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Home My WebLink About2004-P07899 - re-roof � PERMIT CI�Y OF ORONO Permit Number: 2750 Kelley Pari�way- PO Box 66 P07899 Crystal Bay, Minnesota 55323 Permit Type: Mi�or a�ceranons (952) 249-4600 Date Issued: 8/31/2004 SITE ADDRESS: 125 Smith Ave Wayzata,M[�155391 PID: o2-i i�-23-2i-ooi� DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pemut Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 139.25 Valuation: $ 6,850.00 State Surcharge Fee: $ 3.95 TOTAL FEE: $ 143.20 APPLICANT: Higgins Construction OWNER: Bradley&Pamela Horner 3432 Orchard Ave. 125 Smith Ave Crystal,MN 55422 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. � � ! � /r` APPLI ANT P ITEE SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Renorts. 1-Assessing, 1-Finance Page 1 � fi'otal 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 OR CONTRACTOR JOB SITE ADDRESS: � Z�j �Vti�jVl �Ve ZIP: T Will this be a Para 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. Non permitted events will not be allowed. NAME OF OWNER: ��o�A ��C V�e� PHONE: (home) (work) MAILING ADDRESS: CITY: _ Qrore ZIP: CONTRACTOR: � ��, Co�t rfu�� PHONE: ��Z" ��Z '� SZ6 CONTACT PERSON: r �nS MOBILE/PAGER: 3- 3' �Da MAILING ADDRE55: `3 3Z N CITY: ZIP: � ZZ STATE LICENSE: #�C-- ZoLl�77D ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration,�� Land Alteration PROPOSED WORK(describe in detai�:��,.�--� ��-(�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (ezcluding land): $_� �� I hereby apply for a building permit and I aclrnowledge 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 5tate 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: �( ZC�O � i 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 torth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use ot the requested data within the colleMing state agency,political subdivision,or statewide system;(b) whet6er 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 contdential 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 ofticer. The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or oroaertv tax retund instructions instead of on those torms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whet6er 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 o[ stored private or public data on individuals s6a11 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 oeed 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. T6e responsible authority may require the 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 five days ofthe date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot compiy 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 w6en 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,an individual s6a11 notify in writing the responsible aut6ority describing the nature of the disagreement. The responsible aut6ority shall wit6in 30 days either: (s)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by t6e individual;or(b)notify the individual that he believes the data to be correct. Data in dispute s6all 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 provlsions of the administrative procedure aM 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: 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 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 permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. Signature DATE TIME � CITY OF ORONO CALLED IN � INSPECTION NO CE SCHEDULED -' `0 _�7� PERMIT NO. � CQ,MPLETED ADDRESS ��5 �S/yI/Y�11 � OWNER CONTR.�9C�1,�S TELEPHONE NO.__ CY�_7 `� ��J ��O(� � DESCRIPTION �-/�rT/' l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 05 FINA 14 SEWER HOOK-UP 06 PROGRESS � O-SITE 2� SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O >. � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑COFRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Caii for the n t inspection 24 hours in advance. (952) 249-4600 OwnerlCon c o it : Inspector. White Copyllnspector's File Canary CopylSite Notice