HomeMy WebLinkAbout2002-P04940 - re-roof • w PERMIT
CITY OF ORONO Permit Number:
275d Kelley Parkway- PO Box 66 Poa9ao
Crystal Bay, Minnesota 55323 Permit Type: Nt�or Aiterat�o�
(952) 249-4600 Date Issued: 3isi2oo2
SITE ADDRESS: 2500 Shadywood Rd
Fxcelsior,NIN55331
PID: 20-117-23-11-0034
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DESCRIPTION: UBC!Occupancy R3
Proposed Use: Commercial
Permit Class: Building Census Code O/S-Building
Pernut Type: Minor Alterations Perxnit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pemut Fee: $ 713.75 Valuation: $ 60,000.00
State Surcharge Fee: $ 30.00
TOTAL FEE: $ 743.75
APPLICANT' Dalco Roofmg&Sheet Metal Inc. QWNER: Freshwater Foundarion �
� 15525 32nd Avenue N 2500 Shaydwood Rd
Plymouth,MN 55447 � Excelsior MN 55331
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THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE L IMPROVEMEN'TS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL ITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Renorts, 1-Asses inQ, 1-Finance Page 1
. �
Total Fee: S ���- �-� Date Received: 3�-� 0�/
Entered By: � Permit#: ,g����
CITY OF ORONO - SI.TII,DING PERMIT' A.PPLICATION
All information must be submitted in full before plan review will be started. ,
' (please print all informarion) �p����
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THE APPLICANT IS: (circle one) OWNER O ONTRACTOR
JOB SITE ADDRESS: Z�� ` ���
NAME OF O��NER: r PH4 (home)
�-}er (work��� - 4 71 - c3 � 7 3
�r�nvG A�nxEss: a�nc ��J�. r��crrY:_���.1,S l Cl�z�:—��3 )
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cor�rx�c
�cox: � .�o�: ] r�-����-(�a�a
COi�1TACT PERSON: MOBILE/$AGER:
MAILING ADDRESS: 2 CITYr IP:_��l L.�'y
STATE LICENSE: # �
ARCHITECT/ENGINEER: �?HO\'E:
MA.ILING A.DDRESS: CITY:I Z�:
NAME: REGIS�'RATION# �
TYPE OF `�'ORK: New Addition Accessory Structure
Move Remodel/Alteration� ! Land Alteration
PROPOSED�VORK(describe in detain: t- .
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: A T�. � DET.
ESTII�i IA.TED CONSTRUCTION VA.LUATION (exclud.ing d): S �,D����
I hereby app1,- for a buildina pennit and I acknowledge that the �nformation above is complete �
accurate; that the work w�ll be in conformance with the ordinan es and codes of the City and wi
the State Building Code; that I understand this is not a perm.it d work is not to start without a
permit; and that the work will be in accordance with the appr ved plan.
APPL�CA��''S SIGNATURE: DATE: �`�
NOTE! Parade of Homes events require separate permit ap roval by Police Department and
City Council 60 days prior to the event. Non permitted even s wi11 not be allowed.
. p,�c -(v ,s s".e ��- z- lo - z
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Sea13.04 RIGfiTS OF SUBJECTS OF DATa
Subd. 1. Type of data. The ri¢h�of individual on whom the data is sw:�or to be s[nred shall be as set fotth in this secaon.
Subd.2. Information reqirired to be given individual. An ir.dividual ask�co supplY Privace or confidenrial data conceming himself shall
be informed of: (a)the purpose and incended use of the requesud data w:�in the coIIecang Stace agency,polidcal subdivision,or sratewide ryssem;
(b)whecher he may refuse oY is legally required[o supply the requesced daa:(c)any 3�owa coasequence arising from his supplying or refusing to suppty
privace or conndendai data;and(d)the idenriry.of ocher persons or enddes xaehorized by sta[e or federal law to rceive the daca..'ihis requiremca�s6a11
no�apply when an individual is asked to supply invesd¢adve data,purs�:c�o seccoa 13.8?,subdivision 5, co a!aw enforcemenc ofFicer..
'Ihe cortunissioner of re�enue r�av Dlace the nodce reauired ard-r this subdivision in the individual income tax or oropern az tefund
instn�ctions ins�ead of on chose forms.
