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Home My WebLink About2003-P06368 - re-roof PERMIT C� ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P06368 Crystal Bay, Minnesota 55323 Pe►'mit Type: MinorAlterations (952) 249-4600 Date Issued: s�29i2oo3 SITE ADDRESS: 385 Stubbs Bay Rd N I.ong Lake,MN 55356 PID: 32-118-23-31-0001 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Pemut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Pern-ut Fee: $ 125.25 Valuation: $ 5,221.00 State Surcharge Fee: $ 3.15 TOTAL FEE: $ 128.40 APPLICANT: Sela Roofing&Remodeling,Inc. OWNER: Pamela Gregory 4100 Excesior Blvd. 385 Stubbs Bay Rd N St. Louis Park,MN 55146 Long Lake MN 55356 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 MINNES�TA BUILDING CODE REQUIREMENTS. 1 � � �� - � :�? - a �� % APPUCANT PERMITEE SIGNA URE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Revorts, 1-Assessine, 1-Finance Page 1 Total ee: $ Date Received: S�L�— `' '� Entered By: Permit#: CITY OF ORONO - BUII.DING PERNIIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------- ---------------------------- THE APPLICANT IS: (circle one) OWNER O ONTRA�TQR �`� JOB SITE ADDRESS: '�� 5� �,b� � . �� ZIP: S 5 3j 6 NAME OF OWNER: �jrc�.,c�� c��ac�z��S�� PHONE: (home) 95�� `�76' -U123 (work) �jSz - 1��I9 -�b�� MAILING ADDRESS: f� �� CITY: ZIP: 1 corrrRacTOR: ��L 1 ��';� � a�1� xorrE: �i z �2�-�� CONTACT PERSON: �-a� MOBILE�AGER: MAILING ADDRESS:Lll�o ��c e�C,�r �11• � CITY: s� L.�v ,3 p�ZIP: sf�\� STATE LICENSE: # ��5� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED.WORK(describe in detain: � c ��Q �� 5� �'�"^ �c..t'�c�.c� o� cnc��"-�iR. STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ S,'�-"L � 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 permit and work is not to start without a permit; and that the work will be in accordance wi the approved plan. APPLICANT'S SIGNATURE: .� �� DATE: S � Z- � 03 NOTE! Parade.Qf H�omes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGHTS OF SUBJECTS OF DaTA Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set focth in this secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and inunded use of the requested data wirhin the collecting Ytatc agency,poliucal subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply privace or confidenaal data;and(d)the idendty of o[her penoas or enrities au[horized by state or federal law to receive the dara. This requirement shall not apply when an individual is asked to supply invesrigadve data,pursuanc to section 13.82,subdivision 5,to a law enforcement o�cer. The commissioner of revenue mav piace the nodce required under this subdivision in the individual income tax or pronertv taz refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored daca on individuals,and whecher it is classified as public,privace or co�denaal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown che data wirhout any charge to him and,-if he desires,shall be informed of the content and meaning of rhat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed w him for six months thereafur unless a dispute or acdon pursuant to this section is pending or addiuonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or pubiic daca upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediately,if possible, with any request made pursuant W this subdivision,or wi[hin 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 addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exetcise this right,an individual s6a11 nodfy in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct rhe data found to be inaccurate or incomplete and attempt to noafy past recipients of inaccurate or incomplete data, including recipients named by the iadividual;or(b)nodfy the individual thac he believes the data to be correct. Data in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data. The determinarion of the responsible au[horiry may be appealed pursuant to the provisions of the adminisuarive procedure act reladng 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 extent necessary to process the pemvt 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. �� .M Q � - Firs—t� Middle Last Address . C�h, Srete Zip Phone I underst d my rights stated above. / �, Signantre