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Home My WebLink About2005-P09382 - re-roof � � / + PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P09382 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 11/2/2005 SITE ADDRESS: 555 Oxford Rd Unit# Long Lake,MN 55356 PID: OS-117-23-41-0024 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: 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: $ 209.25 Valuation: $ 11,200.00 State Surcharge Fee: $ 5.60 TOTAL FEE: $ 214.85 APPLICANT: Plymouth Roofing&Insulation OWNER: Cornelia Klitzke 17525 Cty Road 24 555 Oxford Rd Plymouth,MN 55447 Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK TN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. , � /� � -� _. .�� r�� c��— E SIG ATU ISSUED BY SIGNATURE Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1 � � � Total Fee: $ ��• �J Date Received: j /� �C�S Entered By: ;� Permit#• f-�(�� 6��. CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in futl before plan review will be started. (please print all i�iformation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �j S�S �X�o��` f� f ziP: ��S.3rS� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS �,NO If yes, a specia/event permit is reqa�ii•ed ivith Police Depar•tment and City Cozrr�cil approval 60 clavs prior to the ever�t. S1zt�ttle G2rs service tivill be r•egt�ir�ed zu�less applicant de��ionstr•ates sarff cient on-site par•Iting is avazlable. Non-pei��rrrtted events lvil!not be allotived. NAME OF OWNER: C-��.� / ,�. PHONE: (home)�,5�-s�7/--dDU/ (work) MAILINGADDRESS: �SS OX�JY'� �C� CITY: O��/1/rJ ZIP: S � S CONTRACTOR: � Oc/ � 2/ PHONE: 7(�3- �73 --33�� CONTACT PERSON: � � sl��,� MOBILE/PAGER: ��- 7/�-os�,6 MAILING ADDRESS: j 7So2s �'o r-�' ,�5� CITY: �''�"r�,�.or/� ZIP: �,��/� STATE LICENSE: # �'3 S� EXPIRATION ATE: v - 3/- D� ARCHITECT/ENGINEEI2: P�IONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration PROPOSED WORK(describe in detain: �'e i�-�� ic� ��ii--riel- �c� r��--oa�'�/i' � �U �ir- ��iz��-� s/,2-s�r -- S'I'ORIES: ( S�.F'EE'I'OF'EACI-I�'LOOit: I+1�. OF BED�2001WIS: GARAGE STALLS: A�"'I'ELC�iED �ETA�I'�E� a�� ESTIIVIA'TEI3 C'ONST'RUC�'ION VAL,i1AT'ION(excluding lanc�): $ ��, ��U , 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 tl�e ordinances and cocies of the City and with the State Buildina Code;that I understand this is not a permit and worl<is not to start without a permit;aild that the work will be in accordance with the approved plan. , APPLICAN'I''S SIGI�A'I'UI2E: �- DA'I'E: �� —G� 31 . � . � Sec.13.04 R[GHTS OF SUBJECTS 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 section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data concerning himselfshall be informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide 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)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue m�,v olace the notice required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shal I be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an 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 desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pttrsuant to this section is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,ifpossible,with any request made pursuant 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 witltin that time,he shall so inform the individual,and may have an additional five days within�vhich to comply with the request,excluding Saturdays, Sundays and Iegal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL The responsible authority shall within 30 days either. (a)correct the data found[o be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 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 e�ctent 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 Last Address City State Zip Phone I understarr my r'g�its s abo . S' n ure �� ' J ;11 � "� � DATE TIME CITY OF ORONO CALLED W ��^Z'�� INSPECTION NOII/CE SCHEDULED cJ5 e� PERMIT NO. ��l � �� COMPLETED — � ' ADDRESS � , 2 OWNER CONTR. � d t. TELEPHONE NO.�� i- y7 �- � ��l J,j� /� /2 7/� U��"3[� � DESCRIPTION � ��. �� `"��A l � 01 FOOTING 11 MECHANICAL 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 Z04 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 INSTALL. 22 FOLLOW-UP = 09 PLUMBING Rf 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � �od �! � ��- �-- ;.�� ____ � � ._r� �� 0 � w � Q � z W � W � j d W� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 7 CITATION ISSUED C INSPECTION REQUtRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952��249-46QQ OwnerlContractor on si : `` Inspector. 'J � � White Copyllnspector's File Canary CopylSite Notice