HomeMy WebLinkAbout2002-P05593 - re-roof ITY F R N PERMIT
C Q O O O
2750 KQIIey�Parkway- PO Box 66 Permit Number: P05593
Crystal Bay; Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 9�io�2oo2
SITE ADDRESS: 1940 Shoreline Dr
Wayzata,MN 55391
PID: io-ii�-23-a2-000�
DESCRIPTION: i7BC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterarions Pernut Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Pemut Fee: $ 9�•25 Valuation• $ 3,964.00
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 99.75
APPLICANT' Garlock-French Roofing Corporarion OWNER: Alan&Anne Nettles
� 2301 East 25th Street 1940 Shoreline Dr
Minneapolis,MN 55406 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICf COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNAT RE IS Y SIGNATURE
Couies: 1-File(SiQnitures Required). 1-Aunlicant, 1-Monthlv Revorts, 1-Assessine, 1-Finance Page 1
SEP.09'2002 09:42 6127229754 GARLOCK FRENCH ROOFING #7135 P.002/002
Tot�l Fee: $ ��� � �7� Date Received: ,���i _ � �,
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Ent.c�ed By: ��� �� Pecmit l�: � � �'�� �'
CITY OF 4RON0 - STJILDING P��T �1.PPL�CATYON
Ap informatfon must be svbmitted in full hegore plan review w�U be started.
�a�� (please prf�tt all inforntation) - ��__� .
____---�---------- ,- ------------------- .
THE APFLICANT XS: (circle one) O'9VNF�t OR N�'RACT
JOB STTE A.AAIt�SS: 1°L'-{n S�no�CP�I'�, �i V�C., ZrP: 553�t (
N� 4F 4WNF�t: �'1 ''f�R.��.� �'�ONF: (lwms) ��3�`�c,5��
(work)
M�r��rGann�ss, tia�+� S��e �+� c�: �wc��zr.�:Ss3q
CONI'RAC�'OR: (�X�'�c,-�+CcVvc�v�. �-ou� Pr30NE: t���-�"�a-�"��°1
coi�t�ACT PrIzSON: E� hra. ' �riUBIIrrrnAGrR:
MAILING ADDR�SS: � � E. ��S'�'^ �e� CI'1'�:V�n ca��uu5 ZIP: S�
STA�'�E LICFNSE: #Obo 14�7 3
A3�tCH�'fECT/�NGIN�EI,t: PI�ON�:
MAILING ADTJItF�SS: C�'Z'Y: Z1P:
N��; RFGJ�TRATION#
TYpF pF WOR�: New Addition Arrcessary St�vcture
1Y�ove Rem�d,eUAl�e�ation l..amd Alteration�
PROPOSFD Wa�(describe tn detai�: �QGV( a-C� (a� �e �i Do-F �10'ft"1R �G.S�c
lG�.�c �
s�o�s: sQ.x�T or EAC��oo�:
rro. or sEnxooM.s: G�G� STALLS: A'�'r. nET.
TSTIMA'i.'F D CONS'X'RUCTION VALUATI:ON (excludi.ng land): $�,����'-4• �b
I herehy apply �'oc a build.ing pe�tnu.�.and I a.clavowledge that the i.nfor,tx�ation above i.s complete and
accucar�e; that the war�C will Ue in confor.mance with.the ordina�ce� en+d codes of th�e Ciry aad with
the State Building Cod�e; thac I understand th.is is n.vt a petmit an�d work is n,ot to start without a
�ermit; a�d t.�at the v�+ork will be in, accordance wft.� the approved, plan.
APl'Lx�ANT'S SIG�iATiTRE: 1�c�.. � . �:�1�`�.� � DA,'TE: �`�l�-f�Z
NOTE! Parade �jZlnes events require separate pernttt approval by Pol�ce T�epartmen�and
City Cou►tcil 60 days prior to tl:e event. Non perm�tted�veRts wfll not be allr�wed.
SEP.09'2002 09:42 6127229754 GARLOCK FRENCH ROOFING #7135 P.001/002
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Since L932
2309 Snelling Avenue • 722-7129 Minn�eapolls, Minnesota 55404
Company Nam�e: ��C{�.1 0� CJ�OVI.�
�A.tbanti.on: ` ' +"� 1�XNli�IC�
,
Tel�hAne Numbex: `I5 � - a.'�q - y(o Om
Fax Numbez: _�5 a - a.y q - �l01�
Number of PageS (including cover page): �
Fx�om �,v � El��+fa.�c�
Teleph.one Number: 722-7129 Fax Num.ber. 722-9754.
