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Home My WebLink About2004-P08043 (Re-roof) CITY OF OR N PERMIT � � Permit Number: 2750 Kelley Parkway- PO Box 66 P08043 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 10/6/2004 SITE ADDRESS: 1270 Arbor st Wayzata,MN 55391 P I D: 10-117-23-31-0029 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Permit Type: Minor Alterarions Permit Sub-type{s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: n-T--r---"`"'-t"'t�'_-- �.G T.::::.G:.:Di:::b::i::i'..:::b FEE SUMMARY: PermitFee: $ 167.25 Valuation: $ 8,900.00 State Surcharge Fee: $ 4.95 TOTAL FEE: $ 172.20 APPLICANT• �er/Self OWNER' Jeff&Andrea Fullerton . M� � 1270 Arbor St Wayzata MN 55391 TI�UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IlVIPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MIl�1NE50TA BUII.,DING CODE MINTS. � �� APPLICANT RMTI'EE SI SUED BY SIGNATURE Conies: 1-File(Si�nitures Requi�ed),1-Apalic�nt 1-Monthlv Reuorts,l-A�essin�,l-Finance Page 1 � Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pYi�at all infor��iatior�) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 12^7� /-�2��r S� ZIP: SS3�'( � Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required witlz Police Department and City Council approval 60 c�ays prior to the event. Non pe�nitted events will not be czllowed. NAME OF OWNER: ^.l c�r� � �e.c� �-e�c'�V� PHONE: (home) 9'S 2"Ll�3�3 y QI� (work) MAILING ADDRESS: (Z ^]O �r�o�(' � CITY: t.e� �Z�e �ZIP: s�� co�r�a�e�o�a: -�� o M s►e� ��o�r�: �7�3--`f 7�i -�� Z- CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY; ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration Land Alteration PROPOSED WORK(describe i�a detai�: e. � �1� �S 1 ir��I�� STORIES: � SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS:� GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION(excluding land): $��, 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 without a permit;and that the ork will be in accordance with the approved plan. -- APPLICANT'S SIGNATURE: � DATE: /� � 2�ro� Sec.13.04 RIGHTS OF SUB.IEC7'S OF DATA Subd.l. Type of data. The rights of individual on whom the data Is stored or to be stored shall be as set forth in this sectlon. Subd.2. Information required to be given individual.An indivfdual asked to supply private or confldential data concerning himself shatl 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 knotvn rnnsequence arising from hts supplying or refusing to supply private or confidential data;and(d)the identity ot other persons or entities authorized by state or federal law to receive the data. This requtrement shall not apply�vhen an individual is asked to supply lnvest[gative data,pursuant to sectlon 13.82,subdivision 5,to a law enforcement officer. The rnmmissioner of revenue mav olace the notice reauired under this subdivis9on in the individual income tax or aroaertv tax refund instructions instead of on those forms. Subd.3. Access to data by indivldual. Upon request to a responsible authority,an individual shall be Informed whether he is the subJect of stored data on iodividuals,and whether it ts classifled as publ[c,private or rnn�dendal. Upon his further request,an individual�vho is the subJect of 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 t6e content and meaning of that data. After an Individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for sLc monfhs thereafter unless a dispute or action pursuant to thls section ts pending or additional data on the Individual has been coUected or created. The rtsponsible aut6ority ahull provide rnpies of the private or public data upon request by the lndividual subJect of the data.The responsible aot6ority may requlre the requestlng person to pay the actual rnsts of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any requcst made pursuant to this subdivis(oa,or within flve days otthe date of t6e request,esclud(ng Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the request within that tlme,he shall so inform the indivldual,and may have an additional flve days within whlch to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data ts not accurate or complete. An indivldual may contest t6e accuracy or completeness of public or private data concerning himself. To exercise this right,an iadividual shall notify In writing the responsible authority describing the nature of the dlsagrcemen�The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or lacomplete and attempt to notify past recip(ents of (naccurate or Inrnmplete data,including recipients oamed by the(ndividual;or(b)notify the individual that he belleves the data to be coreect Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinatioa of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADYISORY 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 certaiu 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 local,state or federal agencies to the extent aecessary 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 permi� F1rst Middle Last Address City State Z[p Phoue I understand righ as - Signature / �� AT TIME � CITY OF ORONO CALLED IN l� � INSPECTION TI SCHEDULED � ' � % PERMIT NO. COMPLEfED ADDRESS �a 7 d ,�<GOY v / OWNERL�D�ZIt��-QF%�7-'��CONTR. TELEPHOI�lE NO. �J'�o� — y 7.3 - .3��.C�J � DESCRIPTION /� L�� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPUIINT J 07 DEMO-FINAL 15 SEPTIC IIVSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J 0 � � 0 � W � Q � Z W � W � � � d W WORKSATISFACTORY:PRQCEED ❑PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIOPIWITHIN HOURS. p pHOTOTAKEN INSPECTOR W{LL RERIRN ❑CITATION ISSUED �STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the ne t inspection 24 hours in advance. (952) 249-46�� OwnerlContra te: tnspector. White CopyMspector's F Canary Copy/Site Notice