HomeMy WebLinkAbout1998-010949 - tearoff/reroof , � PERMIT
CITY OF ORONO PERMIT TYPE: � -� - T� � -
2750 Kelley Parkway- P.O. Box 66 Y-'`_`�`.�'`'`'`�`
Crystal Bay, Minnesota 55323 Permit Number. �;i t_f'�r�'�
I (612)473-7357 Date Issued: �i f:���:�:f�'_����
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FEE SUMMARY:
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APPLICANT/PERMITEE GNATURE ISSUED BY:SIGNATURE ��
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Total Fee: $ Date Received:
Entered By: , Permit#: ��,9�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: �!� ZIP: ���"J �
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NAME OF OWNER: ��6'���i� �'I��- PHONE: (home) �{7� —����
(work) � — �
MAILING ADDRESS: �((� �-eUl�l;� ITY: ZIP:
CONTRACTOR: �(�1 C�/l �, HONE: � —�
CONTACT PERSON: � MOBILE/PAGER: � — �
MAII.ING ADDRESS: CITY: ' Q ' �ZIP:��"�
STATE LICENSE: # �'
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �Q�T_�`P�l-���-
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ � ���0
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 accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: �l�'3�
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.
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Sec.13.04 RIGFiTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual an whom the data is stored or to be stoced shall be as sec forth in this secaon.
Subd.2. Information reqtiared to be givw individual. An individual uked to supply private or confidencial data concaniag himself shall
be informed of: (a)the pucpose and inunded use of the�equesced data wirhin�he collecring Etare agency,polidcal subdivision,or statewide rystem;
(b)whether he may refuse oY is legaliy cequired to supply rhe requesud daea:(c)any laiown caauqueace arising from his supplying or retusing to supply
priva�e or confidendal data;and(d)the idendry of other persons or eaddes authorized by state or federnl law to roceive the data. This requirement shall
not apply when an individual is asked to supply invesrigadve data,pursuaat to section 13.82,subdivision 5,to a taw enfotcement officer.
The commissioner of revenue mav olace the noace reauiced under this subdivision in the individual income tax or prooem taz refund
instrucdons instead of on rhose forms.
Subd.3. Access to data by indiridual. Upon requesc to a msponsible authoriry,aa individual shall be informed whether he is the subject
of stoced data on individuals,and whecher it is classified as public,private or confidendal. Upon his further request,an individual who is the subject
of stoced 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[hat data. ARer an individua!hac bcen shown the private data aad informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuanc to this secrion is pending oc addidooal data on the individual has been collected or eFeated.
The«sponsibte authoriry shall provide copies of[he private or public data upon request by the individual subjecc of the data. The responsible auchoriry
may mquire the roquesting person to pay the actual cosu of making,certifying,and campiling the copies.
The responsible authoriry shall comply immediarely,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Satucdays,Sundays and legal holidays,if immediate compGance is not possible. If he cannot comply with the request
wi[hin d�at time,he shall so inform che individual,and may have an addidonal five days wirhin which to comply wi[h the request,exctuding Sauudays,
Sundays and legat holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compieteness oF public or private
data conceming himself. To exercise chis righG an individual shall nodfy in wridng rhe responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to notify past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual thac he believes the data to be correct Data
in dispute shall be disclosed only if the individual's statemenc of disagreement is included wi[h the disclosed data.
The determinadon of the responsible authority may be appealed pursuanc to the Qrovisions of the administradve procedure act niating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13•�4,Subd.2, "Rights of subjecu 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 determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the Ciry 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 process this application or permit.
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I understand my rights as stated above.
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Sig re
DATE TIMEy
CITY OF ORONO CALLED IN 1 " I — �3: �/�am
INSPECTION NOTICE (� SCHEDULED /11�$ •`r�
PERMIT NO. � ` COMPLETED
ADDRESS ��
OWNER CONTR.
TELEPHONE �1 — 15 �{ 0�
� D TION ���
�y 0 F 11 MECHA I L RI 18 EXCAV/GRADING/FILLING
� 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contract n�e:
Inspector.
White Copyllnspector's Canary CopylSite NoUce