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Home My WebLink About2001-P04148 - re-roof PERMIT CITY �F ORONO Permit Number: 2750 K��iley Parkway - PO Box 66 P04148 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: gili2ool SITE ADDRESS: 1795 Shadywood Rd Wayzata,NIN 55391 PID: »-�t�-23-2i-000g DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Census Code 434 Permit Class: Building Permit Sub-type(s): Building- Re-Roof Permit Type: Minor Alterations DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: � 69.25 Valuation: $ 2,000.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 70.25 APPLICANT: HUBER CONSTRUCTION OWNER: Lee&D Pilgram 403 E CENTRAL 101 1795 Shadywood Rd P.O. BOX 403 Wayzata MN 55391 ST MICHAEL,MN 55376 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 l�� //--� G��.f %1,�, '`' s" /. APPLICAN PERMITEE SIGNATURE ISSU BY SIGNATURE Cooies: 1-File(SiQnitures Repuired). 1-Apolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 To. Fee: $ Date Received: Ent�d By: Permit#: � CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- . -,.._ THE APPLICAI�TT IS: (circle one) OWNER O�GONTRACTOR� � �`. , ' JOB SITE ADDRESS: ` � -1 = �'L„ �-�- �� ZIP: / / �' r_�C (1 r-- l' NAME OF OWNER: � � '�- ;�'i��;; l 4� i 1 l PHONE: (home) � `�' (work) ;. � ,� NIAILING ADDRESS: CITY: ZIP:�/„?j � ^, v� �lU NTRACTOR: �- � •� � PHONE: "�p`' � �,'� :� U�� CO �� _ ,,r 2� �. � l -�/� V CONTACT PERSON: ��,- ��_ /�' � , MOBILE/PAGER: MAILING ADDRESS: %' � ✓;��,� � C/c�� CITY:;� /�'l,�� /ZIP: i�._>�}�� STATE LICENSE: # ._)�_��j�>;��i�� ,' ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAlVIE: REGISTRATION# TYPE OF WOR�i: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration > � PROPOSED WORK(describe in detai�: � �,y/��t�f �l�_?�s'� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � ' � ESTIMATED 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 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 with the approved plan. �- �- ! APPLICANT'S SIGNATURE:� �� 4�r�� , _ , DATE: � � � NOTE! Parade o Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non perntitted events will not be allowed. � � � Sec.13.04 RIGHTS OF SLTBJECTS OF DATA � Subd. 1. Type of data. The righa of individual on whom che data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information requdred to be givea individual. An individuai asked to supply private or confidendal dara concerning himself shall be informed of: (a)the purpose and iatended use of the requesred data wirhin the collecting Stare agency,political subdivision,or sratewide system; (b)whether he may refuse oti is legally required to supply the requested data:(c)any Irnown consequence arising from tus supplying or refusing to supply privace or confidential data;and(d)[he idendry of o[her persons or enrides auchorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigadve dara,pursuant to secdon 13.82,subdivision 5, co a law enforcement o�cer. The commissioner of re�enue mav place che nodce tewired under this subdivision in the individual income tax or propertv taz refund instructions instead of on[hose forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whecher ic is classified as public,private or confidendal. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown rhe dara without any charge to him and, if he desires,shall be informed of the content and meaning of�hat data. After an individual has been shown�he private data and informed of its meaning,the data need not be disclosed to him for six months thereafter utiless a dispute or acdon pursuant to this secdon is pending or addidonal 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 rhe data. The responsible authoriry may requiro rhe requesdng person to pay the accual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply 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 addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurste or complete. An individual may contest the accurecy or completeness of public or private data concerning himself. To exercise[his right,an individual shall noafy in wriang the responsible authority describing che natttre of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incompiete data, inciuding recipients named by rhe individual;or(b)nodfy the individual that he believes the dara to be correct. Data in dispuce shall be disciosed only if the individual's sta[ement of disagreement is included with the disclosed data. The determinadon of the responsible au[horiry may be appealed pursuant to the provisions of the administrarive 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 pemut 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 shazed with other local, state or federal agencies to the extent necessary to process the pemut 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. (. Your full name is required to process this application or permit. � � �c r-��;✓ �rG �� o ��7 - First Middle Last �D ��d �� Address �/) L �/� '� � CO � 7� � 7 7�� S / ' /� G/,or n� Ciry State Zip Phone I understand my ri hts as stated above. �� . Signature .DATE TIME CITY OF ORONO CALLED IN �� INSPECTION NO CHEDULED -� PERMIT NO. � TEo '— --� �� ADDRESS � � y OWNER CONTR. TELEPHONE NO. ��'� ' �7 ��Q� � DESCRIPTION �1�`.Y`Y� '�'�f'�lcU-' lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: � a \ � � . ��t 0 �.. �� o �� W � Q � Z W � W � � �ID�/ORK SATISFACTORY:PROCEED �ROJECT COMPLETE W �❑ CORRECT WORK R PROCEED f- ISSUE CERTIFICATE OF OCCUPANCY O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. - pHOTOTAKEN INSPECTOR WILL REfURN ❑ STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-4600 OwnerlContractor n site: Inspector.___��G�G�-�Z�G�—/�13 White Copyllnspector's File Canary CopylSite Notice