HomeMy WebLinkAbout1996-008480 - window replacement �____ _ _ __ _. �.�
PERMIT
CIJ�.OF ORONO PERMIT TYPE:
2%50 Kelley Parkway- P.O. Box 66 fi;:t 1�;�[3�i��
Crystal Bay, Minnesota 55323 Permit Number: ;_y�y�_�;_�y
(612)473-7357 Date Issued: f�_���Y�`�i,��,
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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.. -ToCdl Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must he submitted in full before plan review will be started.
(please print all information)
-------------------------------------------------------- - -------- -----------------------------
T�iE APPLICANT IS: (circle one) CONTRACTOR
JOB SITE ADDRESS: ��.� ���l� �/�lJ.� ZIP:
NAME OF OWNER: ��� S� ll.e�-�-�-�Q PHONE: (home) �f7a-�7 96
(work)
MAILING ADDRESS: 5��..` CITY: C1�1�,,.�� ZIP:
CONTRACTOR: /�'1.T c - G � PHONE: `�rG � O �a"1
CONTACT PERSON: G.�.� "�,.�..�„� MOBILE/PAGER: �c�� — � ?�o
MAILING ADDRESS: l3 � `� /�CC�.r�d1� ,OirCITY: r'� ZIP: .r'S/a�
STATE LICENSE: # '7 7 7 �
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: �'�,J¢�` c��' ��� c�,��,�rQ �,.s � c�J�r�
�.ao-�s r�s — /'�T'll `7�a /�+�l�— 0 4• o .2 -.Q _rJ' e cr cQ.A�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ l� �'`�o
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 pemut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE• DATE: l"T � ^�G
NOTE! Parade qf 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.
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Sec.13.04 RIGHTS OF SLJBJECTS 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 secaon.
Subd.2. Information req�red to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)[he purpose and in[ended use of the requesced data withia the collecting Ytate agency,political subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply rhe requested data;(c)any{aiown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)che idendry of o[her persons or enrities au[horized by state or federal law to receive the dara. This requirement shall
not apply when an individual is asked to supply invesdeadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the nodce required under this subdivision in the individual income tax or proaertv tax refund
instrucdons instead of on chose forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher it is classified as public,private or confidenaal. Upon his further request,an individual who is the subjecc
of stored private or public data on individuals shall be shown[he data wirhout 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 che private data and informed of iu meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this secrion is pending or addidonal data on the individual has been collected or created.
The responsible au[horiry shall provide copies of the private or public data�pon requesc by the individual subject of the data. The responsible authority
may require the requesring person to pay the acmal costs of making, certifying,and compiling the copies.
The responsible authoriry shall compiy immediately,if possible,with any requesc 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
within that time,he shall so inform the individual,and may have an addirional five days within which to 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 private
data conceming himself. To exercise[his right,an individual shall nodfy in wridng the responsible authority describing the nature of the disagreement.
The responsible authority shali within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy 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 determinadon of the responsibie authority may be appealed pursuant to the provisions of[he administradve procedure acc 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 pemut 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 detemune 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.
(. Your full name is required to process this application or permit.
� � �rt Jo Nt
First Middle Last
L 3 � 9 /��C4� f��:P: ,O ir �:��
Address
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Ciry State Zip Phone
I understand my rights as stated above.
Sign
D TE TIME
CITY OF ORONO CALLED IN / ) / �i��
INSPECTION NOTIC SCHEDULED / .'/ � ��'
PERMIT NO. �� `^�-� COMPLETED
ADDRESS ��'
OWNER ��%�,� —�, �_ C "� ��CONTR.
TELEPHONE NO. � �(,�1 - _`�/"7�
� DESCRIPTION L���,i�.�c�'
� Oi FOOTING 11 MECHANICALRI 1BD(CAV/GRADIN�/FIWNC3
Q 02 FRAMING�-�!���t-� 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
��"03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAI
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK•UO O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FINAL 3fi FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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WL CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. r pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �-�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlContra on i e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
D E TIME
CITY OF ORONO CALLED IN �� t
INSPECTION N IC/� SCHEDULED � 96 l/�
PERMIT N0. '�`' � COMPLETED
ADDRESS /.� � � '
OWNER � CONTR. `'� � �
TELEPHONE NO. �l� 9 —�/'7 S
� DESCRIPTION
� 01 FOOTIN� 11 MECHANICALRI 18IXCAV/C�RADINC�/FIWNO
�Q 02 FRAMIN 13 MECHANICAL FlNAL 19 LAI�SHOREIWETLANDS
24/251NOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z p4 Vy�L Bp. 12 WATER HOOK-UP 17 SITE INSPECTION
� p5 FlNAL 14 SEWER HOOK-UO 06 PROORESS
v 07 DEM�SITE 27 SEP11C MAINT. 21 COMPWNT
W 07 DEMO—FlNAL 15 SEPTIC INSTALL 22 FQLLpW{1p
= OB PLUMBIN(�RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FlNAL 36 FOUNDATION REMOVAL
Z OWN TO MEET YOU: YES_NO
y COMMENTS:
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d WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
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OO O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COMERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIREO.CALL TO ARRANGE ACCESS.
Cali for the next i pection 24 hours in advance.473-7357
OwnedCont n s e:
Inspector:
1Nhit�CopyAnspector's Fils Canary CopylSib Notiw