HomeMy WebLinkAbout1997-009521 - tear-off/re-roof .., PERMIT
. CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date Issued: -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - `;= = '; - . . - - OWNER:
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APPLI /P ITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ Date Received:
Entered By: i�;�� Permit#: �f 5 �� '
CITY OF ORONO - BUII.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 O CONTRACTOR �
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JOB SITE ADDRESS: _�, ' I �� � ��"��.�O��y�� K� ZIP: �3.� � 3� /
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NAME OF OWNER: /��E' �- PHONE: (home) ���/-�'���
; (work)
MAILING ADDRESS: ��� , � • ��GL,�J� �,�CI'I'Y: � �z_L���.��,� ZIP: �:�.�� /
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COi�1'I'RACTOR: ���- ,�,,�-�._��.� C�c" , PAONE: `�> �(�� -// ��
CONTACT PERSON: ,�E�,L MOBILE/PAGER:
MAILING ADDRESS: / =��� '".� ��s�� - z , �� ZIP:��_.
STATE LICENSE: � � (r. ' '�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New ,V,�ddition Accessory Structure
Move �emo�Alte�tion Land Alteration
PROPOSED WORK(describe in detai�: �`(� 1 i) ���(� ;���u',:�� -- /CE�.-�� � -�"
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C-�f � ti '
STORIES: I SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
C:�`
ESTII�i IATED CONSTRUCTION VALUATION(excluding land): $ -�=> �.� C�c�,` �
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 ordi.nances and codes of the City and with
the State Building Code; that I unde tand this is not a permit and work is not to start without a
permit; and that the work will be ' accorda�ce�it� e approved plan.
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APPLICANT'S SIGNATURE,�' �(�� DATE: c��' -� �� �" �C �
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NOTE! �Parade of omes events require separate permit approval by Police Department and
� City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SIJB.TECTS OF DaTA
Subd. 1. Type of data. Thc righcs of individual on whom the data is stored or co be stDred shall be as set forth ia this secdon.
Subd.2. Information reqirired to be given individual. An individual azked to supply privace or confidendal dara concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wi[hin the collecang�tace agency,polidcal subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply[he requested data:(c)any known wasequence arising from his supplying or refusing to supply
private or confidential dara;and(d)the idendry of other persoas or enades authorized by state or federdI law to receive the data. This requirement shall
not appty when an individual is asked to supply invesngadve dam, pursuant to secdon 13.83, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the noace rwired under�his subdivision in the individuai income tax or orooem az refund
instrucdons ins�ead of on�hose forms.
Subd.3. Access to data by individual. Upon requat to a respoasible authority,an individual shall be informed whether he is the subject �
of stored dara on individuals,and whether it is classified as public,priva�e or confidenaal. Upon his further request,aa individual who is the subjecc
of stored private or public data on individuals shall be shown the dara wichout any charge to him and;if he desires,shall be informed of the content
and meaning of that data. Aher an individual has been shown che priva�e daca and informed of irs meaning,the dara need not be disclosed to him for
six monrhs thereafrer unless a dispuu or acdon purSuant to rhis secdon is pendiag or addiaonal dara on the individual has been collect�d or creared.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible autfioriry
may require the requesdng person to pay the actual costs of making,cerrifying,and compiling the copies.
The responsible authoriry shall compiy irnmediately, if possible,with any request made pursuant to this subdivision,or wichin five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is noc 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 wi[h the request,excluding Saniniays,
Sundays and legal hotidays.
Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accurdcy or comple[eness of public orprivate
data concerning himself. To exercise chis righ[,an individual shall nodfy in wridn;the responsible au[horiry describing the nacure of the disagreemenc
The responsible au�hority shall within 30 days either: (a)correcc the data found co be inaccu�ate or incomplete and atumpt to nodfy past recipientt of
inaccurate or incomplete data, inciuding recipients named by the individual; or(b)notify the individual that he believes the dara to be correct Data
in dispute shall be disclosed only if[he individual's stacement of disagreement is included with[he disciosed data.
The determinadon of the responsible authority may be appealed pursuanc to the provisions of the admirust:adve procedure act reladng 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 deternvne 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 ocher local, state or federal a;encies to the extent necessary to process
the permi[ or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself.
6`� Your full name is required to process this applicat' n or permit.
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I underst my rights as stated abov
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Signam e j ;
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DATE TIME
CITY OF ORONO CALLED IN /O-/�/- �7
INSPECTION NOTICE p SCHEDULED /o- i S �
PERMIT NO. / Shc I COMPLETED
ADDRESS � � y/ 1P,��L[�i�o �I2�1
OWNER CONTR. (�
TELEPHONE NO. � �� — /�7 �
� DESCRIPTION �
� O7 F 11 MECHANICALRI 18IXCAWCiRADINO/FIWNO
FRAMIN 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q ULATION 24/2$WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= 05 FINAL 14 SEWEH HOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC M/UNT. 21 COMPLAINT
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W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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�d ORK SATISFACTORY:PROCEED
- PROJECT COMPLETE
W C_'CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. r- pHOTOTAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CAIL TO ARFiANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContra r n t :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice