The URL can be used to link to this page

Home My WebLink About2001-P04365 - re-roof CITY OF ORONO PERMIT 2750 Kelley :&rkway - PO Box 66 Permit Number: Po436s Crystal Bay, Minnesota 55323 Per'mit Type: MinorAlterations (952) 249-4600 Date Issued: 9i19i2ooi SITE ADDRESS: 2800 Shadywood Rd Excelsior,MN 55331 PID: 21-117-23-13-0023 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S- 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: $ 237.25 Valuation: $ 13,860.00 State Surcharge Fee: $ 6.95 TOTAL FEE: $ 244.20 APPLICANT: Western Cedar Supply OWNER: Kenneth Severinson 9700 13th Ave 2800 Shadywood Rd Plymouth, MN 55441 Excelsior MN 55331 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 BU[LDING CODE REQUIREMENTS. t�---, ,:;:: , i� �L✓ �__,(_ ( z ( yY�l c a"� �� APPL[CANT PF,RMITEE SIGNATURE ISSUEDBYS NATURE Cooies: I-File(Sienitures Repuired). 1-Aoplicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------�---------------------------------------------- THE APPLICANT IS: (circle one) OWNER O �C;UN�TRACTOR JOB SITE ADDRESS: Sh��c �� ZIP: SJ �3J NAME OF OWNER: �'� S�c,�%n� PHONE: (home) C� 7 r��6-� (work) MAII.ING ADDRESS: ,s�-v�c� CITY: �— ZIP:��S��/ CO:�ITRACTOR: � � � � PHONE: ��S '� S r//•- ��a� CONTACT PERSON: r �� BILE/PAGER: MAILING ADDRESS: �7� � sri�;,�,> s�,� CITY: ZIP: �5�� STATE LICENSE: # �<<�/55`�� 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�: �C�f��f'�/2��cz� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � 31 ��6 � 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. APPLICAI�T'S SIGNATURE: �� DATE: � ' ��"-�� NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non pernzitted events will not be allowed. Sea 13.04 RIGH'TS OF SCTB.TECTS OF DaTA ' , Subd. 1. Type of data. The righcs of individual on whom rhe data is stored or to be stored shall be as set fo�th in this secdon. Subd.2. Informadon reqirired to be givea individual. An individuai asked ro supply private or confidendal data concerning himself shall be informed of: (a)the purpose and int�nded use of rhe mquesred data within rhe collecting�tate agency,political subdivision,or statewide rystem; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply privace or confidendal data;and(d)the idenriry of o[her persons or entides au[horized by state or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply investigadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav otace the nodce rewired under this subdivision in the individual income tax or arooertv tax refund instrucuons instead of on those 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 data on individuals,and whether it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown che data without any charge to him and,�if he desires,shall be informed of the content and meaning of chat 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 unless a dispu[e or acdon pursuanc to this secrion is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay[he acn►al coscs of making,certifying,and compiling the copies. The responsibte authoriry shall comply immedia[ely, if possible,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 withiet that time,he shall so inform the individual,and 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 aot accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise chis right,an individuat shall nodfy in wridng the responsible authoriry describing che nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccunte or incomplete data,inciuding recipients named by the individual;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 disciosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administracive 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 fumish certain private or confidential information. You are 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 permit 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. fi. Your full name is required to process this application or permit. First Middle Last Address City Stace Zip Phone I understand my rights as stated above. Signamre DATE TIME CITY OF ORONO C LED IN INSPECTION TIC � SCHEDULED b_ -0( �� PERMIT NO. � �� COMPIETED /� /�/ ' �-- ��% ADDRESS � Qv t OWNER S �,^� �-2�� CONTR. .��-�%��'�"�r � TELEPHONE NO. � DESCRIPTION �� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04l1 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION OS FINA 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT � 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 � OWNERICONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W ` a � � � o� �1/r'� fi�'�`j' � �`� � l �/l��,r-��' %�' ,-1 �. , , � � ; �-;��.��.� `�,�;�� ;h�� f r_ �� <�:.- ��1z��-� 0 Q�' ,' :r-'��-<- r- �-- 1 t,� �= fi � ��%-� � � a W Zc W � � � 9'GVORK SATISFACTORY:PROCEED ��"'FROJECT COMPLETE W ; ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-Q6QQ OwnerlContractor on site: Inspector.��-�� 4 c-�J�� White Copyllnspector's File Canary Copy/Site Notice