HomeMy WebLinkAbout2001-P04727 - re-roof CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po4�2�
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: �2ii4i2oo1
SITE ADDRESS: 1375 Cherry Pl
MOUND,MN 55364
P ID: 08-117-23-32-0024
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Buildin Census Code O/S- Building
Permit Class: g
Permit Type: Minar Alterations Permit Sub-type(s): Building- Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 125.25 Valuation: $ 5,99195
State Surcharge Fee: $ 3.00
TOTAL FEE: $ 128.25
APPLICANT: Lake Wood Roofing& Siding QWNER: D H BOYD&C K BENSON
610 13th Ave. 1375 CHERRY PL
Hopkins, MN 55343 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
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI A PERMITEES NATURE ISSUEDBYSIGNATURE
Copies: 1-File�Signitures Required). 1-Apolicant_l-Monthlv Reaorts, 1-Assessine. 1-Finance Page 1
- .
Total Fee: $ Ia-�.a� Date Received: /� -/y-0/
Entered By: ,��,yyL, Permit#: ����j -�� -7
CITY OF ORONO - BUILDING PERNIIT APPLICATIOl`�T
All information must be submitted in full before plan review will be started.
(please print all information)
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TI3E APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �I ZIp:
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NA1�iE OF OWNER: PHONE: (home) �.� a'� `�'��j
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(work) �
MAII..ING ADDRESS: , CITY: ZIP: C�
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CONTRACTOR• �. PHONE: q'�j��c3�c��
CONTACT PERS N: MOB GER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #��Q/�/���'
ARCHITECT/ENGL�TEER: PHONE: _�--�
MAILING ADDRESS: T�ry���� ZIP:
N REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain:
STORIES: � SQ. FEET OF EACH FLOOR: c,� fli'
NO. OF BEDROOMS: GARAGE STALLS: ATT. L DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ `7
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 pernut and work is not to start without a
pernut; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNA • (! w DATE: � ` —
NOTE! Parade of Flomes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
, -
Sec.13.04 RIGH'TS OF SLJB.JECTS OF D�TA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be scored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara conceming himself shall
be informed of: (a) the purpose and inrended use of the requested data within the collecting'state ageacy,poliacal subdivision,or statewide sysum;
(b)whecher he may refuse or is legatly required to supply che mquesced data;(c)any lrnovm consequence arising from his supplying or refusing to supply
privace or confidentiai dara;and(d)the idenriry of other persoas or enaaes authorized by sta[e or federal iaw to receive the data. This requiremenc shall
not apply when an individual is asked to supply invesrigadve dara, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the noace rewired under this subdivision in the individual income tax or properrv tax refund
instructions inscead of on those forms.
Subd. 3. Access to data b�individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of scored data on individuais,and whe[her it is classified as public, priva�e or confidendal. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown che dara wichout any charge to him and, if he desires, shall be informed of the content
and meaning of[hat data. Afrzr an individual has been shown�he private data and informed of i�s meaning, the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuanc co this secrion is oending or addidonal data on the individual has been cotlected or creared.
The responsible authoriry shali provide copies of the privace or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesring person to pay the actual cosu of makine, cerrifying, and compiling the copies.
The responsible auchoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of
the date of rhe request,excluding Saturdays,Sundays and lega!holidays,if immediace compliance is not possible. If he cannot comply with the requesc
within that time,he shall so inform che individual,and may have an addidonal five days within which co comply with che 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 chis righc,an individual shall nodfy in wriring�he responsibie auchoriry describing�he nacure of the disagreemeoc.
The responsible authoriry shall wichin 30 days either: (a)correct che data found to be inaccurate or incomplete and attempt to norify past recipients of
inaccurate or incompiete dara, including recipienrs named by che individual; or(b)notify the individual tha[he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinadon of the responsibte auchoriry may be appealed punuan[to the provisions of the adminis�aave procedure act relaang to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "RiQ.hts of subjects of data", we would like to inform you that your request
for a pernut or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified thar.
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 Ciry deny the permit or license.
3. The information may be shared wi[h ocher local, state or federal a�encies to the extenc necessary to process
the pemut 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 N1.S. 13.04 (available upon request) [o review private data on yourself.
6. Your full name is required to process this application or permit.
Firsc �tiddle Lasc
Address
C�h, State Zip Phone
I understand my ri;hts as stated above. �
�
Signature