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Home My WebLink About2007-P11572 - re-roof PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P11572 Crysti7 Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/30/2007 SITE ADDRESS: 4115 Watertown Rd Unit# Maple Plain,MN 55359 PID: 31-118-23-41-0014 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Tear off and Reroof Small Flat Roof FEE SUMMARY: Permit Fee: $ 167.25 Valuation: $ 8,157.00 State Surcharge Fee: $ 4.10 TOTAL FEE: $ 171.35 APPLICANT: Walker Roofing Co.,Inc. OWNER: Micheal&Jill Dyer 2274 Capp Rd 4115 Watertown Rd St.Paul,MN 55104 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 Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 OCT-12-2007 09 :38 AM WALKER, ROOFING 6512510916 P. 01 Total Fee: S 7l Date Received: /D 7 Entered By: Permit#: / CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in lull before plan review will be started. (please print all lr{lormation) THE APPLICANT IS: (circle one) OWNER CONTRACTOR �111_5 JOB SITE ADDRESS: ��-��""� ZIP: Will this be a P de of Homes, Remodelers Showcase Home or other Display Home? [] Yea No !f yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event, Shuttle bus service will be required unless applicant demonstrates suffi:o�t ' parkin available. Non-permitted events will not be allowed.NAME OF OWNER: r✓E` PHONE: (home)�IZ-3.3?%5f_V _ (work) ?sa-Y-A--&Q 3o MAILING ADDRESS: J �i!/A %'jTiw�✓ CITY: D<o""' ZIP: SS IF;r - CONTRACTOR: r1 o G PHONE: CONTACT PERSON: ICYLL _ MOBILE/PAGER: l► MAILING ADDRESS: IL-24 GAAP A CITY: Sr ZIP: STATE LICENSE: #_ NZL9 EXPIRATION DATE: 3 og ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration(ie: Siding, Windows) Arty earth movement may require McwD,�'eview and perm a! PROPOSED WORK describe in detail): T�4 a&.f_ �4i. 1�r 2a t". STORIES: � SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): S I hereby apply for a building permit and 1 acknowledge that the info is complete and accurate; that the work will be in conformance with the ordinanc o the City and with the State Building Code;that 1 understand this is not a permit and work-ft4 out a permit;and that the work will be in accordance with the approved plan. f" l J I APPLICANT'S SIGNATURE: r DATE: l o�� v� 731 OCT-12-2007 09 :38 AM WALKER, ROOFING 6512510916 P. 02 See.13,04 RIGHTS OR StWECTS OR DATA Subd. 1. Type of data, The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd,2. Information required to be given individual.An individual asked to supply private or confidential data concerning 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 known consequence arising from hill supplying or refusing to supply private or confidential data;and(d)the idemity of other persons or entities authorized by state or federal law to receive the data.This requirement shall not apply when an Individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. TbC --=-n of reyennl;may nth the notice Mqujred under this subdivision Ln he individual income tax QL oMpo(ty tax refund insteadinstructions Subd.3,Access in data by individual. Upon request to a responsible authority,an 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 swred private or public data on individuals shall be shown the data without airy charge to him end,if he desires,shell be informed of the content and meaning of that data. After an Individual has been shown the private date and informed of its meaning,the date need not be disclosed to him for six months thereafter unless a dispute of Action pursuant to this section is pending or additional date an the individual has been collected or created.The responsible authority shall provide copies of the private or public date upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costa of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any requestmade pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,i f im mediaw compliance is not possible.If he cemnot comply with the request within that time,he shall so infbrm 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 when data Is noteccurats or complete.An individual may contort the accuracy or completeness of public or private data concerning himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and atttanpt to notify pest rec001113 of inswurate or incomplete data,including recipients named by the Individual or(b)notify the individual that he believes the data to be correct.Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed date. The determination of the responsible authority may be appealed ptasuant to the provisions of the administrative procedure act relating to contastod 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 It 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 qualifreadon for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the parmit 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. kyJ7wale` NOS —J, Fltst MWdk Leal 2Z7 CSP Addr� dd 4!/- S& (, 0 L) City state Zip Pbome 1 understand my rights as s -• " r.r Slgratut+e 77/ 32 t � E .'� ,w"� •AP , eats '�' » ...... -...._.,�.�m_...._.m. .,,„..,,„_„..._.,_..._. ....__ nn! SO] a » s s *w a P►a` �aa ��mrs..;,» r t+'` � '� ,obi' �' �”^•» q - - �.' �- 1�S M - _ ,'e�' �. ,, ,gym .�;�'�^ a� ... `'- '� " .:• m.i` +s 'yN 3 k' - r -to " »' r A 1, soc AN eo* e,