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Home My WebLink About2003-P06218 - re-side CITY' OF ORONO �ERMIT 2750 Kelley Parkway- PO Box 66 Permit Number: Po62i8 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: a�22i2oo3 SITE ADDRESS: 480 Russell Ave Wayzata,MN 55391 PID: 02-117-23-31-0003 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Pernut Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: PernutFee: $ 111.25 Valuation: $ 5,000.00 State Surcharge Fee: $ 3.00 TOTAL FEE: $ 114.25 APPLICANT: Tim Lovett OWNER: Josephine Carpenter M� 480 Russel Ave Wayzata MN 55391 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. �-'� cJm��,� /�� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Cooies: 1-File(SiQnitures Required). 1-Avnlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 'Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATI01� All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR �� ' - JOB SITE ADDRESS: � �5 5�� ,��'_ ZIP: ,�S��f/ NAME OF OWNER: ,�>� �/�,,�,,� e�,�t,�;;�� PHONE: (home) � (work)�j; �y� MAILING ADDRESS: �i� OCv;5�� CITY: �'��Z�7� ZIP: SS?,�, � CONTRACTOR: ��.-,� Lc�,,�� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING Al)DRESS: CITY: ZIP: STATE LICF�;NSE: # ARCHITEC7'/ENGINEER: PHONE: MAILING Al)DRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration P1�OPOSED WORK(describe in detai�: ��-5;��- ��,,z �,�r�<<x-.E ,�� i� �,�� — __�Ch�✓icL�t.L � STORIES: � SQ. FEET OF EACH FLOOR: NO. OF BE�iROOM5: GARAGE STALLS: ATT. DET.� SDUC� ESTIMATE�1 CONSTRUCTION VALUATION (excluding land): $- _ � 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 Builciing Code; that I understand this is not a permit and work is not to start without a permit; and tl��at the work will be in accordance with the approved plan. APPLICAN7''S SIGNATURE: ��ic_-�-- DATE: Z D� NOTE! ParGcde o,�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 of data. "Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked ro supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting"state agency,poliacal subdivision,or sratewide system; (b)whether he may refuse oY is legaily required to supply the requested data;(c)any lmown consequence arising fmm his supplying or refusing to supply private or conndendal data;and(d)the iden[iry of o[her persons or enddes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigadve data, pursuan[to secaon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re•enue mav place the ❑otice Tequired under this subdivision in the individual income tax or proper[V tax refund instructions inscead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subject of stored data on individuals,and whether 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 without any charge to him and, if he desires, shall be informed of the content and meaning of rhat data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hicn for six months thereafter unless a dispute or acrion pursuanc to this secrion is pending or addidonal data on the individual has been collected or created. The responsible au[hority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making, certifying, and compiling the copies. The responsible au[hority shall compiy immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addicional 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 conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing[he nature of the disagreement. The responsibte authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disc(osed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 fumish certain private or confidential information. You are 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 pemut 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. First Middle Last Address C�ty State Zip Phone I understand my rights as stated above. O ( /( �-_ Signature