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Home My WebLink About2003-P06122 - re-roof CITY �F ORONO PERMIT 2750 Kelley Parkway- PO Box 66 Permit Number: Po6i22 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 3/24/2003 SITE ADDRESS: 1340 Rest Point Cir MOUND,MN 55364 P I D: 07-117-23-31-0021 DESCRI PTION: Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernrits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 181.25 Valuation: $ 9,058.00 State Surcharge Fee: $ 5.05 TOTAL FEE: $ 186.30 APPLICANT: Allstar Consiruction I OWNER: JACK EDWARDS KUTZ 8401 73rd Ave N-Suite 80 ' 1340 REST POINT CIR Minneapolis,MN 55428 MOLTND MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMI SION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT CO�PLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF NIINNESOTABUILDING CODE REQUIREMENTS. ;' � , L'�,�C-'�i1�I /C� P ANT PERMITEE SIGNATURE ' I D BY SIGNATURE Conies: 1-File(Signitures Required), 1-Aunlicant 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1 �'otal Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. " (please print all inforntation) THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: ��(�/ �;�C�f l/'ii�T ,,�- ZIP: NAME OF OWNER: ��G I� ��-I�r�I� PHONE: (ho� �7�'3.�/3 (work) MAII.ING ADDRESS: CITY: ZIP: CONTRACTOR: �/`S�ig d' �G��' T PHONE: '7�3-.S�13'.53�.�� CONTACT PERSON: MOBILE/PAGER: MAII.ING ADDRESS: lI 73 1� �- CITY: (�v tqvl�� P k��:��' STATE LICENSE: # ARCHITECT/ENGINEER: PHOI�TE: MAII.ING ADDRESS: CI'TY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: ��i"�/�� /'��j��/�� /�/S�i (�`rs��e��— STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION�TALUATION (excluding land): $ �f, �-�� I hereby apply for a building permit ajnd I acknowledge that the inforn�ation above is complete and accurate; that the work will be in con�formance with the ordinances and codes of the City and with the State Building Code; that I unde�stand this is not a permit and work is not to start without a permit; and that ihe work will be in iaccordance with the approved plan. APPLICANT'S SIGNATURE: " DATE: �'� �� NOTE! Parade Qf 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. . ' . Sec.13.04 RIGHTS OF SLJBJECTS OF D?►TA Subd. 1. Type o[data. The righrs of individua!on whom the data is stored or to be stoced shall be as set forth in this section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or con£dendal data concerning himself shall be iaformed of: (a)�he purpose and inreaded use of rhe requested data wirhin the collecting Ytate agency,political subdivision,or sratewide rystem; (b)whether he may iefuse ot is legally required to supply the requesud data;(c)any lmown coasequence arising from his supplying or refusing W supply private or confidential data;and(d)the idenary of other persoas or entiaes authorized by state or federal law to receive the dara. This requirement shall not apply when an individual is asked to supply investigadve dara,pursuant to secdon 13.82,subdivisioa 5,w a law enforcement o�cer. The commissioner of revenue mav Dlace che nodce rewired under this subdivision in the individual income tax or proaertv tax refund instmcdons inscead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of swred data on individuals,and whether it is classified as public,private or confidential. Upon his fur[her request,an individual who is the subject of sWred private or public data on individuals shall be shown rhe dara without any charge to him and,-if he desires,shall be informed of rhe content and meaning of ehat data. Aher an individual has been shown che private dara and informed of irs meaning,the data need not be disclosed to him for s'vc months�ereafter unless a dispute or acaon pursuanc to this secrion is pending or addidonal data on the individual has been collecud or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of rhe data. The responsible authoriry may nquire the requesting person to pay the acaial coscc of making,certifying,and compiling the copies. The responsible authoriry shaU compiy immediately,if possible,wi[h any request made pursuant w this subdivision,or within five days of the date of the nquest,excluding Saturdays,Sundays and legal holidays,if irnmediate compliance is not possible. If he cannot comply with the request within that_time,he shall so inform the individual,and may have an addiaonal five days within wluch to comply with the request,excludiag Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is aot accurate or complete. M amdividual may conust the accuracy or completeness of public or pri��ate data concerning himself. To exercise this right,an individual shall nodfy in wriring the respoasible authoriry describing�he nature of the disagceement. The nsponsibie authoriry shall within 30 days either: (a)correct et►e data found to be inaccurate or incomplete and attempt to noafy past recipienu of inaccurate or incomplete data, iacluding recipientc named by the individual;or(b)nodfy the individual that he believes the data to be correct Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinaaon of the responsible au�horiry may be appealed pursuant to the provisions of the administrative procedure act relating W conusted 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 aze notified that: 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. 6. Your full name is required to process this application or permit. � �� ` Middle Lasi . F��J �� 1� �dn� � �� -S��/.�� 6�--,��-.3�.��_ Ciry Stare Zip Phone I understand my rights as stated above. Signamre