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Home My WebLink About2006-P10415 - re-roof PERMIT CITY OF ORONO permit tvumber: 2750 KellPv Parkway- PO Box 66 P10416 Cryst�l 6 Minnesota 55323 Permit Type: Minor Alterarions (952(��00 Date Issued: 10/4/2006 SITE ADDRESS: 1300 Shoreline Dr Unit# Wayzata,MN 55391 P�� 02-117-23-31-0018 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Pernut Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 209.25 valuation: $ 12,000.00 State Surcharge Fee: $ 6.00 TOTAL FEE: $ 215.25 APPLICANT: Foss Exteriors LLC OWNER: Richard Brown 1891 Sandbar Circle 1300 Shoreline Dr Waconia,MN 55387 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. �-�'�.,�..1� �C��/�r� APPLICANT PERMITEE GNA ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 �►tal 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 pj•int all informatio�2) ------------------------------------------------------------------------------------------------------------------------ TH�APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: l�C�� ,��Ol�U,D� -1��_ZIP: Will this be I'arade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes NO If yes, a specia/event permit is reqz�irec!with Police Deparlment arzd Cily Council a�proval 60 dcrvs p��ia•to the event. Shutdfe bus service will be requi��ed unfess applicant demonstr•ates sa�cient on-site parking is available. t\ron-per�rrittec�events tivill not be allowed. NAME OF OWNER: ��/�I�� PHONE: (home) (work) MAILING ADDRESS: G��D ��c�G-d/U� .� CITY: � C� ZIP: CONTRACTOR:��S ��L/U f� PHONE: 6/Z ZZS��o l� CONTACT PERSON: ��,�n� �S� MOBILE/PAGER: S/�-t,t�,.�,�- MAILINGADDRESS:/�cgi S�ua,��2 �,2 CITY: j,�l,4c�N�a ZIP: �,T-�7 STATE LICENSE: #20�/3�U�--f2- EXPIRATION DATE: 5— 3 � - v� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRA,TION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Altecation (ie: Siding, Windows) � Any earth movement may require MCWD review and perm s! PROPOSED WORK(deseribe in cletc�i�:�� a N� c�.�2n v�� STORIES: �_ SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACH�D DETACHED_ ESTIMATED CONSTRUCTION VALUATION(excluding land): �/G Uv� -�' I hereby apply for a building permit and I acknowledge that the infonnation above is complete and accurate; that the work will be in conformance�vith the ordinances and codes of the City and with the State Buildin� Code;that I understand this is not a permit and�vork is not to start without a permit;and that the work�vill be in accordance�vith the approved plan. APPLICANT'S SIGNATUI2E: DATE: �C� -- — U� 3l Sec.13.Od RIGHTS OF SUBJECTS OF DATA � . � Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set foRh in this section. Subd.2. InFormation required to be given individual. An individual asked to supply private or contidential dam conceming himselfshall be informed ot (a)tlte purpose and intended use of the requested data within tile collecting state agency,politicai subdivision,or statewide system;(b) �vhether he may refuse or is legally required to supply the requested daca;(c)any known coasequence arising from his supplying or refusing to supply private or contidential data;and(d)the identity of other persons or entities authorized by state o�federal law to receive Uie data.This requirement shal I not apply when an individual is asked to supply investigative data,pursuant ro section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income ta�or�roper tax refund ��stnictions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be intiormed whether he is dte subject of stored data on individuals,and whetlier it is classitied as publ ic,private or confidentiai. Upon his further request,an individual�vho is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shaU be informed of the content and meaning of that 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 monH�s thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collecced or created. The responsible authority shall provide copies of the private or public data upon request by the individuai subject of[he data. The responsible authoriry may require th�requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request mAde pursuant to this subdivision,or within tive days of the date of the request,etcluding Saturdays,Sundays and legal holidays,if immediate complianco is not possible. If he cannot comply with the request within that time,he shall so info�m the individual,and may have an additional tive days within which ro comply with the request,excluding Sawrdays, Sundays and legal holidays. Subd.4.Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,nn individual sltall notify in writing the respoiuible authoriry describing the nature of the disagreement. 'Che responsible authoriry shall within 30 days either: (u)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incompiete data,including recipients named by the individual;or(b)notify the individual that he believes the datl to be correct. Data in dispute shail be disclosed only if the individual's statement of disagreement is included with die disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act rellting to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforn�you that your request for a pern�it or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish wil( 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 ri�hts under Ni.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 ��H"�/+ �'Iiddic �/�l� .s LHst ,�0�-�`�� 2s�c l�d`�� f (�J ,a�a��5s �--��t,��2i�4 N l/�'�-�-� �� ,��z- 2-z7�l�. Cih� Statc 7.i� Phone I understand m,v rights as stated above. Sign:�turc i Reset Form 32