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Home My WebLink About2005-P09258 - minor alterations PERMIT CI�Y OF ORONO ' �750 Kelley Parkway- PO Box 66 Permit Number: P09258 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/5/2005 SITE ADDRESS: 1375 Brown Rd S Unit# Wayzata,MN 55391 PID: 10-117-23-31-0048 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: Re-Roof House&Garage FEE SUMMARY: Pernut Fee: $ 50.95 valuation: $ 1,350.00 State Surcharge Fee: $ 0.70 TOTAL FEE: $ 51.65 APPLICANT: Owner/Self OWNER: Craig Sarner � 1375 Brown Rd S Wayzata,MN 55391 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. /�� r l� 1..�--� �� APPLICANT P MITEE SIGNATURE I UED BY SIGNATURE i Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, l-Septic) Page 1 , � . � Total Fee: $ Date Received: �;, �"j �a �� Entered By: Permit#: ; �„ ' �a�> CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all infoi�mation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNE OR CONTRACTOR JOB SITE ADDRESS: l?�� ✓o�,� �� S�, zIP: j--3�,c Will this be a Par of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, n special event pernzit is reqzrired�vith Police Depar•tn�ient and Ciry Council approval 60 dnys pr�ior to the evenf. Shuttle bi�s ser•vice will be regz�ired ttnless applicant demonstrates si fficient on-site parking is availab[e. Non-permitted events will not be allowed. NAME OF OWNER: C_/L A�� S'�4-�1 N h PHONE: (home) �/$�d_ _�—�,?(o� MAILING ADDRESS: 1� �-��1�ivt�Ju� �c� CITY: Z512Z��.�'�woZIP: /SS3c� �P,�� CONTRACTOR: S� �� PHONE: CONTACTPERSON: ,S�-�t,C_� NIOBII.E/PAGER: MAILINGADDRESS: _5'�€ CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDItESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration � PROPOSED WORK(desct�ibe iiz rletain: �� (2�-�pr--�/vG� �5�= f�fl�5� --�' .Q r7�-f��i{�.�tG F STOI2IES: SQ.FEET O�'EACH�'LOOl�: NO. OF BEDROOMS: GARAGE STALI,S: ATTACHED DE'I'ACHlED ESTIMATED CONS�'Ri1CTION VALiJA�'ION(exciuding land): � f-� �j� I hereby apply for a building permit and I acknowledQe that the infonnation above is complete and accurate; that the work will be in confocmance with the ordinances and codes of the Cit�� and with tlze State Building Code;that I understand this is not a permit and work is not to start without a permit;and t11at the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: �3--ZS,,S� 31 � � ► . Sec13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. Type of data. The nghts of individual on whom the data is stored or to be stored shall be as set forth in this sec[ion. SuUd.2. Infbnnation required to be given individual. An individual asked to supply private or contidential dataconcerning himselfshall 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 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 law enforcement officer. The commissioner of revenue ma�place the notice rec�uired under this subdivision in the individual income tax or property 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 infonned whether he is the subjec[oY stored data on individuals,and whether it is classitied as public,private or confidentiaL Upon his tLrther request,an individual who is the subject of stored private or public data on individuals shalt be shown the data widiout any charge to him and,if he desires,shall be informed of d�e content and meaning of that data After an individual has been sho��t the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter uniess 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 tive days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannotcomply 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,excl uding 5aturdays, Sundays and legal holidays Subd.4. Procedure when data is not accurate or comple[e. An individual may contest the accuracy or completeness of publ ic or private data concerning hiinself. To exercise[his right,an individual shall noti(y in writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days either. (a)correc[the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate 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 stafement of disagreement is included with the disclosed data. The derermination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRNACY 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 perniit or license from the City of Orono or any of its departments may rec�uire you to furnish certain private or confidential information. You are notified that: l. The inforn�ation 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 federai agencies to the extent necessary to process the permit or(icense. 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. ]3.04(available upon request)to review private data on yourself. 6. Your full name is rec�uired to process this application or permit. _ ,,�� 1�.�v S�.vfl�. First Dtiddle Last �� /G.J�� {�� Address �11�� S-�S�r/ �j 2- �a�� Cit� State Zip Phone 1 understand my r' hts as stated above. Signature j7