Subd.3. Access to data by individual. Upon request to a rsroasible aethority,an iadividual shall be informed whether he is the subject
of scored da[a on individuais,and wherher it is classified as pubiic,privae or confider.aal. Upon his further request,aa individual who is[he subjecc
of scorod priva�e or pubtic dara on individuals shall be shown che dara wiu.ouc any c':�rge to him and,-if he dzsires, shall be informed of the contenc
and meaning of�hac dara. Afcer an individual has been shown the priva:�dan and ia:crmed of ics meaning,che dara need not be d'uclosed to tiun for
six monchs ehereafcer unless a dispute or acrion pursuanc to this secuon is�ending or addidonal data on the individuai has been collected or creaced.
The responsible au�horiry shall provide copies of the priva[e or public daca c:on reques:by che individual subject of che dara. The responsible auchoriry
*-2y requEr�rhe requesting person to pay the acmal coscs of makin2,ce=.:•ing,and compiling che copies.
The responsible au�horiry shall comply immediacely,if possible,wich anv r_quesc made pursuant to this subdivision,or wichin five days of
the date of tht reques[,excluding Santrdays,Sundays and legal holidays,if is.mediate compliance is not possible. If he cannot comply with the request
wi�hin[ha�ame,he shail so inform che individuai,and may have an addieoaai five da;s wichin which to comply with che request,exctuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not acctu�ate or complete. An indiviZual may contest the accuracy or completeness oP public or pri�•ate
da�conceming himself. To exercise�his right,an individu�l shall nodfy ia wridng ca responsible authoriry describing ehe nacure of the disagreemeoc.
The responsible auchoriry shall wi�hin 30 days either: (a)correct[he da�icund to be inaccurate or incomplete and aaempe co nodfy past recipienu oF
inaccurate or incomplete data, including recipients named by the individuI;or(b)r_odfy the individual that he believes the data to be correcc Data
in dispuce shall be disclosed only if the individual's statement of disagr�:�:nc is i.c:a3ad with ehe disclosed data.
The de�erminaaon of the rosponsible au[horiry may be appea::d pursuacc to che provisions of the adminisaarive procedure act relaang to
contesced cases. .
DATA PRIV�CY AD�'ISORY
In accordance with M.S. 13.04, Subd.2, "Riohts of subjects ot e�ata , we would like to inform you that your reouest
for a pemuc or license from the Ciry of Orono or any o�ia deparments may require you to furnish eenain privace or
confidential information.
You are no[ified thar.
1, The information you fumish will be used to dz:ermine�•our qualification for the permit or license requested.
2, You may refuse to supply data, but refusal nay require that the Ciry deny the permit or license.
3, The information may be shared with o[her loc�l, state or federal agencies to the extent necessary to process
the peraut or license.
4. If your requested permit or license requires Council action to approve, some information may become
. , public, • �
j, . You have certain rights under M.S. 13.04 (available epon request) to review pri'vate data on yourself.
6, Your full name is required to process this application or permic.
Fi�� Middle Lasc
Address �
Ciry Stace Zip Phone
I understand my ri?hts as stated above.
Signantre
• ` INFORMATION F4R BUILDING :PERMITS
- JOB -
Nuint�er: 3490-OZ
.fob Name: GRAY FRESHWATER CENTER
Address: 2500 SHADYWOOD DRIVE City: EXCELSIOR
Val:ue: �60,000.00
Cost of S11eet Metal: N/A
(St. Paul only)
Squares: 8]
Building Use: OFFICE
Description of Wot•k:
"I'f�AR OFF'I'O C07�'C.'R.ETE DECI�. INSTALL NE�V IIvSi.iLATION,4 PL�'CiLASS FELT NEW ASPHALT AND CiRAV
SLIRFA<'[NG. NE�% SHEET METAL.
Insulatian Used: ?.7" ISOC�'ANURATE, '%2" VVOOD FIBER R - Value: ?2,?
Architect's Name & Address:
'�"A o
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- OV�'NER- I
Name: GRAY FRESNWATER CENTER '; Phone: 952-471-9773
Address: 2500 SHADYWOOD DRIVE
City: E�:CELSIOR
State: MN 55331.
D:\Quattro\Dalco\#1BUR.wb3 03/04/02 01:22 PM
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FRESHWATER SOCIETY Jan. Book# � ��
2002 485 � GRAY FRESHfi�ATER CENTER
2500 SHADYWOOD ROAD � 2500 SHADYWOOD ROAD
NAVARRE, MN D. Smith ���`��r���'•� NAVARRE, MN