HomeMy WebLinkAbout2003-P05992 - re-roof C�TY�. OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Pos992
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: ii24�2o03
SITE ADDRESS: 2130 Shevlin Dr
Wayzata,MN 55391
P�D: 03-117-23-34-0022
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
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:
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FEE SUMMARY: Pernut Fee: $ 293.25 Valuation• $ 17,982.00
State Surcharge Fee: $ 9.50
TOTAL FEE: $ 302.75
AppL�CANT: Sela Roofing&Remodeling,Inc. OWNER: Mr. &Mrs. Wyer
4100 Excesior Blvd. 2130 Shevlin Dr
St. Louis Park,MN 55146 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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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Sienitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Total Fee: �a Date Received:
'�nter�d By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
=�.s 2 - 2 �- y - y��f�; U
All information must be submitted in full before plan reYiew will be started.
' (please prini al1 information) .
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THE A.PPLICANT IS: (circle one) OWNER OR ONTR.ACTOR
JOB SITE ADDRESS: � �5 �! ��?���i I/1 IIJ�' - ZIP: . �
I�TAME OF Oti�NER: Y� )G�/�E � Uv V�P c� PHO�IE: (home) ��-a_�?1�,_ �(�� �
(work)
I�IAILPi iG�.DDRESS: . CITY: ZIP:
SELA ROOFING�;REiV1�uDELIN(�. ?Nt`
CO�I'RA.CTOR: " 4100 EXCEI,SIOR �Lt� PI30ti'E: (,� I�'��3 ��"c..��( L�
CO��I'I'ACT PERSON: ° t„y,,,,,,,;,�n __°`j C?BILE/PAGER:
MATI,ING ADDRESS• ` CITY• ZIP:
STATE LICENSE: # ('l; >�
ARCHI'I'E CT/ENGI�i'EER: PHO\TE:
NIA.IL�'G ADDRESS: CITY: ZIP:
�T�y�: REGISTRATION# �
TYPE OF ti�'ORK: New Addition Accessory Structure
i�Iove Remodel/Alteration Land Alteration
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PROPOSED tiVORK(describe in detai�:� � � �� �'� ' ' " � �; �
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STORIES: SQ.FEET OF EACH FLOOR:
I�TO. OF BEDROOI��iS:� GA.�GE STALLS: ATT-. � DET. . � �- = �= - . � -,
ESTI1�i IATED C4NSTRUCTION VALUATIO\ (exclud.i.ng land): �___�_� � � �
I hereby apply for a buildin�pernut and I ackno�vledQe that the information above is complete and
accurate; that the work will be in conformance witn the ordinances and codes of the City and with
the State Buildin� 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.
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APPLICA_:�TT''S SIGNATURE: ✓ ' � DA'I`E: � – � l� � � _
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NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. tVon permitted events will not be allowed.
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Sec.13.0-i RIGHTS OF SZ,'BJECTS OF DATA
Subd. 1. T}�of data. 'Ihe ri¢hcs of individual on whom[,`.e data is s:n:�or ro be swred shall be�s sec forth in this secdon.
Subd.2. Informatioa reqtrired to be given indiridual. An i:.c'i�idual asY�to supply privac_or confrdcndal data coacecning himseIf 53a11
�e ir�ormed of: (a) the purose a�d inrerded use of che requesred data v.;�in the eolI_cring"sta[r agency,policcal subd.ivisioa,OC SI3:GWi�e ryr�m;
('o)wFec:zer he may r_fuse or is Ie3aIIy requir.d to supply[he r.quesced daa;(c)any 3co•xn eoasequeace arisin�froci his supplyin�or reFusing to supply
pri+am or conndenc:I da�;zr.d(d)the idendry of o�Fter persoas or eadd:s a��c�oriz-d by stace or federbl law to rceive the dan_._'Ihis requiremeat s�aii
r.ot app(y wnan an ir:dividual is asked to suppty invudoadvt daci,pursL.�o sec�oa 13.83,subdivision S,co a law enforemen�ofricer. �
The commissiorer of rvenua mav ola.e the nor.ce rauir_d er.�er chis su�division in ihe ir.dividual ir.corr,e tax or orooem ex r_E�r.d
ins�rvctiors ir,s;e�d of on ct:ose forms.
