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Home My WebLink About2005-P08461 - re-roof ` �� ' PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P08461 Crystal Bay, Minnesota 55323 Permit Type: Mi�or Atterations (952) 249-4600 Date Issued: 2i22�2oos SITE ADDRESS: 345 Spring Hill Rd Wayzata,MN 55391 PID: 25-118-23-43-0008 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernvt Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 153.25 Valuation• $ 7,770.00 State Surcharge Fee: $ 4.40 TOTAL FEE: $ 157.65 APPLICANT: �'�'esturn Roofmg OWNER: Mark&Carla Morris Lindsay 9700 13th Ave 345 Spring Hill Rd Plymouth,MN 55441 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. —y��%�� APPLICANT P ITEE SIGNATURE I SUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Avnlicant 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � . - � 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 OR NTRAC JOB SITE ADDRESS: -� �� .S .P�� ' ZIP: -��9� 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. Non permitted events will not be allowed. NAME OF OWNER: �byN��i��,, ,l�,�i��j� PHONE: (home) ySd- ��'�"O7 B� MAILING ADDRESS: ��-�� C'��c��/1 C� ��'�'ork) � CITY: � �� ZIP: SS3Sl CONTRACTOR: l/v�` S��il�/" PHONE: ?��S��.3� � CONTACT PERSON: o MOBILE/PAGER: MAILING ADDRESS: GI 7a G • /�f�, }y/'� � CITY: r,a �' ZIP: STATE LICENSE: # �Ce2v/SSS� �-^�" 3�3�Ib.� 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�: ��d� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (ezcluding land): $_?�7�J I hereby apply for a building permit and I aclmowledge 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 SIGNATURE: DATE: �/ o • ' - . � 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 iK thts sectton. Subd.2. Information requlred to be given Individual. An individual asked to supply prlvate or cont3dential data rnncerning himself shall be informed of: (a)the purpose and Intended use of the requested data w(thin the colleMing state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)sny known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or enHtles authorized by state or tederal law to receive the data. This requirement shall not apply when an indiv[dual is asked to supply investtgative data,pursusnt to seMion 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice reauired under this subdivision In the Individual income tax or orooertv tax refund instruMions instead of on those forms. Subd.3. Access to dsta by indtvidual. Upon request to a responsible authority,an indlvidusl shall be informed whet6er he is the subject o[ stored data on individuals,and whether it is cisssified as public,prtvate or contldenttal. Upon hts further request,an ind(vidual who is the subject of stored private or publlc data on individuals shall be shown the data without any charge to him and,if he desires,shall be iniormed of the content and meaning of that data. After an individual has been shown the private dats and iniormed of Its meantng,the data need not be disctosed to him[or siz months thereafter unless a d[spute or action pursuant to this sectlon is pending or additional data on the individual hss been collected or created. The responsible suthority 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 psy the actual rnsts of maldng,certifying,and complling the coptes. The responsible authority ahsll comply immediately,if possible,with any request made pursuant to this subdivisian,or wtthin five days of the date of the request,excluding Saturdays,Sundays and legal holidays,it immediate compliance is not possible.It he cannot�mply with the request wtthin that time,he shall so Inform the individual,and may 6ave an additlonal tive days within which to comply with the request,excluding Saturdays,Sundays and legai holidays. Subd.4. Procedure when data is not accurate or rnmplete. An individual may contest the accuracy or completeness of publicor private data rnncerning himself. To exercise this right,an individual sha11 noti[y in writing the responsible suthority describing the nature of the dtsagreemen� The responsible suthority shall wit6in 30 days eit6er: (a)correct the data found to be inaccurate or incomplete snd attempt to notity past reclpients ot inaccurate or incomplete data,including reciplents named by the individual;or(b)notlfy the tndividual thst he believes the data to be rnrrect. Data in dispute shall be disclosed only If the indivtdual's statement of disagreement is included with the disclosed data. The determination of the responsible suthoNty may be appealed pursuant to the provtsions ot 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 confdential 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. Flrst Middle Last Address Ctty State Zip Phone I understand my rights as state above. i��'`i� Signature