �� Z-�j
CONTRACTOR: C����C�u� ��C�i�g�n/`�nJLPHONE: ���-'����
CONTACT PERSON: }� pn��-ij-�S ui•l MOBILE/PAGER: �7p -32�-�
MAILING ADDRESS: %8 7 O�6�s�' CITY:��� ZIP: «0 7 7
STATE LICENSE: #
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 detain: f D C� � � �� I����_ ��-.�-bS��9�41��
�.� ;�.�,N�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $
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�rdance with the approved plan.
APPLICANT'S SIGNATURE: ��'� � DATE:
NOTE! 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.
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Sec.13.04 RIGi3TS OF S[lBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the coUecting State agency,polidcal subdivision,or statewide system;
(b)whether he may refuse o'r is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or zefusing to suppiy
private or confidenrial data;and(d)[he identiry of o[her persons or enuaes aurhorized by state or federal law to receive the data. This requirement shall .
not apply when an individual is asked to supply invesdearive data, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav p(ace the norice required under this subdivision in the individual income tax or propertv tax refund
instrucdons instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whecher ic is ciassified as public, priva[e or conFidendal. Upon his furthec request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wi[hout any charge to hicn 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 meaaing,the data need not be disclosed to him for
six months theteafter unless a dispute or acdon pursuanc to chis secdon is pending or addiaonal data on the individual has been collecud or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of[he data. The responsible authority
may require the requesring person to pay the actual costs of making,cercifying,and compiling the copies.
The responsible authoriry shall comply immedia[ely,if possible, with any request made putsuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,exctuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or comp(eteness of public or private
data concerning himself. To exercise this right,an individual shall nodfy in wriang the rosponsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccutate or incompiete and attempt to nodfy past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individual that he be(ieves the data to be correct. Data
in dispute shall be disciosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinarion of the responsible authority may be appealed punuant to the provisions of the adminisuadve procedute 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 request
for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You aze 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 suppiy data, but refusal may require that the City deny the pemut or license.
3, The information may be shazed 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.
6, Your full name is required to process this application or permit.
First Middle Lasc
• . Address
City State Zip Phone
I underst d my rights stated above.
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Signaare
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT CE SCHEOULED �'r�t`yb � � 'T—
PERMIT NO. Z COMPLETED r� �
ADDRESS 3► 35 N�it�Tl�-� 5 i-�� �2��►�4
OWNER CONTR. SL��t-��r�.�
TELEPHONE NO.
� DESCRIPTION G F'-���ti �;
� Ot FOOTINO 17 MECHANICAL RI 1
CAV/GRADING/FI W NO
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORElWETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL 8D. 72 WATER HOOK-UP 17 SITE INSPECTION
_ �INAL 14 SEWER HOOK-UO O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEM�FINAL 75 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER FlEMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �WORK SATISFACTORY:PROCEED �PROJECT COMPLETE
W �L CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pH0T0 TAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR
C CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.47�73�J7
OwnerlCoMra on�'j�e:
Inspector. �X���`-
White Copyllnspecfor's File Canary CopylSlte Notice
✓
DATE TIME
CITY OF ORONO CALLED IN �� ����" ��'
INSPECTION NOTICE SCHEDULED 9 - � � � � '�
PERMIT NO. �9�� COMPLET D
t� �
ADDRESS �f�h.5 ��l�fiL-�t �l-�Zh� �.� _
OWNER C�1�-a�L<e�.- CONTR.
TELEPHONE NO. �SS — �� 3 �
.� �
� DESCRIPTION f
� 01 FOOTIN(3 11 MECHANICA I 18IXCAV/GRADING/FIWNd
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNEH/FIREPLACE 34 TREE REMOVAL
Z pq yy p. 12 WATER HOOK-UP 17 SITE INSPECTION
e FI � 14 SEWER HOOK-UO O6 PROGRESS
2
� 07 DEMQ—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOWUP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��ORK SATISFACTORY:PqOCEED ��ROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r, pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP OROER POSTED.CALL INSPECTOR ��CITATION ISSUED
❑ INSPECTION REQUIRED.CA�L TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnedContracto n '
Inspector. w-�
White Copyllnspector's File Canary CopylSite Notice
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