HomeMy WebLinkAbout2001-P03995 - re-roof F ORONO PERMIT
C I T ��� Permit Number:
2750,Ke ey Parkway- PO Box 66 P03995
Crystal Bay, Minnesota 55323 Pe�mit Type: Minor Alterations
(952) 249-4600 Date Issued: 6i26i2ooi
SITE ADDRESS: 745 Sping Hill Rd
Wayzata,1�M155391
P I D: 36-118-23-21-0002
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 593.25 Vatuation: $ 45,000.00
State Surcharge Fee: $ 22.50
TOTAL FEEe $ 615.75
APPLICANT: Sela Roofing&Remodeling, Inc. QWNER: Donald&Nina Wildman
4100 Excesiar Blvd. 745 Spring Hill Rd
St. Louis Park,MN 55146 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESO'TA BUIL ING DE REQUIREMENTS.
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APPLIC T ERMITEESIGNATURE ISSUEDBYSIGNATURE
Copies: 1-File(SiQnitures Reauired). I-Aoplicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1
To<< �''ee: $ Date Received:
Ent�i�d By: Permit#:
CITY OF ORONO - BZTII�DING PERMIT A.PPLICATION
A11 information must be submitted in full before plan review �vill be started.
' (please print all information)
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR j
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JOB SITE ADDRESS: � S s" �, �; � ; c Z�:
NAME OF OWNER:.�;;.;� �- i�1���v1c� �,��� I��c�y� _ PHONE: (home) `-� �7 S — C�z I�j
(work)
1�IAILP�iG A.DDRESS: . CTTY: ZIP:
SELA ROOF'�NG& REMODELING. ���y�
4100 EXCELSIOR BLVD.
CONTR.A.CTOR: � ST. LOUIS PARK, MN 55416 PHONE: � �"��`> ��'`� {v
C0�ITACT PERSON: tD#0001050 �IOBII.E/PAGER:
MA,II�ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGI�Ii EER: PHO\TE:
1VIA,ILING ADDRESS: CITY: Z�:
N�ME; REGIST`RATION# '
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TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: I�E�,,; � � ��-� " '`�-��'
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF B�DROOMS:� GARAGE STALLS: ATT�. � DET. � � - - � -
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ESTI�VIATED COti'STRUCTION VALUATIO\ (excluding land): S ��S ���'--
I hereby apply for a building permit and I acknowled;e that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with
the State Buildin� Code; that I understand this is not a perm.it and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
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APPLICANT'S SIGNATURE: �� � �� D=�TE: ������� �� � _
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1�'OTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.0-1 RIGFiTS OF SLJBJECTS OF DaT.�
Subd. 1. Tppe of data. The righ�c of individual on whom the dara is stor-3 or ro be stored shall be as set forch ia this secaon.
Subd.2. Intormation reqiric�ed to be given individual. �1n ir.di�idual asYt3 w supply privare or confidendal data concerning himseif shall
be informed of: (a)ehe purpose and incended use of the reques�ed dan wi�ia the eollccang Ecace agency,polidcal subdivision,or sratewide rystem;
(b)whec'�er he may refuse oY is legally required to supply[he requested dan:(c)any l�own eonsequence arising from his supplying or refusing to supply
priva�e or conndenaal data;and(d)the idendry of other peaoas or enddes aechoriz:d by sute or federsl taw to receive th�data..This requiremen�s6a11
no[appiy when an individual is asked to supply investigadve daca,pun�^c to seccoa 13.82,subdivision S,to a.law enforcemenc o�cer.
'!he commissioner of reverme mav place the nodce tewircd erd•r this subdivision in ihe individual income tax_or�roaem tax refund
instructions instead of on those forms.
Subd.3. Access to data by iadi�idual. Upon requesc to a r_swasible aechoriry,an individual shall be informed whether he is the subject
of swred data on individuals,and whecher it is classificd as public,privau,or confider.aal. Upon his further request,an individual who is the subjec[
of scorni privace or public dara on individuals shall be shown che data wiu out any e'narge to him and;if he desires,shall be informed of rhe coacent
and meaning of chat daca. Afttr an individual has been shown[he priva��an and in:ormed of ics meaning,che dara need not be disclosed to 6im for
six monchs chereaiser uniess a dispute or acdon pursuanc to ehis secdon is tiending or addidonal data on the individual has been collecced or creaced.
The responsibl�au�horiry shali provide copies of the private or public dac�c�on requ�:by[he individual subject of�he data. The responsible authoriry
may rquire che requesdng person to pay ehe acaial cosu of makin¢,ce.^:;ing,and compiling the copies.
'Ihe responsible auchoriry shall comply immediatety,if possibl=,wich any r_quest made pursuant ta this subdivision,or wichin five days of
the dace oP che reques�,ezcluding Saairdays.Sundays and legal holidays,ii is.mediac-compliance is not possible. If he cannot comply with the requesc
wichin chac ame,he shall so inform che individual,and may have an addicer.al five days wiehin which to comply with che request,ezcluding Satucdays,
Sundays and legal holidays.
Subd.4. Procedure when data ss not accurate or comptete. An indiviZual may contest the accuracy or complemness of public or pri�•ate
dan concerning himself. To exercise this rieht,an individua!shalt nodfy ia wriang c:s responsible authoriry dascribing�he nacure of the disagreemenc.
The responsible authoriry shall wichin 30 days either: (a)correct[he dae fcund to be inaccuratc or incomptete and attempc to nodfy pasc recipiencs of
inaccuh�e or incompiete data, inciuding recipiencs named by the individi:al;or(b)�odfy the individual thac he believes the dara to be coaecc. Da�a
in dispuce shall be disclosed only if the individuai's sta�emenc of disagrr_�ent is�.clnded with the disclosed data.
The decerminaaon of the rasponsible authoriry may be appea�ed punuac�to the provisions of che adminisaarive procedure act relaring to
contes.ed cases. .
DATA PRIV:�CY ADVISORY
In accordance wich M.S. 13.04,Subd.2, "Rights of subjects of data", we would like to inform you that your reauest
for a pemut or license from the Ciry of Orono or any of ia deparments may require you to furnish cercain priva[e or
confidencial information.
You are notified that:
1, The informacion you fumish will be used to de:ermine rour qualification for the permit or license requested.
2, You may refuse to supply data, buc refusal nay require that the City deny the permit or license.
3, The information may be shared with ocher loc�l, state or federal agencies to the excent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some informa[ion may become
. . public.
�, 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 aoplica[ion or permic. �
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Finc � �fiddle Last
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Address ���'
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C`ry Sm� Zip Phone
I understan my ri;hts s ed above. .
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