HomeMy WebLinkAbout1997-009195 - re-roof / tear-off PERMIT
CIT� O�ORONO PERMIT TYPE: - - �
2750 Kelley Parkway- P.O. Box 66 _`�'""���''�'"''`
Permit Number: `. ..''�-'i`=�•'='
Crystai Bay, Minnesota 55323 - --�- --��
I (612)473-7357 Date Issued: �;~` ,`-.'` ;'=� :
SITE ADDRESS:
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REMARKS:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan revie�v will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
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JOB SITE ADDRESS: �%'� � '~.� _,�,',,�..�;,,- ���!��` ZIP: -% � S �
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NAME OF OWNER: ._�c>1 � �-� ���°�� �(� PHONE: (home) � 7� �` �� ' �
(work) `� ��l . �'�� � `�'
MAILING ADDRESS: CITY: � ZIP:
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CONTR.ACTOR• ...� .1.��.�_ i✓I �' ���-�-�" PHONE: `' � ..`��-��� �� ���
CONTACT PERSON: ` r� ��� -.: G� BILE/PAGER: �� - � � `�
MAILING ADDRESS: �� CITY: ,$^.,� ,�ZIP: S.� / �
STATE LICENSE: # �'C� ;'��
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detain: /,Q�Ci%? C�;� �-;.>�i �%3�.�2�,,:�:�_�t�!r ..�`.h_%
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ , �%��
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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 accordan�e with the approved plan.
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APPLICANT'S SIGNATURE: / ��� � /��-DATE: � ��_ L ;`J ,
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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 RIGATS 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 forrh in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting'state agency,policical subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the identity of ocher persons or enrides authorized by state or federal law to receive the data. This requirement shall
not appiy when an individual is asked to supply invesrigadve data,pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propem tax refund
instruccions instead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is rhe subject
of stored data on individuals,and whecher it is classified 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 the data wichout any charge to hirn and, if he desires, shall be informed of the content
and meaning of�hat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hun for
six months thereafrer unless a dispute or action 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 the data. The responsible authoriry
may require the requesting person to pay the actual costs of makine, cerafying,and compiling the copies.
The responsible authoriry shall comply immediately, if possible,with any request made pursuant to this subdivision,or wi[hin five days of
the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within[hat ticne,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 complete. An individual may contest the accuracy or completeness of public or private
data concerning himseif. To exercise this right,an individual shall norify in wridng the responsible authoriry describing the narure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify 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 dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the admuustrarive procedure act relaang 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 pemut or license requested.
2, You may refuse to supply data, but refusal may require that the City deny the permit or license.
3, T'he 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. j
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City State Zip Phone
I understand ;ny rights as stated above.
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Signa re
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DATE TIME
CITY OF ORONO CALLED IN '�'��:, 7
INSPECTION N TICE SCHEDULED �1�� � �
PERMIT N0. � � � �� COMPLETED -s��
ADDRESS 2��'`-> >-������ � ., �<��
OWNER CONTR. _---��'-��%
TELEPHONE NO. �� � •- �G� `�" �%
� DESCRIPTION _��k--2-�-�--/�
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADINd/FIWNG
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORENVETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
F`� 7 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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�Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� j�WORK SATISFACTORY:PROCEED
PROJECT COMPLETE
WL[ CORRECT WORK 8 PROCEED : ISSUE CERTIFICATE OF OCCUPANCY
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t in ction 24 hours in advance.473-7357
OwnerlContract site:
Inspector.
Whiie Copyllnspector's File Canary Copy/Site Notice