HomeMy WebLinkAbout2002-P05559 - re-roof CITY�F ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Posss9
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: g�2s�2ooz
SITE ADDRESS: 2975 Casco Pt Rd
Wayzata,MN 55391
PID: 20-117-23-31-0045
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 335.25 Valuation: $ 20,600.00
State Surcharge Fee: $ 10.80
TOTAL FEE: $ 346.05
APPLICANT: �'illiams Construction OWNER: Stewart&Kathleen Perry
5318 Jersey 2975 Casco Pt Rd
Crystal, MN 55428 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
M SOTA BUILDING CODE REQUIREMENTS.
,, '
�
� �
APPLICANT PERMITEE SIGNATURE [SSU BY SIGNATURE �%��
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1
Au�-26-2002 11:48am From-CITY OF ORONO +Q622494616 T-906 P.001/002 F-693
Total Fee: $ Date rtecei�ved: _
Entered By: Permit#:
cY� oF o�o�ro - BL�LDING P�R1V�T AP�'�.ICATION
All informatian must b� su�rnitted in full before plan review will be started.
. . .
(please pnnt adl infamrat�on �
���----------------------------�-- ---=__�----------�}-------T---------�_
T�IE APpLICANT IS: (circle one) OWNER 4 C4NTR.ACTOR
,
JOS SI'�'E ADDR�SS: ���� �� �ftS��-�i � ZIP: � 3�
AIVIE Q�' 4WN�R: "f�� l/�.�r� P�O1VE: (i�ome) J�2 �f' —����
N �� f .
, (work) _
ME�I�LING ADAR�SS: ` c' '�"l5J �k35�--r �� C�TX: G���`t: ZIP:,��'�,,,
C(]NTRACTOIt: V�i � � '
'r-S?czuc���n� PxoxE:(��o �33-3��c�
CONTACT P�itS4N: t 5c b.cl� MaBlZE/PACER: — � �� cF�'"`
NTAILIN�AbDRFSS: �
CITY: '�� ,� ZYP:.S_,S`�z„� `�
STATE LICENS�: �# -���� �
A.�tC�TECT/ENGINEER: PHONE:
� MAI.LIl�IG A:DDRESS; CITY: ZIP: .
NA1V�: REG�IS�.'RATION#
.r+Yp� p� Wpgg; N�w Additian Accessory Suucture
�o�,� Remodel/Alteration Land Aheration____�_
�
� ', ` �� �� �� i '`�`�
PRQP�SE QRK(describe in detai�:
� � �� � �� �
STOR�S: SQ.�T OF F{ACH FY.OQR:
Np. QF BEDROOMS: � G�ARAGE STALLS: ATT. DET.
ESTIMATED C4NS7.'RUCTIQN VAY.YJATION(excluding land): $ ,��� �;��%
T hereby apply for a building permit and Y a�cknawledge that the informatian above is compleie an�l
accurate; that die work will be in canfarmance with the ordinances and codes of the City and with
the State Building Code; that I unde�ys chis is not a permit and work is not to start withaut a
permit; and that tb.e work will be ' a. rdance with the oved plan.
--,
AP
PT.ICaNT�S SIGNATURE: � � � ' DATE: � �(d �
NQrE! � � events require separate permrt approval bY Police Department and
City Council 60 duys prior tn the event. N�n-permitted events will not be alIowed.
Au�-26-2002 11:48am From-CITY OF ORONO +9522494616 T-906 P.002/002 F-693
.
Sec.13_04 RIGF�'f5 OF SEJ�ECTS O�Y?.�TA
Subd. 1_ Tyge of da�3• Th�riShrs of individcaal ou whocu dnc dsra is szorCd or to be sta�d shall bc as sct fOrch in this scc4Qn•
�u�.�,,. �Qrm3poa required to be given iudividnal. An+ndividuai askcd[o supP�Y P�vau or confidential dara cancecning himsclP shaIl
ba infonned of: (a)rhe putgose and inccnded use of the requcs►td dara wichin the cpUectwg�tar�agency,po[iucal subdivision,or sracewidc sysrem;
(b)w6ether he maY tefuse or is legally tcquired ro supply the rcquas[cd es�a;(c?anY lmown cansequcnce arising from kus supplying orrcfusing w supP�Y
priva�c or confidendal data;attd(d)�he idenpcy of acher pcisans or ee�des aushorized by sn�e or fade�Iaw to s-eeeive the data• Ttus requireiaenc shell
�qi appiy when an indsvidu�is a�ked to supply imesti83ave ds�a.pursc�an�w seedon 13-82.subdivision 5, to a!aw e�or�Cmen�o�cer.