Date: `'� � `1 � va.. ��; 10:b0 c�.hn
Reference:
,Additional Comm.ex�ts: �J�CG/J� C�� W�� �- ���
�k �c- l�Q r+m,:�� • ��- uut� •
Total Fee: $ �la•�S Date Received:
Entered By: Permit#:
�
CITY OF ORONO - BUII�DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
�a�� (please print all inforn�ation)
TI� APPLICANT IS: (circle one) OWNER OR NTRACT
JOB SITE ADDRESS: �°�`"�v �o�(�,�1hQ, �i Vt, ZIP: 5539 l
NAME OF OWNER: Pc� Y1k-��� PHONE: (home) K"�3�`�v�`'�
(work)
MAILING ADDRESS: Iq4u S1no�C1t�Q. �r� CITY: �Wu�+ {�ZIP:5539
CONTRACTOR: �AXIOGk.'�V�UV�. �-ooE-� PHONE: t�t�-`�'�a-��q
CONTACT PERSON: E� k�^G.. MOBILE/PAGER:
MAILING ADDRESS: �30� E. a�S'�`^ �r�c-�� CTTY: Yh;�hnca�ot,iS ZIP: Ss�lo�v
STATE LICENSE: #U�����3
ARCHITECT/ENGINEER: PHONE:
MAII..ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move � Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �2LV� �-�� G.V� �� '�no-� 1�'� �GIS�
Ftak, r uu�- .
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding lancn: $�,�I�y� �b
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 SIGNATiJRE: �G DATE: ���-f��
NOTE! Parade o�'Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
i
Sec.13.04 RIGFTTS OF SIJBJECTS OF DaTA ' '
Subd. i. Type of data. The righrs of individual on whom che dara is scored or to be smred shatl be as set focth in this secaon. ,
Subd.2. Information req�dred to be givw individnal. An iadividual asked to supply private or confidendal dara conceming himself shail
be infocmed of: (a)the puc�ose and inrended use of the�equesced daa within the coUecoag itarc agency,polidcal subdivision,or sracewide rystem;
(b)whether he may refuse ot u legally required co supply the cequesoed dara;(c)any l�own coauque�e arising from his supplying or refusing to supply
� private or coafidendal data;and(d)che ideadry of ocher peaons or enddes aurhorized by sta[e.or fedecal law to receive rhe da�a. 13is requiremenc shall `
noc apply when an individual is asked to supply invesdgarive dara,pursuant to uction 13.82,subdivuion S,to a law enfarcemenc officer.
The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propern raz refund
instnicdons instead of on those forms.
Subd. 3. Access to data by individual. Upan request to a responsible auehoriry,an individual shall be informed whechec he is the subject
of scored da[a on individuals,and whether it is classified as public, priva[e or confidendal. Upon his further request,aa individual who is the subject
of stored private or public dam on individuals shall be shown che dan wichout any chacge to him and,'if he desires, shall be informed of the content
and meaning of fiat data. After an individuai haz been shown che private daca and infocmed of ics meaning,ehe dara need not be disciosed to him for
six mon[hs[hereafter unless a dispute or acdon pursuanc to this secdon is pending or addidonal data on the individual has been collected or creattd.
1he cesponsible authoriry shall provide copies of che private or public data upon roquest by the individual subjecc of�he data. The responsible au�horiry
may iequire the requesring person to pay rhe acmai coscs of making,certifying,and compiling the copies.
The responsible auehoriry shall comply immedia[ely,if possible, with any request made punuanc to this subdivision, or within five days of
the dace of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply wich rhe requesc
within[hac time,he shall so inform rhe individual,and may have an addiaonal five days within which to comply wich che request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data u not accurate or comp(ete. An individual may contesc the accuracy or compteceness of public or private
data concerning himself. To ezereise chis righc,an individual shap noafy in wridng the responsible authoriry describing the nature of the disagreement.
The responsible auchoriry shall within 30 days eicher: (a)correct[he dam found to be inaccurate or incomplete and attempt to nodfy past recipiena of
inaccurate or incomplete dan,including recipiencc named by che individual;or(b)noufy the individual thac he believes the data to be cocrecc. Data
in dispute shall be disclosed only if[he individual's statemen[of disagreemenc is included with�he disclosed data.
The determinaaon of the responsible auehoriry may be appealed pursuanc to the provisions of the administradve procedure act nladng to
contesced 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 Ciry 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 will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusaI may require that the City deny the permit or license.
3. 'The information may be shared with ocher local, state or federal agencies to the eztent 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.
6. Your full name is required to process this application or pecmit.
Ficsc Middle ��
Address .
Ciry State Zip Phone
I understand my rights as stated above.
Signamre