HomeMy WebLinkAbout2003-P06692 - re-roof PERMIT
�i;T� ��F O RO N O Permit Nu m ber:
2750 Kelley Parkway - PO Box 66 P06692
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: s�2s�2oo3
SITE ADDRESS: 2237 Shadywood Rd -
WAYZATA,MN 55391
P I D: 17-117-23-43-0129
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building
Pernut Sub-type(s): Building-Re-Roof
Perniit Type: Minor Alterations
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 633.65 Valuation: $ 49,000.00
State Surcharge Fee: $ 25.00
Misc.Fee: $ 180.00
TOTAL FEE: $ 838.65
APPLICANT: custo�Remoaeiers,Inc. OWNER: T�cY�rrTOLa
474 Apollo Drive 2237 SHADYWOOD RD
Lino Lakes,MN 55014 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.
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PLICANT PERMITEE SIGNATURE � SUED BY SIGNATURE
Cooies: 1-File(SiQnitures Required), 1-Anolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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PERMITS - 6UIlDIN6
� Base F�1 � U.44 0.04
! � � 633.65 fi33.b5
Plan Review
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� Mai 1 i rr Fees
I S�ate Surrharge Q.Op G.04
` SAC Charge� �'5.04 �.f�p
1@ 0.t)0 U.00
f Investigatidn fee
I f@ 180.aQ !8t►.Up
; : �UB?OTAL �38.65
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I Check Rpceived �.65
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' Total Fce: $ Date Received:
Entered By. Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan re�iew will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER O CONTRAC OT R
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JOB SITE ADDRESS: ���� �L�t.C�.� ti`C'`L� • Z�: �h��
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NAME OF OWNER:,� l.(�, 2 i� , PHO\'E: (home)� �> >�'7��- �J�
(work) ��'��'�''7( --� �q�i
�'TA�.�G E����.5: ���J ��'"{�.l.ti�. �CIT i�: ��l,�i�'�� Z�: 5 3 2
CONTRACTOR: �'� L�' , PHO\"E: �r �l '"�7 g��� � �Ip
CONTACT PERSON: >> - > MOBILE/PAGER:
MAILING ADDRESS: 1 �-C..�,t�r%� CITY: �" (,) ' '' =', ZIP; �C� �
STATE LICENSE: # `
ARCHITECT/ENGINEER: PHO\�E:
MAILING ADDRESS: CITY: Z�:
NANIE: REGIST'RATION�
��,YPE OF WORK: New Addition Accessory Structure
' �1.��- Move Remodel/Alteration Land Alteration
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PROPO, ED WO (describe in det� .: • �
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STORIES: SQ. FEET OF EACH FLOOR: � �.�t9��t.rn1
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. / , � �Oa�
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EST 1MATED CONSTRUCTION VALUATION (excluding land): S �_
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 w ork is not to start without a
permit; and that the work will be in accordan i e approved plan.
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APPLICANT'S SIGNATURE: :�� DATE:
NOTE! Parade Qf Homes events require separate permit approval by Police Depariment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGIiTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual on whom the data is stored or co be scored shall be as set for�h ia this section.
Subd.2. Information reqirired to be given.individual. A,n individual asked to supply priyate or confidendal data concecning himself shall
be informed of: (a)the purpose and inrended use of the�equested data wiehin the collecdng Stace agency,political subdivision,or statewide system;
(b)whe[her he may refuse o'r is legaqy mquired to supply ehe requested data:(c)any Imown wnsequence arising from tus supplying or refusing to supply
privace or confidendal data:and{d)the idendry oEo�her penoas or enrides auc6orized by seate or federal law to rcceive the d�ta. 'This requiremenc shall
not apply when an individual is asked to supply invesdgadve data,pursuant�o secdon 13.82,subdivision 5,to a law eniorement o�cer.
The commissioner of re�enu� mav place the norice rewired under this subdivision in che individual income sax or Drooe�tv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individuai. Upon requesc to a responsible aurhoriry,an iadividual shatl be inform=d whether he is the subject
of stored data on individuals,and whe[her it is class�ed as public,private or confidendal. Upon his further request,an ir+dividual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to him and;if he desires, shall be informed of the coatent
and meaning of ct►at data. After an individual has been shown the privace dara and informed of irs meaning,[he dara need not be disclosed to him for
six mon�hs chereaiur unless a dispute or acdon pursuanc to �his secdon is pending or addirional data on the individual has been collected or creared.
The responsible aucho�ry shall provide copies of the private or public dara upon roquesc by the individual subjecc of the daca. The responsibte au[horiry
may require the requesting person to pay che acmal coSu of making,cerafying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pucsuant to this subdivision,or within five days of
the date of the requesc.excluding Saairdays,Sundays and legal holidays,if immediate compliance is not possible. If he caanot comply with the request
within that time,he shall so inform the individual,and may have an addirional five days wirhin wtuch to comply with ehe crquest,axciuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or pri�ate
dara conceming himsdf. To exercise rhis right,an individual shall noafy in wridng the respoosibic authoriry describing�he naturo of the disagreemenc.
The responsible auehoriry shall within 30 days either: (a)correct the data faund to be inaccurate or incomplece and aaemec to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)noafy the individual thac he believes rhe data to be correcG Data
in dispuce shall be disclosed only if the individual's statement of disagreement is included wi[h c6e disclosed data.
The de�erminadon of the rzsponsible aufioriry may be appealed pursuanc to the provisions of[he adminisaaave procedure act reladng to
wntested cases. . _
� . DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inforca you that your request
for a permit or license from the Ciry of Orono or any of i[s deparcments may require you to fumish certain private or
confidential information.
You aze notified that:
1. 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 perm.it or license.
3. The information may be shazed wi[h other local, state or federal agencies to the excent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
, public.
�. 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.
Fint Middle Last
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Ciry State .' Zip _ . .; Phone . . �.,, .
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License Expiration Date: �r3/31%2004 .1'' Continuing Educction: ,7 Hrs CE due by 3/31/2C�04� •?'�� �`
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! � 7 D�E/ � TIME
CITY OF ORONO � CALLED IN
INSPECTION NOTICE SCHEDULED �' _��
PERMIT NO. Q`Z�r��'�Z- COMPLETED
ADDRESS �Z- �� �7 �G�c���-i. L.�:`('c'� �`
OWNER CONTR. C� ;����--�
TELEPHONENO. ��� ���1 +��'�{�' ��'��'��f�
� DESCRIPTION �
� 01 FOOTING 11 MECHANICAL RI 18 EX /GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LA SHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL p� 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:�L YES_NO
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� COMMENTS:
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W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
�STOP ORDER POSTED.CALL INSPECTOR
�INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContr n ite:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice