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Home My WebLink About2001-P04381 - re-roof � �' - � PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 P04381 Crystal B�y, Minnesota 55323 P@fCTllt Typ2: MinorAlterations (952� 249-4600 Date Issued: 9i2ii2ooi SITE ADDRESS: 780 Brown Rd N LONG LAKE, MN 55356 P I D: 3 4-118-23-11-0002 DESCRIPTION: UBC Occupancy R3 Proposed Use: tcesidentiai Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 2�9•25 Valuation: $ 17,000.00 State Surcharge Fee: $ 8.50 TOTAL FEE: $ 287.75 APPLICANT: �'�'estern Cedar Supply OWNER: DALE E LINDQUIST&W�FE 9700 13th Ave 780 BROWN RD N Plymouth,MN 55441 LONG LAKE MN 55356 THE iJNDERSIGNED 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. M—'1 �� ,� �'�'�/'r---��°�-, APPLI ANT MITEE SI NATURE IS UED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 - �. Total Fee: $ Date Received: �-�/-�c�� Entered By: Pernut#: �C> �/�� CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- �---.�--�--__----_._ THE APPLICANT IS: (circle one) OWNER O�CONTRACTOI�� JOB SITE ADDRESS: �� . �'n�-�.� �o�� ZIP: �S�j� NAME OF OWNER: � �e'� ��dy L��c�r�r's� PHONE: (home) �73—� �� (work) MAILING ADDRESS: _S�'ri��-' CITY: C✓� ZIP: 5 s 3 S � CONTRACTOR: �/V'eSTC�� I �� PHONE: 7C �� '�G� CONTACT PERSON: e,�� MOBI E/PAGER: MAILING ADDRESS: �`�� /��.��CITY: 6�� ZIP: .5Y / STATE LICENSE: #{ ` �,�;�� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: Ne� Addition Accessory Structure Move Remodel/Alteration Land A teration �,f�S' � PROPOSED WORK (describe in detai�: ��c�G/'P�b-�' �l�t �� E/ji�D STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROO�iS: GARAGE STALLS: ATT. DET. ESTIMATED CO`STRUCTION VALUATION (excluding land): $ � 7� �C�� 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 accor pproved plan. /`' ' 1� APPLIC�'T'S SIGNATtiRE: DATE: �` � �`�nl NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and City Council 60 days prior to the event. Non permitted events will not be allowed. .� . Sec.13.04 RIGHTS OF SUB.JECTS OF DATA Subd. 1. Type of data. The rights of individual on whom[he data is scored or co be s�ored shall be as set forth in this secdon. Subd."_'. Information required to be given individual. .�t individual asked to supply privace or confidential data concerning himseif shall be informed of: (a)the purpose and intended use of[he requested data within the collecring'state agency, polidcal subdivision,or sutewide system; (b)whether he may refuse oY is legaliy required to supply the requested data;(c)any Irnown consequence arising from his suppiying or refusing to supply privare or confidendal data;and(d)che idendry of ocher persons or enrides authorized by sta[e or federal law to receive the data. This requirement shall no[apply when an individual is asked to suoply invesrieadve data, punuan[ro secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue r�a� pla-� the notice reauired under this subdivision in the individual income tax or propercv tax refund instructions instzad of on chose forms. Subd. 3. Access to data by indi�-idual. lipon request to a responsible au[horiry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown the data wichout any cnarge to hun and, if he desires, shall be informed of[he content and meaning of[hat data. Ahzr an individual has been shown the private data and informed of its meaning, che data need not be disclosed to him for six months thereafter uriless a dispute or acaon pursuant to this secdon is pending or addiaonal data on the individuai has been collected or crea[ed. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay [he actual cosu of making, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of the cequest,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 addiaonal five days within which to comply with[he request,excluding Saturdays, Sundays and legai holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise this righ[,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. The responsible au[horiry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by [he individual; or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible au[huriry 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, "Ri�ts 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 pernut 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 a?encies to the e;ctent necessary to process the pemut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5, You have certain riQhts under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your fuil name is required to process this application or permit. First .Ltiddle Last Address Ciry State Zip Phone I understand my rights as stated above. Signature �