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Home My WebLink About2005-P09210 - windows . - "' PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P09210 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterarions (952)249-4600 Date Issued: 9/22/2005 SITE ADDRESS: 1710 Shadywood Rd Unit# Wayzata,MN 55391 PID: 17-117-23-21-0018 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Pemut Type: Minor Alterations Pernvt Sub-type(s): Windows DETAILS: Approved per resolution#: Sepazate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 139.25 Valuation: $ 7,000.00 State Surcharge Fee: $ 3.50 TOTAL FEE: $ 142.75 APPLICANT: D. Schmidt Construcrion OWNER: John&Joan Fitzpatrick 4379 Wilshire Blvd#C311 1710 Shadywood Rd Mound,MN 55364 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. � /`, f: 1 \ � J P T PERMITEE GNA ISSLTED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Sepric) Page 1 � Total Fee: $ /�o�. �� Date Received: -2 2 -U..S�— Entered By: � Permit#: �v `?�-�O CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in fult before plan review will be started. (please pYint all information) ----------------------------------------------------------------------------------------------------------------------- T�IE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �7�v ��3 D �Gc1�d�j 1e.17 ZIP: � `a �� Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes ,�NO If yes,a special event permit is reguired tivith Police Department and City Council approval 60 days prior to the event. Shuttle bus service wild be reguir•ed unless applicant demonstrates sufficient on-site parking is available. Non pe�•mitted events wil!not be allowed. NAME OFOWNER: �� i�P/�Tiel c /G PHONE: (home �� r/- y�� (work) MAILING ADDRESS: � 7/4 �� `jic%ap �D CITY: d��a ZIP: a��3 -`�/ / CONTRACTOR: D, �c�-(c�v�c f�T �eJ 5 T� PHONE: C 9`�� -��' CONTACT PERSON: �,�c� MOBILE/PAGER:��i� S�7> �5��- MAILING ADDRESS: �-F�� ILSr�/!�E �vh CITY: ,�/1 a.c.c ND ZIP: `��.�� STATE LICENSE: # B C - ?�/ � EXPIRATION DATE: �-��-�oa � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGI5TRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration �� PROPOSED WORK(describe in detai�: ��/��/�,l� � �s��a �l /3 l�i� y� (�S 1 J1 �lr�� /Gt �./.��1 e ��yt � �4S� STORIES: _� SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS:� GARAGE STALLS: ATTACHED � DETACHED_ ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � ODO � � 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 accordance witlz the approved plan. G��,.�� APPLICANT'S SIGNATURE: , � DATE: Z d5 3t . . � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.l. Type of data. 'fhe rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2.Information required to be given individual.An individual asked to supply private orconfidential dataconceming himselfshaU be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or�ropertv tax refund instructions instead of on those forms. Subd.3. Access to databy individual.Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. 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 ofthe content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant ro this section is pending or additional 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 making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursua�t to this subdivision,orwithin tive days of the date of the request,excluding Saturdays,Sundays and legal hol idays,if immediate compl iance is not possible. [f he cannot comply with the request within that time,he shall so infortn the individual,and may have an additional 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 himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify 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 corcect. Data in dispute shall be disclosed 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 furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine 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 fu(I name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand ights stated above. i , . Signnture 32