HomeMy WebLinkAbout2002-P05203 - doors 4 " PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P05203
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 6/13/2002
SITE ADDRESS: 3685 Watertown Rd
Maple Plain,MN 55359
PID: 32-118-23-34-0011
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Addn/Remo epair pDe-'`
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 401.35 Valuation: $ 26,000.00
State Surcharge Fee: $ 13.50
TOTAL FEE: $ 414.85
APPLICANT: Pella Windows&Doors OWNER: John&Marla Merideth
15300 25th Ave N. -Suite# 100 3685 Watertown Rd
Plymouth,MN 55447 Maple Plain MN 55359
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.
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Skenitures Required). 1-Applicant. 1-Month1y Reports. 1-Assessina. 1-Finance Page 1
Ly :V10-1fV.5 Nu:)Ls
Total Fee: S Date Iecoived:
Entered By: 7 Permit*: ,� .5� �
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.�._._._..:
CITY OF ORONO a BUILDING PERMU APIPUCATION
All Information must lbe submitted in f dl J*fore.plan review wrlll be started.
(Plese print all it bivatlon)
THE APPLICANT IS: (circle one)' OWNER O CONT�ICTOR •
JOB SITE ADDS:
NAMX OF Overt: SO�nZ 1 e c -4N PKONH: (home) a.y�- Y a
( ) l�
MG ADDRESS: CIff: ZIP;
CONTRACTOR: PELLA WINDOWS&DOORS
CONTAMMN. 75300-25TI4 AVE.N. STE.#100
PLYMOUTH,MN 55447
MAI1NG ADDRESS: 763-745-1400 ZlT:
STAU, MC NSE: # LICENSE##20165884
A$CIVIECT/ENGIlN M: PHONE:
bIAMING A.DIM MS: CITY: ZIP:
Nom: RWJ3T"TaONr#
TM OF WORK: Now Addition Acmsory SMACMm
move model/Akeradon Land Alteration
IPROPOSYE}'VYOItR(descrl6e In detail): ?, 1 r, A -Aloin Nb&
SQ-FM OlEACHFLOOIs
NO. OFBEDROOMS: GARAGE f*A&
ATT. DEL np�
B,STIMATED CONSTdi,'UCi1ON VALUATION(excluding land): $- (A i
I hereby apply for a building'pormit anti I acknowledge that the information above ie complete knd
accurate; that tine work will be in confohnance with the ordinances and poft of the Cirj and with
the State Building Codd; that I understand rhos.is not a pennit and work is not to :tart without a
permit; and that the work will be in accordance with the.approved plana
APPLICANT'S SIGNATURE:62LDATM-
NOTE! ia�g e�a�f�gg events require upgrok pence approval by lance Depot' wnt and
C* Coftncll 60 dye prior to glee event. Non^permiffed events will not be allowed.
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- DATA PRNACY ADVIBA>lEY _ '
In atxocdaaae wish MA'
u11�J
13.04,Subd.2,••RiShta of sew of dace',we would like to inform you brat your request
for a permk or 11011110 from the City of Orono or any of its depntmtnti,many tegnire you to Aurnish ands private or
coadldptdd inPotrhladion. ,
You ace nedb d diet: ,
1. Tho kb imulon you fbrriidir will be uued'fa dcwmlm your quditicsodop for f110 permit or Hosm tequated.
2. You may While to supply data. but refi tray require tbat tie City deny tie permit or 1'1mm.
-, 3. IU Information may be•ahered wait other lord,`roue or federal gpnd s to tie eq tis—necessaiy.oprocces
*0 permit bf license
4. . U your requateed pempt or Ilcom t"dm Caddell mdon to approve, tome intorraadea pvq► become
rule.
S. You have cerasin righn under M.S. 13.04 (available upon inquest) to'mit w pdvam data on yontatf.
6. Your lull name is t+agWmd to prot:ess tuts applicatloo or permit.
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BuUdng Pam*Sewios,Inc.
