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Home My WebLink About2004-P07650 - windows PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po�6so Crystal Ba��,�Minnesota 55323 Permlt Type: Minor Alterations (952)�49-4600 Date Issued: 6i2si2ooa SITE ADDRESS: 4225 Forest Lake Dr Mound,MN 55364 PID: o�-ii�-23-i2-oo2s DESCRIPTION: Proposed Use: Residential Buildin Census Code O/S-Building Permit Class: g Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 335.25 Valuation: $ 20,500.00 State Surcharge Fee: $ 10.75 TOTAL FEE: $ 346.00 APPLICANT: Renaissance Exteriors, Inc. OWNER: Kenneth Anderson 7351 Kirkwood Lane 4225 Forst Lake Dr Maple Grove, MN 55369 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. -,,-� 'J --- - , ��, /��- -�- �-._ �__ � �-_ _ ,��-- � �r�-c'.�-� /� G LICANT PERMITEE SIGNATURE ISSUED BY SIGNATURF, L__- Cooies: 1-Fi1e(Si�nitures Required), 1-Aoplicant. 1-Monthlv Reoorts. 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PER'VIIT APPLICATION All information must be submitted in full before plan revie�v �vill be started. (please pri�it all information) -------------------------------------------------------------------------------------:=,--�-.--------------------------------- THE APPLICANT IS: (circle oiie) OWNER OR .ONTRACTOR�! _� JOB SITE ADDRESS: �ZZ S ��'S� �"� � �� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, c� special event permit is Yequired tivitl� Police Department and City Council approval 60 days prioN to the eveht. Non pernzittecl events will not be allowed. NAME OF OWNER: �-�1/� fi �'d✓� ��.�n pHONE: (home) �S� 4�Z ��7� MAILING ADDRESS: `+ZZS� �Cu-Qlt �� CITY: (`V�rLG��j ZIP: CONTRACTOR:�2 l/tG�l l SSG�ViC: ��C,I�S � V1L � PHONE: �'�'J � a U Z�D CONTACT PERSON: (�ili( � Gt�t-� MOBILE/PAGER �7 �—�� MAILING ADDRESS: � 1 (G� Vl.�`'�d��- (,v►- CITY: l�;(�p(Q (,G(a-c ZIP: �� STATE LICENSE: # Zd Z Z� Z X S �� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF`VORK: New Accessory Structure Addition Move RemodeUAlteration Land Alteration PROPOSED WORK(desf;�i�ie in detain: �� Z � �� G�/!/s , T�� Y��'I7 U !�O(.l�-GS �U ��,��`��E � �V6 �T�f� �_�-G� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �; SD� �-- I hereby apply for a building pern-ut 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. � � __ _ _ �� APPLICAIVT'S SIGNATURE:/" �_- DATE: l Sec.13.04 RIGHTS OF SUBJECTS OF 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 arisin;from his supplying or refusing to supply private or confidential data;and(d)the identity 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 larv enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject o[ stored data on individuals,and whether it is classifed as public,private or confidential. Upon his further request,an individual who is the subject o[ stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shorvn the private data and informed o(its meaning,the data need not be disclosed to him for sir months 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 authority 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 pay the actual costs of making,certifying,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. If he 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,excludin;Saturdays,Sundays and legal holidays. Subd.4. Procedurc when data is not accurate or complete. An individual may contest 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�ature of the disagreement. The responsible authority shalf within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients ot inaccurate or incomplete data,including recipients named by the individual;or(b)noti(y 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 data. 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,"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 tocal,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. C' �n t..� First � � i ' dle Last Address City State 7ip Phone I understand my rights as stated above. '"--�� -- --- G �