HomeMy WebLinkAbout1998-010362 - tear-off/re-roof PERMIT
CITY OF ORONO PERMIT TYPE:
• � �750 Kelley Parkway- P.O. Box 66 �,;;r��1 +;;f°�{_
Crystal Bay, Minnesota 55323 Permit Number: :s'� .
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(612)473-7357 Date Issued: �^J�.,;�;��;��;`�
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANTPERMITE ATURE ISSUEDBY:SIGNATURE
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Total Fee: $ Date Received:
�� �ntered By: _�,,Q� Permit#: /(� ,�(0 2
CITY OF ORONO - BUILDING PERiVIIT A]PPLTCATION
All i ormation must be submitted in full before plan review will be started.
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- ------- --------r�'----- �!.an_ �tl ----------------� ��--------- ----------------
THE A.PPLICANT IS: (circle one) OWNER OR ONTRACTOR
JOB SITE ADDRESS: Yo SS �!% lo�e ���-.;•� Z�:
,
NAME OF OWI�TER: .�� PHO�tE: (home)
(work) �d '!�-�
MAII.ING ADDRESS:� t-� ,�.�,� �!� CITY:� ZIP:_��s�`�,
CONTRACTOR: �,, PHONE: �/��/-Z'>�fY
CON'TACT PERSON: � MOBILE/PAGER:
1VIAII.,ING ADDRESS: CI"TI': o ZIP:
STATE LICENSE: #v?O �i'�2.3
A.P CHIT`ECT/ENGINEER: PH0�1E:
MA.ILING ADDRESS: CITY: ZIP: _
rJAME; REGISTRATION#
TYPE OF tiVORIi: New Addition Accessory Structure
Move � Remodel/Alteratio� Land Alteration
PROPOSED`VORK(describe in detai�: '��
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STORIES: �_ SQ FEET OF EACH FLOOR: �
NO. OF EED�OOiVIS: _�„� GARAGE STALLS: ATT. DET.
ESTII�i LATED CONSTRUCTION VALUATION (excluding land): $
I hereby apply for a building permit and I aclrnowledge 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
perinit; and that the work will be in accordance with the approved plan.
A.PPLICANT'S SIGNA TE� ����
NOTE! �arade of Flomes 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 S[1B.TECTS OF D?,TA
Subd. 1. Type of data. Ihe righcs of individual oa whom the data is stored or to be scored shall be as set forth in this secaon. -
Subd.2. Information reqirired to be given indiPidual. An individua!asked to supply private or confldendal data concerning himself shail
be informed of: (a)che purpose and inrended use of the requested data wichin che collecdng�tare agency,polidcal subdivision,or satewide rystem;
(b)wherher he may refuse or is legally required to supply che izquested daca;(c)any lmown coasequence arisinr�from his supplying or refusing to supply
private or eonfidendai data;azsd(d)the idendry of other persoas or endaes aachorized by state or federal law ro receive the data. Tbis requiremene shall .
not apply when an individual is asked to svpply invesrigafive dara,pursuanc to secdon 13.82,subdivision S,to a law enforcement o�cer. -
The commissioner of revenue mav olace che noace r-auired under rhis subdivision in the individual income rax or�ropem tax refuad
inscrucdons instaad of on chose forms. ,
Subd.3. Aceess to data by indi�idual. tipon requesc to a responsible auchority,an individual shall be informed whether he is the subject �
of scored data on individuals,and whecher it is class�ed az public,private or co�denaal. Upon his fucther request,an individual who is the subjecc
af stored private or pubtic dara on individuals shall be shown the data wichout any,charge to li�m and;if he de�ires,shall be informed of che content
and meaning of chat dara..Aher an individual has been shown che privare data and informcd of ics meaning,the data need noc be disclosed to him for
six monchs chereafter unless a•d'upute or acaon puauan�to �his secaon is panding or addidoaal dam on the individual has been collecced o�creared.
The tesponsibte authoriry shall provide copies of the privace or public dara upon request by the individual subject of ehe dara. The responsible authority
may require[he«quesring person to pay the actual coscs of making,cerdfying,and compiling the copies.
The responsible au[horiry shatl comply immediatety,if possible,wich any request made pursuant to chis subdivision,or wi�hin five days of
the dace of[he request,exciuding Sacurdays,Sundays and legal hotidays,if immedia�e compliance is not possible. If he cannat comply with the requesc
wirhin chac time,he shall so inform the individual,and may have an addidonal five days widsin which to comply wieh the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data Ls not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individuat shall noafy in wriang che responsible auehoriry dascribing the nature of the disagceemenc.
The responsible auehoriry shall within 30 days either: (a)corrcet the dara found to be inaccucate or incomplece and attempe to nodfy pasc recipieats of
inaccura�e or incomptete data, including recipiencs named by�he individual;or(b)nodfy the individual thac he believes[he data to b�coaecc Data
in dispute shali be disclosed only if the individual's scacemert�of disagreement is includtd wich the disclosed daca.
The decerminarion of the rasponsible au[horiry may be appealed punuant to the provisions of the administradve procedure act relating to
contested eases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "RiQ,,hts of subjects of data",we would like to inform you that your request
for a permit or license from the Ciry of Orono or any of ics 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 supply data, but refusal may iequire that the City deny the perm.it or license.
3. � The information may be shared with other local, state or federal agencies to the eztent 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 (avatlable upon request) to review private data on yourself.
6. Your full name is required to process this application or permic.
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First vliddle Last
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Addreu / /� �c�.Jl
G,�' ,/f/ �l'
Ciry State Zip hone
I understand �Y ri;�ts az stated above. .
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Signature
DATE TIME
CITY OF ORONO CALLED IN �� �' �
INSPECTION NOTICE SCHEDULED � Z- � �r��
PERMIT NO. �0��� � COMPLETED
ADDRESS -3� �� � ���`u ��
OWNER ��� CONTR. 7��/'-� ,���lK.�.�.
TELEPHONE NO. y�`y � �-G/� 7
� DESCRIPTION �- �/C�-G
� 01 FO 11 MECHANICA I 18 EXCAV/GRADING/FILLING
Q 2 FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 0 NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE
W C CORRECT WORK 8 PROCEED ,' ISSUE CERTIFICATE OF OCCUPANCY
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance.473-73�J7
Owner/Contrac qr s e
Inspector. - �
White Copyllnspector's File Canary CopylSite Notice
���� TIME
CITY OF ORONO CALLED IN
INSPECTION NO I E3 Z SCHEDULED ��,�� �
PERMIT NO. COMPLETED
ADDRESS� �o gS � e�r��,�Q[ •
OWNER CONTR.��/t.�
TELEPHONE NO. �D�f'� .Z 9�`J�
� DESCRIPTION ��,h,�
� Oi FOOTING 11 HANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WA BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FINA 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C tSSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473�73rJ7
OwnerlContrac n i :
Inspector. .�
White Copyllnspector's File Canary CopylSite Notice