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Home My WebLink About2005-P08607 - minor alterations �- !T�' OF R N PERMIT � � � Permit Number: 2750 Kelley Parkway- PO Box 66 P08607 Crystal Bay, Minnesota 55323 Permit Type: Mi�orAiteTat�ons (952) 249-4600 Date Issued: aiiai2oos SITE ADDRESS: 725 Sixth Ave N Wayzata,MN 55391 PID: 25-118-23-33-0004 DESCRI PTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: T"_"__�I /l/_I,1 FEE SUMMARY: Pernut Fee: $ 251.25 Valuation: $ 14,500.00 State Surcharge Fee: $ 7.75 TOTAL FEE: $ 259.00 APPLICANT: Montgomery Brinlanan (',�nQ.f, OWNER: Spring Hill Golf Club MIv 70 o X�iq s4vt S. Go rd�.r,r/�ur..� 5s�f r � 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 BUIL O REQUIREMENTS. T ITEE SIGNATURE UED BY S[GNATURE Conies: 1-File(SiQnitures Required), 1-At�vlicant, 1-Monthlv Renorts, 1-Assessin¢, 1-Finance Page 1 �.�` � , t ,�,.'`�� a.,� � . � � -, ti.�' ; � �� ' ` � � c c �-/ � otal Fee: $ - ` ��' Date Received: �� Entered By: f�!� ��.��, �;� ��_ c�`-- Permit#• � /� /C`r 7 CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -- --------------------------------_��----------�-�----��iC/��C�-------------------- THE APPLICANT IS: (ccrcle one) ��V NER OR CONTRACTOR JOB SITE ADDRESS: /'i�-c �; ZIP: 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 City Council approval 60 days prior to the event. Sha�ttle bars service will be regz�ired unless applicant demonstrates sufficient on-site parking is avai able. N n pen�zitted events will not be allotived NAME OF OWNER: �� e D ��PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: �� CONTRACTOR: � - �/` /1l� u�cL PHONE: G?I�'�'�-�� CONTACT PERS : �� MOBILE/PAGER: 7��1�—�� MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accesso Structure Move Home Remodel/Alteration � PROPOSED WORK(describe in detai�: �'`� �'�r��S S��t e � ;vG � ��c - �v.e�� C�'�� STORIES: � SQ.FEET OF EACH FLOOR: � NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��, S—� 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 ord' d codes of the City and with the State Building Code;that I understand this is not a permit a or�Ts not�to start without a pernut;and that the work will be in accordance with the approved plan. � APPLICANT'S SIGNATURE: DATE: � /� � f. / 31 1 � 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.M individual asked to supply private oc confidential data conceming himselfshall 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.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 officer. The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or,progerty tax refund instructions inscead 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 fwther 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 informed 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 authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authotity shall 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]egal 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 this right,an individual shall notify in writing the responsible authority describing the nalure of the disagreement.The responsible authority shatl within 30 days either: (a)correct the data found to be inaccurate oc incomplete and attempt to notify past recipients of inaccurate or incomplete data,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 determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act celating 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 deparhnents 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 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 rights under M.S. 13.04(available upon request)to review private data on yourself. 6. Your full na is require s this application or perpnit. First Middle Last ress City St te Zip Phone I understand my rights as stated above. Signature 32 D�� 76� �- � �� n-r' �