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Home My WebLink About2008-00383 - roofing ,,, ` CITY OF ORONO PERMIT NO.: 2oos-oo3s3 ��' 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 1 U24/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 3542 SHORELINE DR PIN : 17-117-23-43-0113 LEGAL DESC : NAVARRE HEIGHTS : LOT 000 BLOCK 007 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 17,150.00 NOTE: TEAR OFF AND REROOF APPLICANT pERMIT FEE SCHEDULE 309.75 WALKER ROOFING CO.,INC. STATE SURCHARGE(VALUATION) 8.57 2274 CAPP RD ST.PAUL,MN 55104 MAIL-IN FEE 1.50 �� TOTAL 319.82 Minnesota State License#:4229 OWNER ZITZLOFF,LOWELL 319 BARRY AVE S.#301 WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant percnission for additional or related work which requires sepazate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. 7'he applicant is responsible for assuring all required inspections aze requested in confortnance with the State Building Code.This permit may be revoked at any time for due,cause. �►'�� '-+�- / / ��,�� / / Applicant Permitee Signature Date Issued Signature te SEPARATE PERMITS REQUIRED FOR WORK OT R THAN DESCRIBED A VE. � � � 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 CONTRACTOR JOB SITE ADDRESS: 3542 SHORELINE DR Z�: 55391 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes Q✓ No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wi/l be required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events wi!!not be allowed. NAME OF OWNER: LNR PROPERTIES PHONE: (home) �6�z�3�o-�9ia (work) MAILING ADDRESS: 319 BARRY AVE S#301 CI•I•Y� WAYZATA Z�: 55391 CONTRACTOR: WALKER ROOFING PHONE: �651)251-0910 CONTACT PERSON: KYLE MOBILE/PAGER: MAILING ADDRESS: 2274 CAPP RD CITY: ST PAUL ZjP; 55114 STATE LICENSE: # 4229 EXPIRATION DATE: 03/31/09 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) ✓ Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detain: TEAR OFF AND REROOF STORIES: � SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ».�so.00 I hereby apply for a building permit and I acknowledge that the in rmation above is complete and accurate; that the work will be in conformance with the ordinances an . es of t City and with the State Building Code;that I understand this is not a permit and work is not st witho a permit;and that th work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: � ` � 3 , ; v Sec.13.04 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 forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) 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 identity of other persons or entities authorized by state or federal law to receive the data.7'his requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or propertv 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 confidential. 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 be informed of the content and meaning of that data. After an individual has been shown the private data and infortned of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shal l comply immediately,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 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 ofpublic or private data conceming himself. To exercise this 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 daffi,including 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 disclosed data. The detertnination of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 furnish certain private or confidential information. You are notified that: I. 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 reyuested permit or license req:�ires 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 permit. WALKER ROOFING First Middle Last 2274 CAPP RD Address ST PAUL 1�'n`1 55114 (651)251-0910 City State Zip Phone I understand my ts as ted above �_---... Sigoature ��.��3 z1Lis, : �� ._.:; 32