Subd.3. .�ecess to data bp indiciduai. tiport requesc to a r_raasible au�.oriry,an iadividual shall be iniormed whe[her he is rhe ssbject
of scor_d data on u:dividu:ls,and whecher ic u class��d as public,priva�ar confid=n�a1. Upon fiis furt�er rt�:esc, an icdividual who is che st:bject
of s:or:d privace or public dara on individuals shall be shown che dara w•i�ouc any c:.azge to him and,-if he desires,shall be informed of che concenc
ar.d mea.ting of chat dac�. Afr=r an indi•�idua!hu been shown the priva::tati and ir:ormed of ics meaain3,the data need not be diselosed to him for
si; mor.chs �t:ueatter unless a dispu[e or acdon pursuant to chis sec¢on is te1QL1ff Oi addidooal data on the individual has been colleckd or aeac�d.
�:e res�onsib[e aud:oriry shall provide copies of che privare or public dac�c_on reqn:s:by the individusI subjecc of li4=data. 'I"ne responsible aau.oriry
cay requir�[he requesdng person to pay the acmal costs of making,ce_.;:ing,ar:d eompiling the copies.
The responsibl�aun4oriry shall conply im„iediacety,if possib!_.�xich any requesc made pursuant to this subdivision,or wichin fiv�G�3VS Ot
t'r�e da��of che requesc,etciuding Sancrdays,Sundays and legal holidays,ii is.mediace eompliance is nocpossible. Ii ha cannot comply wich che r_quesc
wichin chac ame,h�shall so inform�he individuai,and may have an addice:3I five da:s wi�`�in which to comply with the request,ezcluding San�rdays,
Sandays and legai holidays.
Subd.4. Procedure when data is not accurate o�complete. :�i indiri�u:1 may contest the accuracy or completeness of pablic o�pri�•ate
dara concer.-iin3 himse(f. To exercise chis right,an individual shall nod��ia��•ridn�ce r`spoasble authoriry d:scribiag che namre of the disa;r_emeac_
The responsibie auchoriry s4sll wichin 30 days eirhee (a)corr.ct the dae:cand to be inaccucata or incomple�e and ar.empt to noafy pasc recipier.[s of
inaccur:re or incomplece daa, including recipien�t named by che indivi�`I:or(b) coci.�+the individual that he beli�ves the daca to be correc� Dara
in dispu�e shail be disclosed only if che individual's sra[emenc of disa�re=�=nc is i^.c:�3:d wich[he disclosed dac3.
Ttu decerminadon of[he rasponsibl�aurhoriry may be appey=�pursu�:to the provisions of the adminis¢adve procedure act r.l��n; to
contes:ed cases. .
DATA PRI�'�CY AD�-ISORY
In accordance with M.S. 13.04, Subd.Z, "RiQhts of sL�jects oi da�a", we would like to inform you that your r�euest
for a per�it or license from the Ciry of Orono or any oi i� deparu..ents may require you to furnish certain priva�� or
confdential information.
You are nocif ed thar.
i, The informa�ion you fumish will be used to d�:ermine �•our qualifcation for the permit orlicense requested.
2, You may refuse to supply data, but reiusai �ay require tha[ the Ciry deny the permit or license.
3, The information may be s�ared with o[her locz, state or federal a�encies to the ex�en�necessary to p;ocess
the perm.it or license.
4. It your requested perm.it or license requires Council action to approve, some infornation may become
. . public. . ,
�. You have certain riQhcs under NI.S. 13.04 (a:ailable Loon request) to review private data on yourself.
6. �'our fi:ll nacne is required to process this applicacion or perm.ic. �
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Fin� �tid Lasc
?�ddr_ss _
Ci:v Snce Zip Ptiane
I nnderscand my ri;�s-�s stared above.
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