HomeMy WebLinkAbout2008-P11951 - re-roof CfT'Y OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: p11951
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 4/i/20o8
SITE ADDRESS: 1855 Shadywood Rd Unit#
Wayzata,MN 55391
PID: 17-117-23-24-0007
DESCRIPTION:
Proposed Use: Residential Census Code O/S-Building
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Tear off and reroof house and tool shed
FEE SUMMARY: Pernut Fee: $ 103.25 Valuation: $ 3,750.00
State Surcharge Fee: $ 1.90
TOTAL FEE: $ 105.15
APPLICANT: Owner/Self OWNER: John Motzko
M� 1855 Shadywood Rd
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 UIREMENTS.
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LICAN E T SIG TURE LJED BY SIGNATURE
Copies: I-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ DateReceived•
Entered By: Permit#•
CITY OF ORONO-BUILDING PERMIT APPLICATION
All information must be snbmitted in full before plan review will be started.
(please print all informat�on)
THE APPLICANT IS: (circle one OWNER R CONTRACTOR
JOB SI1'E.ADDRESS: lass s�aywooa R�a �,, 55391
Will this be a Parade of Homes,Remodelera Showcase Home or other Display Home?
❑Ye8 Q NO Ijyes,a speciaJ everrt permit is required with Police Department and City Council approva/
60 days prior to the evenx Shrdtle bus servfce will be requined unless applicm►t demoratrates
sr�,�cie►�t on-site pr�king is available. Non-pernritted evems will not be allowect
NAME OF OWNER: John Motzko pgONE: (home) (9s2�a�i-oo�
1855 S (WOtic� (612)760-3413
MAILING ADDRESS: ��OOd RO� Cj'j'j�• �'OIIO Zj�• 55391
CONTRACTOR: ��* PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAII,ING ADDRESS• CTTY• ZIP•
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ?IP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Siructure
Move Home RemodeUAlteration(ie: Siding,Windows) d
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detai�: �°ove old shingles and insta1123 sq asphalt shingles,9 sq icelwater
shield,15#felt,roof edge,and roll ridge vent. Also roof toot shed about 1 sq.
STORIES• 1 SQ.FEET OF EACH FLOOR• 11°o
NO.OF BEDROOMS: 3 GARAGE STALLS: ATTACHED ✓ DETACIiED
ESTIlVIATED CONSTRUCT'ION VALUAITON(eaclading land): $ 3,�so.00
I hereby apply for a building permit and I acknowledge that#he 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: DATE: o3i3iios
31
Sec.13.04 RIGHTS OF SUBdECTS OF DATA
Subd.1. Type of data. The rights of individual on whom the daffi is stored or W be stored shall be as set forth in this section.
Subd.2.Infornoation requirad to be giva�individusl.Aa individual asked to suppty privabe or rnnfid�tial data concxming himself shsll be
info�med of: (a)the purpoae and iotended use of the teque.vted data within tlte collectirg slste agency,Wlitical subdivision,or stabewide sYstetn:(b)
w►�emer he may�o�is legallr rem►iredw suppir tbe requ�ed aeta;(o)anr�Own consequence arisins from his�pplrins or rcfusingm su�r
private or confidential data;and(d)the identity ofott►er persons or entities audwrized by state or federnt laww receive U�e data.This requirement shsll
not apply when an individual is asked to supply investigative data,pursuant w section 13.82,subdivision S,w a law enfacement officer.
'�'he commissio�of revenue mav nlace the notice reauired undet this subdivision in the individual income ta�c ory�y�refund
i�tioffi inaoead of�those f�ms.
Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informad whether he is the subject of
stored data ott individuals,and whether it is classified es public,private or�dentisl. Upon Uis further reque�st,an individnal who is the subject of
stored private or public data oo individuals shall be shown the data without arry charge to him and,if he desires,shall be infom�ed of the cm►tent and
meaning ofthat data. After an i�edividual tms been shown the�ivate data and'u►famed of its meaning,the data nced not be disclosed to him for soc
months there,aRer�mless a dispute a�tion puisuant to this sxtion is pending or additional data on Nu individual hes boeo collectad or creatad.The
respoagible authority shall pmvide copies of the private or public data upa►re9uest bY the individuel subject of the dam. T6e responsiWe authority
�9�tuire the re9uestu►S Person to pay the actual costs of malcing,certifying,and compiling the copies.
The responsible suthority shall comply immediately,if possible,with any request rt�de pursuant to this subdivision,or within five�ys of
the date of the reques�excluding Saturdays,Sundays az�d legal holidays,if imir►ediate compliance is nM possible.If he cennot comply wiffi the request
withm that time,he shall so inform the individuel,and may have an additiona(five dsys widiin which to cwmpty with Uie raquest,exclud'm8�Yg,
Sundays ard legal holidays.
Subd.4. Procedure when data is not accurateorcomplete.An individusl may contestthe accuracy or compteteness ofpublic orprivate c�ta
conc�►ing himsel£To e�cercise this right,an individual shall mtify in writing the responsiWe autharity describing the nature of the disagreement.'ll�e
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomptete and attempt w notify pest recipieMs of
inaccurata�incwmplete data,includ'etg recipiems namod by the individuat;or(b)notify the individual that he believes the data w be com�,K.I7�in
disp�e shall be disclosed only if the individim!'s staoement of disag�eement B includad with the disdosed dala.
T6e ddermination oftt►e respoffiible aufhoritY�Y�ePP��P��t to the pioviviom of the admu►igtratirve p�ocedure 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 pe�mit 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 famish will be used to detedmine your qualification for the pamit 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 ihe e�ent necessary to
process the pe�nit 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 r�uest)to review private data on yourself.
6. Yow full name is required to process this application or permit.
John p� Motzko
First Middle Last
1855 Shadywood Road
Address
�ao � 55391 (952)471-0096
�Y Stabe Z�p Phoae
I understand my ri s s a
S�wture
Raet Fam 32