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Home My WebLink About2005-P09185 - re-roof PERMIT CITY �F ORONO Permit Number: 275C,�Celley Parkway- PO Box 66 P09185 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 245-4600 Date Issued: 9/15/2005 SITE ADDRESS: 1890 Shadywood Rd Unit# WAYZATA,MN 55391 PID: 17-117-23-24-0019 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: FEE SUMMARY: Permit Fee: $ 223•25 Valuation: $ 12,457.00 State Surcharge Fee: $ 6.25 TOTAL FEE: $ 229.50 APPLICANT: Western Roofing OWNER: M E MASLOW&S S MASLOW 9700 13th Avenue N 1890 SHADYWOOD RD Plymouth,MN 55441 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. � � - ��i, �� ",� �'�'Y-V C'�- i� � APPLICANT PERMITEE SI TURE ISSUEU SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, ]-Septic) Page 1 f Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDII�G PERMIT APPLICATION All information must be submitted in full before plan review will bc started. (please pr�nt a/l information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDI2�SS: /��O JhR/�'vwo�� ZIP: SS3 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ YeS ❑ No If yes, a special eve��t perrrtit is r•eqirired ivith Police Departme�at and City Council appi�•ovnl 60 days prior to the event. Shidde btts se�-vice will be reguired unless applicant demonstr•ntes a•u�cient on-site parking is avnilnb/e. Non-permitted events will not be nllowed. NAME OF OWNER: i��/�SC-�O C-� PHONE: (home) �s�. ¢7/-�� (work) MAILING ADDRESS: �� CITY: ��i��'�� ZIP: ,J 3 7% CONTRACTOR: �/f �,� PHONE: �6 3'S 5ll-«,�� CONTACT PEI2SON: /l�a .g ,MOBILE/PAGER: MAILING ADDRESS: v a r.�,qr/-C CITY: ��r,,v:��ZIP: J��'�t/, STATE LICENSE: # C,�O�{�S� . EXPIRATION DATE: h�n� _ ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration PROPOSED WORK(describe�in cletain:��GT �/-�� 0�,� � n S'I'ORIES: S�.FFE'I'OF�ACI�FLOOR: NO. OF BEDROOMS: GAI2AGE STALLS: ATTACHEI� DETACHEll ESTIIVIATED CONS'I'RUCTION VALUA'I'ION(excluding iand): �� l V I hereby apply for a building pennit 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: DATE: ��,s'�,�� 31 t Sec.13.04 RIGHTS OF SUBJEC'CS OF DATA Subd. 1. Type of data. The 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 or wnfidential data conceming himself shall be informed o£ (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 arising from his supplyingor 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.1'his requirement shall not apply when an individua)is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or procerty tau refund instnictions instead of on those forms. Subd.3. Access to data by individual.Upon request to a responsible authority,an individual shal l be informed wheiher he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuRher request,an individual who is the subject of stored private or publ ic 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 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 miless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsibte authority 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 audiority shall comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliar�ce is not possible. If he cannot comply with the request within that time,he shall so inform the individual,a�d 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 daca concerning himself.To eaercise 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 individuat;or(b)notify 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 determination of the responsible authority may be appealed pursuant to the provisions of[he 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 inforniation 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 e�ctent 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. ]3.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. Firsi�/%%%�� le LAst L4��, Address .�'�G G /.�/�i� �Iv� ✓J ,/�1�/ �5.��1 �„�.�-S��a� City State Zip Phone I understand ights tated above � Sign3ture 32 C� "�I I �� DATE TIME CITY OF ORONO �ED IN � I�� INSPECTION N TIC SCHEDULED PERMIT NO. � � COMPLETED — � --,� ADDRESS n �C� � G��-L-fiL�? � OWNER CONTR. � �Q1��A1 TELEPHONE NO. � � "� J� �`- " � DESCRIPTION �h� � 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMUVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a o ��f.�-�` — C�� C��L — /Uc� � �� a ��-�- 0 � W � Q � Z W � W � � d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W O ORRECT WORK&PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46QQ OwnerlContractor on site: Inspector._��,�/�� White Copyllnspector's File Canary Copy/Site Notice