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Home My WebLink About2007-P11268 - re-roof � 'y ! PERMIT G,T`� OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P11268 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 7/30/2007 SITE ADDRESS: 1475 Shoreline Dr Unit# Wayzata,MN 55391 PID: 11-117-23-23-0002 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Tear off&reshingle half of house FEE SUMMARY: Pernut Fee: $ 9�.25 valuation: $ 3,500.00 State Surcharge Fee: $ 1.75 TOTAL FEE: $ 99.00 APPLICANT: W.F. Smith Construction OWNER: Douglass&Ellen Schmitt 6585 So. Saunders Lake Dr. 1475 Shoreline Dr Minnetrista,MN 55364 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. i �� ' ��I �✓ , APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Reguired), l-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � . Total Fee: $ c 'l•� 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 atl information) THE APPLICANT IS: (circle one) OWNER CONTRACTOR JOB SITE ADDRESS: 1`t � S 5��t-r w� � �" Zrp; SS'3� � Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes,a special event permit is required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non permitted events will not be allowed. �i�_ � �o - oS� �rJ NAME OF OWNER: �vv C-� �� rn� n� PHONE• (home) (work) MAILING ADDRESS: 1� 7Sl ��C�u�`� �f. CITY: ZIP: l Al �r`7�-6:53� CONTRACTOR:�v• � S 1� ��I� �/�S� � PHON�:�91��-� CONTACT PERSON: �v ►� MOBILE/PAGER:G rd- -�56 )3�� MAILING ADDRESS�S�B s S�, 5�.,,,.,uEAr �.k (�r � CITY: ►��'n,Ne"�r,j ,�� ZIP: SS�6 y STATE LICENSE: # S3c� �l EXPIRATION DATE: 3-3 i- �� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Mov� Hom� R�mod�l/Altgration(i�: Siding, Windows) Any earth movement may require MCwD review and permits! PRQPOSEU WORK(describe in detai�: �i°t� o�� St- �C.e s��,r�l� /{y{.L.t=� rs� i-1� �.�s -� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ -�Sd� �� 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: DATE: � � �� - �Z � 31 � . . Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. 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 confidenUal data conceming himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,ar statewide system;(6) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. The commissioner of revenue may place the notice reauired under this subdivision in the individual income tax or r�operty tax refund instructions instead of on those forms. Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidenUal. Upon his further request,an individual who 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,shall he 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 mo�ths thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been col►ccted or created. The responsible authority shall provide copies of the private or public data upon request by the individuai subject of the data. The responsible authority may require the requesdng person to pay the actual wsts of making,certifying,and compiling the copies. The responsible authority sha(1 comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe 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 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 not accurate or complete.An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise tMs right,an individual shall notify in writing the responsible authority describing the 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 notify past recipients of inaccurate or incomplete data,including recipients named by the individuel;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 disclosed data. The determination ofthe responsible authority may be appealed pursuant to the provisions ofthe adminisVative 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 pernut or license from the City of Orono or any of its departments may require you to fumish certain private or confidenrial information. You are notified that: 1. T'he information you furnish will be used to determine yow qualificarion 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 pemvt or license requires Council action to approve, some inforniation may become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your fWl name is required to process this applicarion or permit. ��-,-�.��-� � �r►,.,�- lrl F�c �aaie Last � �� s" .S� . 5�1...�,.�..,e�-�.s L�• �� . Address 1�'� ' �-n.� s'�-A �'l r� . sS�G � �s"�-y�a - �� - �_�►•�N� City State Zip Phone I understand my right stated above. C Signatur � ' " Reset Form � ��- 32 {f'�i�rv�;�`" r,�Cs�4��g