HomeMy WebLinkAbout2002-P05146 - re-roof C�T'� OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Posia6
Crystal Bay, Minnesota 55323 Pe►'mit Type: MinorAlterations
(952) 249-4600 Date Issued: si6i2oo2
SITE ADDRESS: 1336 Rest Pt Cir
Mound,MN 55364
P I D: 07-117-23-31-0020
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 13925
Valuation: $ 6,695.00
State Surcharge Fee: $ 3.85
TOTAL FEE: $ 143.10
APPLICANT: Sela Roofing&Remodeling,Inc. OWNER: Janice DeMatt
4100 Excesior Blvd. 1336 Rest Pt Cir
St. Louis Park,MN 55146 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
,-;
� � �� r�
� ��'�� (�/,.J !7, ��✓ ��/
r/
APPLICANT P ITEE SIGNATURE ISSUE BY SIGNATURE
�
Conies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Total Fee: $ Date Received:
' Entered By: Permit#:
CITY OF ORONO - BUII.,DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
� (please print all information) .
TH� APPLICANT IS: (cirele one) OWNER ONTRA �
JO&SITE ADDRESS: (3 3�p � t5� �o i✓►+ C'i rC �� Z�: SS 36�f
NAME OF OWNER: �C�v1 D�z ma�+t o PHO�IE: (home)�I�",�- �l 7.�- S3�O
(work)
1�IA,II,Ivi G ADDRESS: �33� , �.c5f �a�'h� �'i�IrCTTY: O YOn O ZIP: 5S3 6�
9ELA ROOFING&REMODELING,INC. �
CONTRACTOR: ' 4i�00 EXCELSIOft BLVD. PHO�TE: �o I/�' �i ,�'�ot/!o
COv'TACT P�RSON: ST• s P�,MN 5��1BILE/PAGER:
MAII.,ING ADARESS: CTI'Y: ZIP=
STATE LICENSE: # 1 bS�
ARCHITECT/ENG iNEER: PHO\'E:
iViATL'Pi TG ADDRESS• CITY: ZIP:
r,•��; REGISZ'RATION# •
TYPE OF `VORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED ti'VORK(describe in detai�: �rc,ro� K rcro�+� �aUS e �
STORIES: SQi FEET OF EACH FLOOR:
NO. OF BEDROO`ZS:� GARAGE STALLS: ATT: � DET. � �- �- -_�-•�. .-,
p
ESTNi IATED COti'STRUCTI0�1 VALUATIO\ (excluding land): � ��O�s v
I hereby apply for a buildin�pernait and I acknowled;e 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 Buildin� Code; that I ui�derstand this is not a permit and work is not to start without a
permit; and that the work will b� in acc rdanc th the approved plan.
A.PPLICANT'S SIGNATiTRE:'I � - DATE: S—L'a �
1�'OTE! �arade of Homes even�s require separate permit approval by Police Dep�rtment and
City Council 60 days prior to th�e event. Non permitted events will not be allowed.
,
.
Sec.13.0-t RIGHTS OF SL'BJECTS OF DAT�
Subd. 1. Type of data. Zhe righcc of individual on whom the dara is sto:_3 or co be scorcd shall be as sec forth in this secaon.
Subd.2. Informaaon reqirired to be given individual. An ite'i�idual asY�to suppiy private or confidendal data conceming himself shalt
be infocmed of: (a)�he purose and inrended use of the requesud da�v.:�in the coIItcang�tace agency,policcal subdivision,or sratewide rysum;
(b)wF.echer he may refuse oY is legalIy cequiced to supply che r.quesced daa:(c)any]cowa coasequence arising from his supplying or refusing to suppiy
privace or canndendal daca;ar.d(d)ehe idendry of other persons orendd:s aeciorized by s�ate or federd!law m receive the da�a.,Zhis�equiremeac shali
no�apply when an indir•i�+ual is asked to supply invesdgadve dara,purs��c co secdoa 13.83,subdivision 5,to a.law enforcemenc o�cer.
The commissioner of r�•enue mav olace the noace r-wircd erder this subdivision in the individuai ir.come tax or orooem taz refund
instcuceions ins�ead of on those focros.
Subd.3. Access to data by indirzdual. Upon request to a�r,.oatible aec:^.oriry,an individual shall be informed whechec he is the subject
of swred data on individuats,and whecher it is ctassified as public,privae or conF�decual. Upon his funher requesc,an individual who is[he si:bjecc
of stored pcivate or public dara on individuals shall be shown[he dara wi�out any c'R,'e to him and:if he das'ues,shall be informed of�e coatenc
ar.d meaning of thac dara. Aher an individual has been shown ehe privi��aca and i�:or,ned of its meaniag,the dara need not be disclosed to him for
six mon;hs ehereaiter unless a dispute oc acaon pursuanc to chis secdon is t:ading or addidonal data on the individual has bean collec�ed or creaced.
The«sponsibla auehoriry shall pcovide copies of[he priva�e or public da�c�on reqaes:by ehe individual subjece of che data. The responsible auchoriry
may r:quir_�he requesdng person to pay the acaal coscs of makin¢,ce=.;•ing,ar.d compiling the capies.
'Ihe responsible auchoriry shall comply immedia�ely,if possib!a.wich any r_quesc made pursuant to this subdivision,or wi�hin five days of
the dar of che reqaesc,ezcluding Sacurdays,Sundays and legal holidays,ii ir,.mediam compliance is no�possible. If he cannot comply with the requesc
wichin chac dme,he shall so inform the individual,and may have an addtce;3l five days within which to comply wich che request,ezcluding Samrdays,
Sundays and legal holidays.
Subd.4. Procedure when data Ls not accurate or eomplete. :�r►indivituzl may contesc tha accuracy ar completeness of public or pri�at:
daa concerning himself. To exercise chis right,an individual shaIl nodfy ia wriring ce rssponsible authoriry describing[he nacure of the disagreemenc.
The responsible aurhoriry shsll wichin 30 days eicher: (a)comcc rhe da�icund to ba inaccurete or incomplece and attempc to nodfy past recipienu of
ina:cur3te or incomplece dan, including recipicncs named by ehe individ�l;or(b)codfy ehe individual chac he betieves[he dara to be coaec� Dara
in dispuce shsll be disclosed only if ehe individual's sracemenc of disagrc��enc is i.c:::3ed wich the d'uclosed data.
The decerminarion of the rtsponsible auchoriry may be appaa�:�puauacc to the provisions of ehe admuustrdrive procedure act teladng to
contes.ed cases. .
DATA PRIV�CY AD�ZSORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects oi daca", we would like to inform you that your reauest
for a permic or license from the Ciry of Orono or any of i� depa.r...encs may require you to furnish cenain priva�e or
confidencial information.
You are notified that:
1. 'Ihe informacion you fumish will be used to d:cermine}'our qualifccation for the permit or license requested.
2. You may refuse to supply data, buc refusal nay require that the City deny the permit or license.
3. The information may be shared with ocher locz, state or federal ageacies to the excenc necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some informa[ion may become
. . public.
5, You have cercain ri;hts under N1.S. 13.04 (a�ailable upon request) to review�private data on yourself.
6. Your full name is required co process this applicacion or permic. �
Firsc Middle Last
Addccss ,
Ciry Stace Zip Phone
I understand my ri;hts as s ted above.
� .
Signa e