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Home My WebLink About2001-P04690 - windows * �'�` PERMIT CITY OF ORONO permit Number: 2750 Kelle�r Parkway - PO Box 66 P04690 Crystal Bay, Minnesota 55323 Permit Type: MinorAtterations (952) 249-4600 Date Issued: i2i4i2ooi SITE ADDRESS: 2216 Shadywood Rd Wayzata,NII�I 55391 PID: 17-117-23-42-0004 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Census Code O/S- Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): W�ndows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 153.25 Valuation: $ 8,000.00 State Surcharge Fee: $ 4.00 TOTAL FEE: $ 157.25 APPLICANT: Mr. &Mrs. Keefe OWNER: Mr. &Mrs. Keefe 2216 Shadywood Rd 2216 Shadywood Rd Wayzata MN 55391 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. ' �-� /'� � �/ � ,� ' � y�'�y,�_ L i�'�1 C�.2� (��1�� APP I ANT PERMITEE SIGNATURE ISSUED BY SIGNATURE � Cooies: 1-File(Signitures Reauired). 1-Applicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1 - . s .�-.� Total Fee: $ / `� � � �-� Date Received: � ��/-(;i Entered By: ,��-- Permit#: �� (�� ) CITY OF ORONO - BUILDING PERMIT APPLICATIOI`+T All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) COWN�R CONTRACTOR JOB SITE ADDRESS: �2 ( �S2 Y l(;�QI/1/ �i'�; � � ZIp• �� V G� Z � �i��-U NAME OF OWNER: U�1 � . �� S�L� `C�� PHONE: (home) G��Z-t 7I '� I��'�' (work) �9 I �](,�,�- �7 n - l 0 3�/ MAILING ADDRESS: <S�� G�S CTTY: ZIP: c�' CONTRACTOR: �K � �� PHO�TE�(�Q I Z ?I 0 -2�0� COr'TACT PERSON: oSGI.VYLQ MOBILE/PAGER: � MAILING ADDRESS: ' CITY: 1 ZIP: ? STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration � Land Alteration PROPOSED WORK(describe in detai�: ��a�(�� " ��-� ��S STORIES: Z SQ. FEET OF EACH F'LOOR: I�(� f�`�F NO. OF BEDROOMS: �j GARAGE STALLS: ATT. DET. ESTTiVIATED CONSTRUCTION VALUATION (excluding land): $ � ! ��, �lro 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: , �U � � (�Q,� DATE: �Z C� NOTE! Parade of Homes events require arate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. �,v�,�;�,�- : i:�� -c� ; . w--v.� l Sec.13.04 RIGATS OF S[JBJECTS OF DaT.� Subd. 1.- Type oP data. The righ[s of individual on whom che data is stored or to be scored shall be as set forth in this secaon. Subd.2. Information req�rired to be givw individual. An individual asked to supply private or confidenrial data coacerning himself shall be informed of: (a)the purpose and incended use of the iequested data within the collecting Ytate agency,polidcal subdivision,or sratewide rystem; (b)whether he may refuse oY i�legally required to supply the requested data;(c)any lrnown consequeace arising from his supplying or refusing to supply priva[e or confidendal data;and(d)the idenary af ocher pecsoas or entides auchorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara,punuant to secdon 13.82,subdivision 5, to a law enforcement o�cer. The commissionet of revenue mav olace the noace rewircd under this subdivision in the individual income taz or oroaertv taz refund insnvctions inscead of on[hose forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored dara on individuals,and whecher it is class�ed as public,private or conHdendal. Upon his further request,an individual who is rhe 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 of[he coutent and meaning of[hat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafur unless a dispuu or acdon pursuanc to this secrion is pending or addidonal daa on the individual has been collecud or created. The responsible authoriry shall provide copies of the privau or public data upon request by the individual subject of the dara. The responsible authority may require the requesdng person to pay the actual cosu of making,cercfying,and compiling the copies. The responsible au[horiry shall comply immediately,if possibte,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 compliance is not possible. If he cannot comply with the request within that time,he shall so inform che individual,and may have an addidonal five days wirhin wtuch to comply with the request,excluding Saturdays. Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or private data concerning himself. To exercise ehis righ�an individual shall noafy in wriring the responsible au[horiry describing che nature of the disagreemeat. The responsible authoriry shall within 30 days either. (a)correct rhe data found ro be inaccurate or incompiete and atumpt to nodfy past recipienu of inaccurate or incomplete dara, including recipiencs named by che individual;or(b)nodfy the individual thac he believes rhe data to be correcc. Data in dispuce shall be disclosed only if the individual's statement of disagreemenc is included with[he disclosed data. The de�erminadon of the responsibie auehoriry may be appealed pursuant to the provisions of the adarinistradve procedure act reladng to contesud 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 aze notified that: i, 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 pemut 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 full name is required to process this application or permit. � First j � iddle Lasc �l � Addre�` ��.� / " �1`-' �� t ��Z �`7�l �1 �� ii� Ciry State Zip Phone I understand my righu as stated above. � - �/��.� tgnature