HomeMy WebLinkAbout2000-P02723 - re-roof � � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Po2�23
Crystal Bay, Minnesota 55323 Pet'mit Type: MinorAlterations
(612) 249-4600 Date Issued: �i24i2oo
SITE ADDRESS: 630 Pazk La
LONG LAKE,MN 55356
P ID: 06-117-23-44-0014
DESCRIPTION:
Proposed Use:
Permit Class: Building Census Code 434
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• $ 9,000.00
State Surcharge Fee: $ 4.50
TOTAL FEE: $ 171.75
APPLICANT: �CK ANDERSON OWNER: R D ANDERSON&N L ANDERSON
630 PARK LANE 630 PARK LA
LONG LAKE,MN 55356 LONG LAKE MN 55356
TI�UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII.,DING CODE REQUIREMENTS.
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I SLTED B SIGNATURE
Copies:City,Applicant,Assessor,Finance Page 1
. .
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BU�I.DING PERMIT 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: �.3�� l �+ �` � �-N - ZIp; 5J�3S 6
���50�
NAME OF OWNER: 1`> >v� � / "�'`� PHONE: (home) �f 7�`y °S�
(work) `�1`/-O Z Z.5—
MAILING ADDRESS: � CITY: ZIP:
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �C Land Alteration
PROPOSED WORK(describe in detai�: �c- - Zao�'�ti _ Td t0. 1 fiP-o►.^ v 7�
STORIES: Z SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 9,DOO
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 accord wi the approved plan.
APPLICANT'S SIGNATiJRE: DATE: 7� Z y'�0
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.
� r
Sec.13.04 RIGHTS OF S[TBJECTS OF D�Ta
Subd. 1. Type of data. The righcs of individual on whom the data is s[ored or to be stored shall be as set for[h ia this section.
Subd.2. Informarion reqirired to be given individuai. a.n individuai asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and inunded use of the requested data wirhin the collecting State agency,politicai subdivision,or statewide sysum;
(b)whe[her he may refuse oY is legally required to suppiy the requested data;(c)any imown consequence arising from lus supplying or refusing to supply
privace or eonfidendal data;and(d)the idenury of other penoac or enddes auchorized by state or federal law to receive the dara. This requirement shall
not apply when an individual is asked to supply invesdgadve dara,pursuant to secdon 13.82,subdivision 5,co a law enforcement o�cer.
The commissioner of ro�enue mav place the nodce re4uired under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individuai. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whe�her it is class�ed as public,private or confidendal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown rhe data wirhouc any charge to him and,�if he desires,shall be informed of the content
and meaning of chat data. Afrer an individual has been shown che private data and informed of iu meaning,the data need not be disclosed to him for
six months thereafrer unless a dispute or acrion pursuanc to this secrion is pending or addidonal 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[he data. The responsible authority
may require the requesting person to pay the actual cosu of making,certifying:and compiling the copies.
• The�esponsible authority shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exciuding Saardays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the request
within that rime,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or comptete. An individuat may contest the accuracy or completeness of public or private
data concerning himself. To exercise[his right,an individual shall natify in wridng the responsible authoriry describing[he nature of the disagreement.
The responsibie authoriry shall within 30 days either: (a)correct the data found to be inaccunte or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, inciuding recipients named by[he individual;or(b)noafy the individual thac he believes the data to be correct. Data
in dispuce shall be disclosed only if the individual's sra[emenc of disagreement is included with[he disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administradve pmcedure 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 vr
confidential information.
You aze notified thar.
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.
First Middle Last
Addross
City State Zip Phone
I understand my ' hts as stated above. ,
t-
Signature
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED
PERMIT NO. � COMPLETED 2 ��
ADDRESS �� �✓1�- �-C�Y�-
OWNER �Av�Iicv�'� CONTR. C3u��'�e✓
TELEPHONE NO.
� DESCRIPTION __�-�.`�+�� I�CS-�G�
ty 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
Q 3 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALI. 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
v�, COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� �CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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Ol0 CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOF � CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
OwnedContra r on site:
Inspector.
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