Tha commis ioner af te.�cr�a� mav lace the nORCe rc013tfcd OPdcC fhis subdivision in �hc ind�viduai income rax or ro em tax rcfu�d
irtS��C[inns insuad 4f G}1�hnBe famis.
Subd•3. Aecess�o da�a by indiridaai. Upon reques�Lfl�a�or confidc a�alryUPon h�Is�fu���q es�an�mdiv daal�who s tlie u6ject
of�[orcd dafa on ittdi�iduals,and wher�ar it is classificd as public, p
of sio�sd privaao or public ds�a on individuals shall be shnwn�h�da�a w'thvut sny chars��o��•if hc dairC�,shaU be informcd of�hc con�cat
and mearung E��d���dl5pu�os'crian pursuac�cho ch'�s secdoe s pandinS Oad �id aonaltdan on�the i�ai��uat�h��a�o►►��ed o�crexctdr
six mOn[hs th
Tha responsible auchoriry Shafl provide copies of dro private or public ce up n �nd com il'ul �hcico i�bjac�of the da�a. "fhc sespoasible aurhonry
may requirc che requesting person w pay d1e accual cos�s af ma3cing. �Y S. A S P
Thc responsible auchoriry shall�omply immcd�ateiy,if possihlo, W+�►�Y rcQues�made pursuant co diu subdivision,or wiihin fiv<days 4f
tne dace of�he reques�,cxcluding Sacurdays,Sundays a�td 1cga1 ha�idays,if immtdiatC campliancc is no�possiblc�I��c�u��'npclud'ec�Saairdaysi
wichin tha[dme.hc slialt so its�arm�e ir�dividusl,and maY haYe an addidonal ft�e days wirhh�n which ro cvmply
5titndays Aitd k$al h4lidays.
gu�,q, praccdure when data is aoc aeeur�te or complcte. An ind�vidual may conres�the accuracy or complereness of public or pri�•a�e
daw eoncers�ing himsClP. 'I'a exercisc d�is ri�h�,an i=tdividual shall nodgi in wr+rin�d►e responsible aurhoriry describing�se nacure of tha dis�gtecmea[.
'I'he resQonsibte om�e c duraa`�nciud'u,S�yPientsenam deby��e�aaaa��o�cb�fla�the�individualmd�ac[tre bel'it es�hc da�a io beycorrec�� Da�
inaccurx�or tinc p
�dispuce shall be discEosed only if�he individual's ssatemenc of disagrezmeni is included with�n disclvsz ��-
Thc docermination of thc raspoesiblc audtonry maY bc appz�lcd pursaazu tu d►a pravisions of the adm'tnisQarive proccdurc acc rcEaang co
con�esced cases.
DATA PRrVAC'Y ADVISORY
In aecordauee wl�o��e�ry of Orono or�y of cs deP��ents9 inay equ re you o furn sh cetcain privace or
for a permit ar llcens
confidential information.
You are noti��ed that:
1, 'The information you furnish wiil be used�o deLermine your qualifiCa�ion for the permit or license requested.
2, You may rcfuse �o supply daia, but refusal iriay require tha[ Che Ciry dG�y thc permi� or license.
3, 'T'he informaiion may be shared with other lacal> state or federal ageacies ta zhe�xient necessary to process
the permit or license_
�}. If your r�quested permit or lieense requires �ouncil action to agprove, some inform3tion inay become
public.
5, You have certain tights under M.S. I3.Q4 {availabie upan request) to review private da�a on yoursclf.
b_ Your full naule i$ required co process this applicat� or permit_
/. �
s �
�' � r��aa�� ��
F;rs� � 1�wi��0�✓►-�, ��t
G �i ,--
Address '� �_ �� �� ��� ��� �f �
G °�� Z�� phonc 2L���
Smce
Ciry �
/
I unde t y rig$ts-a�-stazed above.
� .
Sirnsn+re