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Home My WebLink About2001-P04396 - re-roof � � PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po4396 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 9i2��2ooi SITE ADDRESS: 4175 North Shore Dr MOLJND,MN 55364 P I D: 07-117-23-44-0044 DESCRIPTION: UBC Occupancy R3 Proposed Use: Kesidentiai 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: $ 167.25 Valuation: $ 8,100.00 State Surcharge Fee: $ 4.05 TOTAL FEE: $ 171.30 APPLICANT: Gopher Co. Inc. OWNER: ANN MARIE MAXFIELD 445 Malcolm Ave. SE 38 ADDRESS UNASSIGNED Minneapolis, MN 55414 MN 00000 TNE UNDERS[GNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITN ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � " - ' � C� � (f � A LI A P R I'I' SIGNA7'URE ISSCIED BY SIGNATURE �, � Copies: 1-File (Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 � Total Fee: $ � ��, 3 C' Date Received: �f�'%�u>/ Entered By: e Permit#: """///��,-� f 3 i b �c G CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------- ------------- -------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR � JOB SITE ADDRESS: y��J� �� , m ZIP: NAME OF OWNER: ,� � � ' � � PHONE: (home) ��z-- y 7Z-3 3/ 7 � (work) MAILING ADDRESS: L//7i� ��, .�n-;p �L CITY: ZIP: CONTRACTOR: ,y.�, PHONE: 6'�Z- '3 3/-/5 5,j CONTACTPERSON: � 11�IOBILE/PAGER• G�Z--(��`-�43yh� � MAILING ADDRESS: � , �� _CITY: �' ' ZIP: �S /� STATE LICENSE: # j��`7 ARCHIT'ECT/ENGINEER: PHONE: MAILli�1G ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration PROPOSED WORK(describe in detai�: / �- ' ��7 STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �', /`� `�j 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 ordance with the approved plan. � �, �, - APPLICANT'S SIGNAT . % -'� DATE: �� NOTE! Parade of Homes events •equ' e separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. �'� n� � 1��r y '"' � Sec.13.04 RIGHTS OF SUBJECTS OF DATA . Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting State agency,polidcal subdivision,or statewide system; (b)whether he may refuse ot is legally required m supply the requested data;(c)any imown cansequence arising from his supplying or refusing to supply priva[e or confidential data;and(d)the idearity of o[her persons or entiaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigadve data,punuant m secdon 13.82,subdivision 5, ro a law enforcement officer. The commissioner of revenue mav alace the norice rewired under chis subdivision in the individual income rex or proaem�c refund instrucdons instead of on those forms. Subd.3. Access to datn by iadividuai. Upon requesc w a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and wherher it is class�ed as public,private or confidendal. Upon his further request,aa individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and;if he desims,shall be informed of die content and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six mondu theceafter unless a dispute or action pursuant to this secdon is pending or addidonal data on the individua!has been collected or created. The responsible authority s6a11 provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesdng person ro pay the actual cosu of making,cerdfying,and compiling the copies. The responsible authority shail comply immediately,if possible,with any request made pursuanC 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 requesc within thac time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Sanudays, 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 private data conceming himself. To exercise chis right,an individual shall nodfy in wridng the responsible authority describing che nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and auempt to nodfy past recipienu of inaccunte or incomplete data, includin�recipients named by the individual;or(b)notify the individual that he believes the data to be correcG Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The decermination of the responsible authority may be appealed pursuanc to the provisions of the administradve pracedure 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 furnish certain private or confidential information. You are notified that: 1. The information you fumish will be used to detemii�e 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 pr.ocess this application or permit. gi�� Middle � Address . C�� 5tate Zip P6one I underst my rights as stated above. ` � Ig � � � DATE TIME CITY OF ORONO CALLED IN INSPECTION NO ICE SCHEDULED _'` -� ��'-� PERMIT N0. � COMPLETE '-2 '�'� � ADDRESS `717� �4/"Y'h ��1�. �J. OWNER CONTR. �r ��P/? Cyl� . TELEPHONE NO._ ��"331—�SS� � DESCRIPTION �� 2..z�t.=c., �1y-, ��'� , � 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESNORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 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 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � � O � � O � W � Q ti 2 W � W � � d � � '�jIORKSATISFACTORY:PROCEED �l P,ROJECTCOMPLETE �_� W �CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractpr�on site: Inspector.� � �_ < < c�i 5� � White Copy/lnspector's File Canary CopylSite Notice