HomeMy WebLinkAbout2001-P04417 - re-roof CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po441�
Crystal B�ay, Minnesota 55323 Permit Type: Minor Aiterations
(952) 249-4600 Date Issued: ioi2i2ooi
SITE ADDRESS: 4009 North Shore Dr
Mound,MN 55364
P I D: 07-117-23-44-0004
DESCRIPTION: uBc occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 54.00 Valuation: $ 1,500.00
State Surcharge Fee: $ 0.75
TOTAL FEE: $ 54.75
APPLICANT: Owner/Self OWNER: Peter&Elizabeth Luzich
MN 4009 North Shore Dr
Mound MN 55364
THE UNDERSIGNED 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
M A BUI CODE REQUIREMENTS.
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APPLICANT I ATURE IS UEDBYSIGNATURE
Conies: 1-File(SiQnitures Repuired). 1-Annlicank 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1
Total Fee: $ Date Received:
Entered.�y: Permit#:
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CITY OF ORONO - BUII�DING PERNIIT 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: �D4� /19�"���f?d�� ZIP: �
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NAME OF OWNER:fT-,�I...���C�� PHONE: (home)�� �c���
(work)C���j��`j'�c�S�—�
MAILING ADDRESS:�G��'/U��/S�d-�2�CITY:����_ZIP• _
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CONTRACTOR: ��� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
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STATE LICENSE: # —
ARCHITECT/ENGINEER: PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
�TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain:�p�'
STORIES: SQ.FEET OF EACH FLOOR: l��
NO. OF BED OOMS: �_ GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ,,��i,��
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 pernnit and work is not to start without a
permit; and that the work w' e in a o �dance ' the approved plan.
APPLICANT'S SIGNA - DATE:�4 c3 � �
NOTE! Parade of 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.
.
Sec.13.04 RIGHTS OF STJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqtrired to be given individual. An individuai asked to supply private or confidendal data concerning himself shall
be informed of: (a)che purpose and intended use of the requesred data wichin the collecting§tate agency,political subdivuion,or sratewide system;
(b)whether he may refuse ot is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idenriry of other persons or enrides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve data,pursuant to secaon 13.82, subdivision 5, to a taw enforcement o�cer.
The commissioner of re�enue mav place the nodce rewired under this subdivision in the individua! income rax or aropertv tax refund
instructions 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 wherher it is classified as public,priva�e or confidendal. Upon his further request,an individual who is the subjecc
of stored private or public data on individuals shall be shown rhe data wichout any charge to him and,if he desires,shall be informed of the content
and meaning of chat data. After an individual has been shown the privau data and informed of ics meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this section is pending or addidonal data on the individuai has been collected or crea[ed.
The responsibie authoriry shall provide copies of the private or pubtic data upon request by the individual subject of che data. The responsible authoriry
may require the requesting person to pay rhe actual costs of making,certifying,and compiling the copies.
The responsible authority shal!comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exeiuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compty with the requesc
within that rime,he shall so inform the individual,and may have an addiaonal five days within which w comply with 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 or pri�•ate
data conceming himself. To exercise chis right,an individual shall nodfy in writing[he responsible authoriry describing[he nature of the disagmement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and atumpt to nodfy past recipients of
inaccurate or incomplete data, inciuding recipiencs named by the individual;or(b)nodfy the individual that he believes the da[a to be correc[. Data
in dispuce shall be disclosed only if the individual's statemenc of disagreemenc is included with rhe disclosed data.
The decerminarion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure 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 pemut or license from the City of Orono or any of its departments may require you to fumish 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 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.
,
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City State Zi Phone
I derstand m rights stated abo .
Signamre
� DATE TIME
CITY OF ORONO CAL E IN
INSPECTION NOTIC SCHEDULED �r
PERMIT N0. 5� COMPLETED /o-S-� =o�v
ADDRESS � .
OWNER �-' CONTR.
TELEPHONE NO. 5 " 7 S
� DESCRIPTION c.�c.:w� � � �
� 01 FOOTING 11 MECHANICAL RI 18 CAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
i09 PLUMB(NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOH TO MEET YOU: Y S_NO
��., COMMENTS:
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� ORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContr or on site:
Inspectoy� 1�����c���
White Copyllnspector's File Canary CopylSite NoUce
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT SCHEDULED 01
PERMIT N0. COMPLETED �- ^O( �3�
ADDRESS `-�C��� Nll,�'� ��-�
OWNER ;��.c z ie ' CONTR. �!�I ay-r_���z�''
TELEPHONE NO. �J�� `��oZ �U�P 7
� DESCRIPTION \ /�'2 /
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ DING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
2 OWNERICONTRACTOH TO MEET YOU: YES_NO
� COMMENTS:
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��ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED � ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARflANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46�0
OwnerlContrac r on site:
Inspector. ,
White Copylinspector's File Canary CopylSNe Notice