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Home My WebLink About2006-P10455 - re-roof PERMIT Cii��Y OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: p10455 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/16/2006 SITE ADDRESS: 140 Brown Rd S Unit# Long Lake,MN 55356 PID: 03-117-23-12-0011 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: Cedar Shake Reroof FEE SUMMARY: Perniit Fee: $ 209.25 Valuation: $ 11,300.00 State Surcharge Fee: $ 5.65 TOTAL FEE: $ 214.90 APPLICANT: Plymouth Roofing&Insulation OWNER: Mr. &Mrs. Coleman 17525 Cty Road 24 140 Brown Road S Plymouth,MN 55447 Long Lake MN 55356 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 REQUIREMEN . i ; � '1� y: /. APPLICANT PfiR SIG UED BY SIGNATURE Copies: 1-File(Signatures Required), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 .. ! ' Total Fee: � Date Received: �ntered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan revie�v will be started. (please�ri�it al!i�ifof•nzatioi�) ------------------------------------------------------------------------------------------------------------------------ TH� APPLICANT IS: (ci�•cle one) OWNER OR ONTRACTOR y� � ^ I� I�,, JOB SIT�ADDRESS: � �v ��C,ll,l�'C�J c/��.1�(J C��-� ZIP: .5 ��S �o Witl this be a Parade of Homes, Remodelers Sho�vcase Home or other Display Home? ❑ Yes �o If}�es, a special event perniil is reqari�ecli�vith Police Departmei�t and City Cauncil approval 60 days pr ior to t/�e event. Sl�zrt�le bi�s sei•l�ice rvi(1 be reqz�ired�rnless applica�7t der»onstrates sarfficie�7t a�-site pni•Icing is available. 1Von-pern�ittecf evenls ivill not be alloti�,ed. NAME OF O�VNER: ��J�1 �`e m-�� PHONE: (home)GI�a- ��3�7�3� `�� (�vocl<) MAILING ADDRESS: � `�-O s b�0�-L%N � Y�° CITY: l�,C�'� ZIP: �S�S(� CONTRACTOR: �-�i 'I�(, L� O��lv PHONE: 74a3--��3 �3��1 � CONTACT P�RSON: o�-L� MOBILE/PAGER: �,i�-�7 l��c��I MAILING ADDRESS: ( "7 S�5 C�y �y CITY: "'L�mo�� ZIP: _�_�5�y 7 STATE LICENSE: # S3�� YPdRATION DATE: 3 - 3�•-��a c�� ARCHIT�CT/Ei�'GINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessoty Structure Move Home RemodeVAltecation (ie: Siding, Windows) � Ar.y earth movement may require MCWD review and permits ! PROPOSED WORK(descr•iGe i» rleta�n: -I�G��S�-tton) E� N�Ix.S� ��Y9 5�� .Q�f�� '�� C"�b��--��-� zr►s��-e �rcler�, fe� l�-3o��t}.�n�Sp��ts" nNt.c�bc3�' l ��r�c�� STORIES: � SQ.FEE�'OF EACH FLOOR: 1V'O. �F BEDRO01Vi�: GARA�E �'TALLS: A'I'TAC�i�D I�ETAC�iE�_ a� ESTINIATED CONSTRUCTION VALUATION(excluding land): � /�� I hereby apply for a building permit and I ackno�vled¢e that the information above is complete and accurate; that the�vork will be in conformance ��ith the ordinances and codes of the City and �vith the State Buildin� Code;that I understand this is not a permit and work is not to st �t w'cho a perizlit; and that the��ork will be in accordance �vith the approved Q,lan. APPLICANT'S SIGNATUR,: � �AZ�: C>`-�'�� `-' 31 a ' l Sec.13.0� RIGE[TS OF SUBJECTS OF DATr� Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set foRh in this section. SuUd.2. Information required[o be given individual. An individual asked to supply private or contidential data concerning himseifshall be informed of: (a)the purpose and intended use oftlie requested data within the collecting state agency,political subdi��ision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusin�co supply private or coilfidential data;and(d)d�e identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place thc notice required under this subdivision in the individual income ta�or r�ooerry ta�retiind instructions instead of on those fonns. 5ubd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be intbrmed whether he is the subject of stored data on individuals,and whether it is classitied as public,private or confidenCiaL Upoii his further request,an individ�ial who is Ihe subjcct of stored private or public data on individuals sltall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning ofthat data. After an individual has been shown die private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coUected 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 aufhority may require the requesting person to pay the actual costs ofmakine,certitying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or��ithin tive days of the date of the request,e�duding Safurdays,Sundays and legal hofidays,if immediate compliance is not possiUle. [fhe cannot comply with the request within that time,he shall so infonn the individual,and may have an additional tive days widtin which to comply with the request,excludin�Saturdays, Sundays and legal holidays. � Subd.4, Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To e�ercise this right,an individuai shall notity in wri[ing tlie responsibie authoriry describing the nature ofthe disagreement. The responsible authority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to noti(y past recipients of inaccurate or incomplete data,including recipients nained 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 data. The determination of the responsible authoriry 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 inforni 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 wilf be used to dete�mine your qualification for the permit or license requested. 2. You may refi�se to supply data, but refusal may require that the City deny the pernlit oc 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 ri�hts under:�I.S. 13.0�1(available upon request)ro revie�v private data on yourself. 6. 1'o�u•full name is required to process this application or permit. First i��iiddlc L�st Address Cih Scaic 7_ip Phone - I understan v ri hts as sta d ab Sign;i rc _� � Reset Form 3