HomeMy WebLinkAbout2002-P05822 - re-side ` ' - PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Posg22
Crystal Bay, Minnesota 55323 Pe►'mit Type: MinorAlterations
(952) 249-4600 Date Issued: liisi2oo2
SITE ADDRESS: 2948 Casco Pt Rd
Wayzata,MN 55391
P I D: 20-117-23-31-003 6
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterarions Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolurion#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 993.75 Valuation: $ 100,000.00
State Surcharge Fee: $ 50.50
TOTAL FEE: $ 1,044Z5
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APPLICANT: Donnelly Exteriors OWNER: Paul F.Johncox
2519 E 25th Street 2948 Casco Pt Rd
Minneapolis,MN 55406 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE S►GNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
t . .
Total Fee: $ f D y�, �-S Date Received: ��-�"� Z
Entered By: �'v�� Permit#: 5�'� �-
CITY OF ORONO - BITII�DING 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 OR CONTRACTOR
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JOB SITE ADDRESS: � �j�%� �QS Gv ((o�n l lC� , ZIP:
NAl�TE OF OWNER: �C� 1.� I ��� Y1 G v� PH0�1E: (home) 9�a -Cv�?�
� (work)
�IAILPIG ADDRESS: '���� Cu 5�-��a i n td�CITY: ��Q n �� ZIP:
CONTR.ACTOR: n e I �Yr �- PH0�1E: (G ���7'� _y��?Q c�
CON'TACT PERSON. G r,., �;1�-� MOBILE/PAGER: .
i V I A I L IN G A DDRESS:. S l � S ��.�f CITY: d ' ZIP:�S C�� .
STATE LICENSE: # �
ARCHITECT/ENGINEER: PH0�1E:
`IAILIl�'G ADDRESS: CITY: ZIP:
N�y�: REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �,..R�-�'� +- ��+v2 cc� �`�o �S�' ��r���
�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOI�iS: GARAGE STALLS: ATT. DET.
. ��
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ESTI�i IATED CONSTRUCTION VALUATION (excludi.ng lan�: $ l��,���'
I hereby aoply for a buildin�perm.it and I acknowled�e that the information above is complete and
accurate; �hat 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 pemut and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
, �--, �,� � � `\�; v�r��� DATE: j� - ��
APPLICANT S SIGNATURE:
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NOTE! Parade.Qf Homes events require separate permit approval by Police Department and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
. . •
Sea13.0-1 RIGF3TS OF SUBJECTS OF DaT?.
Subd. 1. Type of data. The rig6cs of iadi�idual on whom the data is stored or m Ue storsd shalI be as sec for[h in chis secaon.
Subd."_'. Informaaon reqirired to be�ven individual. ?.n individuai asked ro suFpiy privare or confidendal data concerning himseif shall
be iafocmed of: (a)che purpose and iar.:nded use of the requesud data within[he collecdng"sa:e ageacy,polidcal subdivisioo,or sncewide rystem:
(b)whe:,'�er he may rfuse or is legally required to si:pply che requesud dara:(c)aay known cobs-"�:=ace arising from his supptyin,or refusing co supply
privace or conr.denaal dara;and(d)the idendty oi o�her persoas or enrides au[horized by stac.or fed�ral taw to receive che dara. This requiremenc s6a11
not apply when an individual is uked to supplv ic�esrigaave dam, pursuanc to secdon 13.82,subdivision 5, co a law enforce�ea�ofFicer.
The commissioner of r enu r�av ol3- che nocc- r-auired under chis subdivision in the individual_income tax or prooem raz refur.d
instrucdons ins.zxd of on those forms.
Subd. 3. ?ucess to data b�indi�zduaI. lipon request to a cesponsible au�horiry,an individual shall be informed�vhecher he is the subjecc
of stor_d dac�on individuals,and whecher ic is clsssified as pubiic,private or confidenaal. lipon his further request, an individual who is the subject
of stor_d priva�t or public dan on indi�•iduals shall be show�n�he dan wi�hout any charge tD h�and,�if he desires, shall be iniormed of the concent
az:d meaniag of ci:ac dac3. After an individual h�c be:n shown che privace dan and informed ot its meaniag,che dara need no�be disclosed to him for
six monchs d:eracter unless a dispute or acrion p�.::suanc to chis secrion is pending or addiaor=! dara on che individual has been collecud or creaced.
The responsibiz au[horiry shall provida copies of che privace or pu6lic data upon request by che i�dividual subject of che dara. Tne responsibie auchoriry
may requir che requesring person to pay the acna!cos�s of making.cerrifying,and compiling �e copies.
'Ihe responsibla authoriry shall compty immediately, if possible, wirh any request s��punuant to this subdivision,or within five days oi
the da[-of rhz request,ezcluding Sacurdays,Sundays and legal holidays,if immediate compliatce is noc possible. If he cannoc comply with[he requesc
wichin chac dme,he shail so iaform[he individuai,u:d may have an addinonal five days wi�hin which co comply wich the request,excluding Saturdays.
Sundays and tegal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may con�est the accuracy or compteceness of public or privace '
dara cor.ceming himself. To exercise chis righc,an individual shali nodfy in wridng che responsicie auchoriry dzscribing che na�u:e of che disagreemzac. .
The responsiblt authoriry shall wi[hin�0 days ei�`_c: (a)correcc[he data found�o be inaceLra:=or incomplece and aaempt to nodfy past recipienu of
inaccurace or incomplete dara, inciuding recipieaa named by che individual; or(b)aodfy tl:a iLdividual thac he believes the dara to be correcc. Da�a
in dispuce shall be dise:osed oniy if the individua:'s sta[emene of disagreement is included wic�rhe disclosed dara.
The de�erminadon of[he rzsponsible auchoriry may be appealed pursuanc to the provisions of tha administrarive procedure act reladng to
con[es:ed cases.
D?,T� PRIVACY ADVISORY
In accordance wich�I.S. 13.04, Subd.2, "Ria.hts of subjecu of data", w�e would like to inform you tha[your reauest
for a permit or license from the Ciry oi Orono or any of its departments may require you to fumish certain private or
confidencial information.
You are notified that:
1, The information you fi:rnish wiil be used to determine your qu�li;ication for the perm.it or license requested.
�. You may refuse to supplv data, buc refusal may require that the Ciry deny the permit or license.
;. The information may be shared with ocher local, scate or federal agencies [o the extenc necessary to process
the permit or license.
.}. If your requested permit or license requires Council action to approve, some information may become
public.
�. You have certain ri�ts under ;�1.S. 13.04 (available upon request) to review private data on yourself.
6, Your full name is required to process this applicacion or permit.
Fitst �fiddle Last
�ddress
Ciry Srace Zip Phone
I understand my ri�hts as staced above. .
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Signacure