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Home My WebLink About2005-P09421 (re-roof) PERMIT CITY �F ORONO 27�0 Kelley Parkway- PO Box 66 Permit Number: P09421 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 11/14/2005 SITE ADDRESS: 2715 Caroline Ave Unit# Wayzata,MN 55391 PID: 20-117-23-24-0007 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: FEE SUMMARY: PermitFee: $ 9�•25 Valuation: $ 3,100.00 State Surcharge Fee: $ 1.55 TOTAL FEE: $ 98.80 APPLICANT: Reroof America Cotp. OWNER: Mr. &Mrs.Rejzer 10740 Lyndale Avenue S 2715 Caroline Ave Bloomington,MN 55420 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. i�—w� 1 (`--1�� "1 C.k��'� �� PPLIC PER EE SIGNATURE ISSUED BY S[GNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) 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. � (�lease print all inforination) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (ci�•cle one) OWNER OR CO RACT JOB SITE ADDRESS: v2 7/S �'/�Roti�F /�t/E ZIP: Will this be a Parade of Homes, Remodelea•s Showcase Home or other Display Home? ❑ 1�eS �1�10 If yes, a specinl even!pen�ait is reqarired tivitl�Police De�artme��t and Ciry Coarricil approvnl 60 dnys pi-iof�to the event. S/�tettle bzrs ser•i�ice�vill be reqa�ired unless npplicarit demonstr•ates su�ficient a1-site parking is nvailnhle. Non�erir�i�ted events r>>ill not be allowe�l. 1'�Al!'IE OF'OWNER: ��R/ �r T 2�� PI30NE: (home) ,/ (work) MAILING ADDRESS: o?7/S �i�c Ro��v�E /7-t/C CITY:�i9-f'Z�T/f ZIP: CONTRACTOR: �Ra a F /'��t�R�C•9 C'o RP PHONE: 9s,? ��p P�f�S�a CONTACT PERSON: �¢dF ,ER�c/�so.�✓ MOBII,E/PAGER: G/,? 68� '�y�'6 MAILINGADDRESS: /OT�"� �N�J �c.F = .�ITY: �a�u•�iaar��LIPe s"s's��o STATELICENSE: #�ZO/S//S//D EXPIRATIONDATE: 3 - 3/- G6 ARC�IITECT/ENGINEER: PHONE: MAiI.iNCa ADDRESS: CITI': ZIP: NAME: REGISTRATION: # 'TYPE OF WORK: New Home Addition Accessory Structure Move Hoine Remodel/Alteration (ie: Sidin�, Windows) ,[_ PROPOSED V5�O1�K(describe dn cletai�: /�F h'O'O�' �T'OR�ES: S�,FEET OF EACI-�F'�,OOR: IVO. OF BEI)R0010'IS: GA1�GE S'TAL,LS: A'I"TAC�I�I) DE'�'AC'�I�:D �5'�'I10�Ir�'I"��CO:�1S'I"I�i1C'�'�O�t`��IJf1'Y"IOI\1(excludirag land�. $ .3 /a'U , �"t� I hereby apply for a building permit aud I acknowledge that the infonnation above is eomplete and accurate; that tl�e worlc will be in conformance �vith tl�e ordinances and codes of the City and with the State Buildina Code;tl�at I understand this is not a pennit and work is not to start without a pennit;and that the work will be in accordance w�ith the approved pla . API'I�ICA�1"T S SIG�iA'I'IJ . .� ° ��.,.,,� ��"�'�: II'/ s� GS 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or[o be stored shall be as set forth in this section. Subd.2. Info�7nation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)die purpose and i�tended use of the requested data within the collec[ing 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 frotn 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 13.32,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or propertv tax refund insnvctions instead of on those fonns. Subd.3. Access to data by individual. lipon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individu�ls,and whether it is classified as public,piivate or confidential. Upon his further request,an individual who 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 infomied of the content and meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six mon[hs thereafter unless a dispute or action pursuant ro this section is pending or additional data on the individuxl has been collec[ed or created. The responsible authority shall provide copies of die private or public data upon request by die individual subject of the data. The responsible authoiity may require the requesting person to pay the acn�al costs of making,ceRifying,and compiling the copies. The responsible authority shall comply inunediately,ifpossible,with any request made pursuant to this subdivision,or within five days of the date of the request,escluding Sahu days,Sundays and legal holidays,if immediate compliance is not possible. lf he cannot comply with the request within that time,he shall so infoi�n the individttal,and may have an additional five days within which to comply with the request,excluding Satttrdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complzte. Ai�individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall no[ify in writing the responsible�uthority describing the nature of the disagreement.The responsible luthority shall within 30 days either: (a)con�ect the data fo�md to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,induding recipients named by the individuxl;or(b)notify the individual that he believes the data to be coirect. Data in disoute shall be disclosed only if dte individual's statement of disagceement is included with the disclosed data. The detennination of the responsible audlority 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 inforn�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: I. The inforniation 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 pemiit or license. 3. The infoi7nation may be shared with other local, state or federal agencies to the extent necessary to process the pernlit or license. 4. If your requested pennit or license requires Council action to approve, some information may become public. �. 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 pennit. �4-U/!� �L..)�(L �'e /C/�St��J First Mi� Last .� � - Address Cit�� State 7ip Phone � -- I c�erst d n� r'sghks as s e bove ign re �? C\� DATE TIME � CITY OF ORONO /ALLED IN �T/��/�� INSPECTION N TICE _ SCHEDULED __=�1�`'�/G� � PERMIT NO. COMPLETED ADDRESS � �/� �� /�� // �� OWNER CONTR.�0 �, /J, TELEPHONE NO! '�� ` ��`f C�g / � � DESCRIPTION / � � 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 � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � w e � J 0 a � 0 � W � Q � Z W � W � j O W WORK SATISFACTORY:PROCEED PROJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the n x inspection 24 hours in advance. (952� 249-46�� OwnerlCon c o sit : Inspector. White Copyllnspecior's File Canary CopylSite Notice