HomeMy WebLinkAbout2008-P11926 - windows PERMIT
CIT�r�'OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P11926
Crystal Bay, M�nnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 3/28/2008
SITE ADDRESS: 2060 Spates Ave Unit#
Wayzata,MN 55391
PID: 10-117-23-31-0096
DESCRIPTION:
Proposed Use: Residenrial Census Code O/S-Building
Permit Class: Building
Permit Type:
Minar Alterarions Permit Sub-type(s): Windows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 88•50 valuation: $ 2,500.00
State Surcharge Fee: $ 1.25
Misc.Fee: $ 1.50
TOTAL FEE: $ 91.25
APPLICANT: Custom Remodeling,Inc. OWNER: Matthew&Jamie Hanson
474 Apollo Dirve 2060 Spates Ave
Lino Lakes,MN 55014 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.
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APPLICANT PERMITEE SIGNATURE I D BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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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 O LONTRACTO
JOB SITE ADDRESS: b � ZIP: ��� 9 I
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �10 If yes,a special event permit is required with Police Department and City Council approva/
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is availa le. Non permitted events will not be allowed.
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NAME OF OWNER: � � � PHONE: (home) ��{—Ds�7 /
(� (work)
MAILING ADDRESS: o���17�;e� U�V►Q. CITY: ZIP: ��
CONTRACTOR: PHONE: �7$�—��[�C
CONTACT PERSON: o�.�, MOBILE/P GER:
MAILING ADDRESS: CITY• �%yca ZIP: � 1
�TATE LICENSE: # EXPIRATION Dt�TE: 3 l31 /U�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeUAlteration(ie: Siding, Windows) �_
PROPOSED WORK(describe in detain: � � . —
I,� ,s�,r � — �, ..�ur� �
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
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ESTIMATED CONSTRUCTION VALUATION(egcluding land): $ �� �Q� •
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 pernut and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATLTRE: DATE: �
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• Sec.13.04 RIGHTS OF SUBJECI'S OF DATA
Subd.1. Type of data. 1'he righu of individual on whom the data is stored or to be stored shell be as set forth in this section.
Subd.2.Infom�ation required to be given individual.M individual asked w 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 knoKm consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities suthorized by state or federal law to receive ihe data.This requirement shall
not apply when an individual is asked W supply investiga6ve data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav olace the notice reapired under this subdivision in the individual income tax or vroneriv 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 informad whether he is the subject of
stored data on individuals,and whether it is classified as public,private or contidential. Upon his fiuther request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any chazge to him and,if he desires,shall be infortned 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 Uus 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 dam upon request by the individual subject of the data. The responsible suthority
may require the requesting person W pay the actual costs of making,certifying,and compiling the wpies.
1'he responsible authority shall wmply immedisuly,ifpossible,with any request made pursuantto this subdivision,or within five days of
the datc of the request,excluding Sahudays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the request
within that time,he shall so infortn the individual,and may have en additional five days within which to comply with the roquest,excludit►g Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is nQt 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 nature of the disageement.The
responsible authority shall within 30 days either. (a)cort�t the data found to be inaccurate or incomplete end attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be cortect 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 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 fumish 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
publia
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.
F��e ���f �aa���.1 �c
Addresv
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City State Zip Phone
I unders y rights as stated above.
Signature
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