DAVE
TIME
FAX It DELIVER IN IEDIATELY TO:
NAME _
COMPANY
FAX NO:
FROM Kara
Permit Service ext.147
NO. OF PAGES TO FOLLOW �
RE: PROJECT NO:
\ � T
NOTES:
Cato
• s• - �r�ct
r
If you have trouble receiving this fad please can me as soon as possible,
E1der,Jonee Building Permli Service, Inc.
1120 East aft' Street a Skmnington, Minnesota 55420.1498
612 864 4 FAX: 8124044M
l ' d £9£9 ' ON Will 1001 ' TON
� &-trawIV V71694I7® � :We/v.)
ToUl Fee: Date Received:
Entered By: Permit#:
CITY OF ORONO BUILDING PERMT "PLICATION
All Information must be submitted in full Afore plan review will be started.
(please print all Information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
-----------------------
JOB SITE ADDRESS:
NAME OF OWNER: �o���- l�.c�`S.� PHONE: (home)_`�S a•y�S<9� o��U
(work)
MAILING ADDRESS: ~ CITY:
ZIP.-
CONTRACTOR:
1P;CONTRACTOR: PELLA WINDOWS&DOORS
CONTACT PERSON: 15300-25TH AVE.N. STE.#100
PLYMOUTH,MN 55447
MAUING ADDREM., 763-745-1400 ZV:
STATE LICENSE: # LICENSE#20165884
ARCIII'I'ECIAENGIMEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAIA: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): fl�o, fl � , r•� , - ��
STORIES: SQ.F'EE'T OF EACH FLOOR:
NO. OF BEDROOMS: - GARAGE STALLS: ATT. DET.
ES`I'IMATiED CONSTRUCTION VALUATION (excluding hand): k-_ (D nncCP
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 rpodes 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: A ,2_ DA`IE: � .
NOTE! P e yIo, � events require separate permit approval by Police l2epatftent and
City Council 60 days prior to the event. Non pennitted events will not be allowed.
Raroive,l Ti C Dd 1 . ADD1!
TY OF ORONO 1; 6124730510 09/24/96 14:00 5 :03/03•NO:5�2
3ec.13.04 RIGIITS OF SUWECTS OF DATA
Subd. 1. Type of data. The rights of individual oil whom the data Is stored or to be stored shall be as set forth In this section.
Subd.2. Warmation regddred to be given individual. An individual asked to supply private or confidential data concerning himself shall
be Informed of: (a)die purpose and intended use of the requested data within the collecting hate agency,political subdivision,or statewide system:
(b)whether 1w may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private orconfldential dam;and(d)the identity of other persons or enddes authorized by state or federal law to receive rhe data. This requirement shall
not apply when an individual is asked to supply Investigadve data, pursuant to section 13.62, subdivision S. to s law enforcement officer.
M cum tit sgnez of rcve true m9v glace the notice required under this subdivision in the individu}i income isx or orotum rax rekrid
Iruttucdont lmswtdgf on NP-9 form4.
Subd. 3. Access to data by individual. Upon request to a responsible authority,in individual shall be Informed whether 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
of stored private or public data on individuals shalt 4e shown the dam without any charge to him and,'if he desires,shall be informed of the content
and inkaning of dist data. After an individual has been shown the private data and informed of its meaning. the data need not be disclosed to him for
drt anondts 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 auftrity shall provide copies of rhe private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,cenity{ng.and compiling the copies.
'The responsible authority shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,If Immediate compliance is not possible. Ifte cannot comply 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 whin data is net accurate or complete. An individual may contest the accuracy or complerenoss of public or private
dim comornbtg Himself. To exercise this right,an individual shall notify in writing the responsible authority describing die nature of the disagreement.
'rhe responsible Authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify put recipients of
Insewtate or incomplete darn, Including recipients named by die individual;or(b)notify the individual that he believes the data to be correct. Data
iso dispute shall be disclosed ottly if the individual's statement of disagreement is included with the disclosed dare.
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, "Flights 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 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.
Fera Wddta I.aat
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Address - rn'+� sal, Iso 3 s•
City Sass zip Miss
r
I-understand rely rights as stated above.
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