HomeMy WebLinkAbout2004-P08215 - windows � ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Pog2is
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: iii22�2o04
SITE ADDRESS: 2805 Casco Point Rd
� Wayzata,MN 55391
P I D: 20-117-23-32-0015
DESCRIPTION:
Proposed Use: Religious
Buildin Census Code O/S-Building
Permit Class: g
Permit Type: Minor Alterations Permit Sub-type(s): Windows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 125.25 Valuation• $ 5,549.00
State Surcharge Fee: $ 3.30
TOTAL FEE: $ 128.55
APPLICANT: Harmony Homes Inc. OWNER: Roger Frommelt
3158 Viking Blvd. 2805 Casco Point Rd
Wyoming, MN 55092 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STWCT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE � ISSUEDBY SIGNATURE
Cooies: 1-File(SiQnitures Required), 1-Avvlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Total Fee: $ ,'")o � �� Date Received: j'/-�� ��
Entered By: ��— Permit#: ,�� ��i�
CITY OF ORONO - BUILDIN�G PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all i�iformation)
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THE APPLICANT IS: (circle o�ze) OWNER OR CONTRACTOR
1
JOB SITE ADDRESS: ��$[�S C���� ,(��v��- � ZIP:��3�'�1(
Will this be a Par e of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �. o If yes, a special event pe��mit is requiYed with Police Department a�zd City
Council approvczl 60 clays pr�ior to tJze everat. Non permitted events will fiot
be allowed. �
NAME OF OWNER (— �C�'� ��-�-- PHONE: (home)��a ' C�?(' ��35
(work)
MAILING ADDRESS: o��US ��fC� l�U.v�-+ GQt( CITY: ZIP:S���
CONTRACTOR: `H�' ✓►-�e � PHONE: �G 3-�%3�- ��uv
CONTACT PERSON: � � MOBILE/PAGER:
MATLING ADDRESS: C` ✓( � CITY: ' � � 7IP: S���a
STATE LICENSE: # t�p �a
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition Move
Remodel/Alteration� Land Alteration
PROPOSED WORK(describe irz detai�: .�5�-� �.1 l� ��-✓ �Il-,�U�/� ti ���
�-�.�2 7 i� ��J �rz,,,,,�;-�c, /\�e�)er(
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
G�___
ESTIMATED CONSTRUCTION VALUATION (excluding land): $�S�/� `
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 accordance with
the approved plan.
( .
APPLICANT'S SIGNATURE: � DATE: ��o���
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. Type ot data. Thc rights ot individual on whom the data is stored or to be stored shall be as set forth in this sectio�.
Subd.2. In(ormation reyuired to be given individuaL An individual asked to supply private or confidential data concerning himsel[shall be
informed of: (a)the purpose and intended use of thc requested data within thc collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is Icgally required to supply thc reyuested data;(c)any known conscyuence arising from his supplying or refusing to supply
private or contidential 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,pw-suant to section 13.82,subdivision S,to a law enforccment officer.
The commissioner of revenuc mav �lace the notice required under this subdivision in the individual income tax'or nroncrtV tax refund
instructions instcad of on those forms.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classifed as public,private 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 cliaige to him and,if he desires,shall be informed of the wntent and
meaning of that data. After an individual has bcen shown the private data and informed of its mcaning,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 collected or crcated. 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 maldng,certifying,and compiling the copies.
The responsibfe authority shall w�nply inunediately,if possible,with any request made pu�suant to tl�is subdivision,or within five days of the
date of the request,esduding Saturdays,Sundays and Iegal holidays,if immediate compliance is not possible.If he cannot comply with thc request within
that time,hc shall so inform the individual,and may have an additional�vc days within which to comply with the request,ezduding Saturdays,Sundays
and legal holidays.
Subd.4. Pirocedure when data is not accin•ate or complete. An individual may wntest the accuracy or coinpleteness of public or private data
concerning himsclf. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of tlic disagreemenL The
responsible authority shall within 30 days eithc�: (a)correct the data found to be inaccurate or incomplete and attempt to notify past rccipients of
inaccurate or incomplete data,including recipients named by tl�c individual;or(b)notify the individual that hc bclicvcs the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of dis�greement is included with the disclosed data.
1'he dctermination of thc responsiblc authority may bc appcalcd pursuant to the provisions of the administrativc procedurc act rclating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of sabjects of data",we rvould like to inform you that your request
for a pernrit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are noti�ied that:
1. The information you furnish will be used to determine your qualification for tlie pernut or license requested.
2. Ybu 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 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 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 pernut.
First Middle Last
Address
City State Zip Phonc
I understan ' hts s stated above.
Sign re