HomeMy WebLinkAbout2003-P06608 - re-side CITY G�F ORONO PERMIT
2750 I�elley Parkway - PO Box 66 Permit Number: Po66og
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: v3i�2oo3
SITE ADDRESS: 3826 Cherry Ave
Mound,MN 55364
P I D: 08-117-23-33-0002
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 9�•25 Valuation: $ 4,000.00
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 99.75
APPLICANT: Sun Contractors and Home Improvement OWNER: 7ames&Betsy Martin
2365 Commerce Blvd 3826 Cherry Ave
Mound,MN 55364 Mound,MN 55364
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
M UILDING C QUI ENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1
Totat Fee: $ Date Received:
�Entered By: Pernut#:
CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER O CONTRACTOR�
JOB SITE ADDRESS: � (/ Or0!'�0 ZIP: �
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NAME OF OWNER: J �� ,( PHONE: (home)
(work)
MAILING ADDRESS: � t, CITY: (�r-d v�d ZIP:�G
CONTRACTOR: v�,� PHONE: cj�� �,2 3��
CONTACT PERSON: n, MOBILE/PAGER: a, � o �r
MAII.ING ADDRESS:02����►•�.��L [Sl�G� CITY: w� ZIP: 5�,3 �
STATE LICENSE: #o2Qo� 'I 3 Sr
ARCHITECT/ENGINEER: ,A- PHONE:
MAII.ING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WO (describe in detai�: ��S'ir�(2 �aae. � /�� C q �a��`
, �,,� j ��
STORIES: �_ SQ. FEET OF EACH FLOOR: A-
NO. OF BEDROOM5: �/k GARAGE STALLS: ATT. �. DET. Z
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �QQQ �
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 i e with the approved plan.
APPLICANT'S SIGNATURE: DATE: 3
..
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed'.
.
Sec.13.04 RIGH'TS OF SLJB,TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set fonh in this secaon.
Subd.2. Information reqirired to be given individual. M individual asked to supply private or confidenaal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wirhin the collecting'state agency,polibcal subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idenriry of other persons or enrities authorized by state or fedecal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesagadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the nodce reauired 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 authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whe[her it is classified as public,private or confidential. Upon his further request,an individual who is the subject
of stored private or public data on individuals shatl be shown the data without any charge to hun and, if he desires, shall be informed of the content
and meaning of that data. Aftzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addiaonal data on the individual has been collected or created.
The rasponsible 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 authoriry shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise[his right,an individual shall norify in writing the responsible authoriry describing[he nature of the disagteement.
The responsible authoriry shali within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipients of
inaccunte or incomplete data, including recipients named by the individual;or(b)noafy the individual that he be(ieves the data to be correct. Data
in dispu[e shall be disc(osed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the admuilstraave 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 inform you that your request
for a pemut or license from the City of Orono or any of its departments may require you to furnish certain private og
confidential information.
You are notified that:
1. The information 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 perinit or license.
3. The infarmation may be shared with other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested permit or license requires Council action to approve, some information may beco�e
public.
5. You have certain ri�hts 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 permit.
����� —
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as st ed above.
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Signa