HomeMy WebLinkAbout2001-P04182 - re-roof • . PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po4ts2
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: gi13i2oo1
SITE ADDRESS: 1385 Cherry PI
MOUND,MN 55364
P I D: 08-117-23-32-0001
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Permit Class: Building Census Code O/S- Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 153.25 Valuation: $ 7,689.00
State Surcharge Fee: $ 3.85
TOTAL FEE: $ 157.10
APPLICANT: Chrristians�nc. OWNER: T B BATES&D E BATES
1480 Park Rd. 1385 CHERRY PL
Chanhassen, MN 55317-0000 MOUND MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE W1TH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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PL AN"C PERMITEE SIGNATURE ISSUEDBY SIGNATURE
Copies: 1-File(Signitures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
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Total Fee: $ f ��. � � Date Received: �-/ � --p i
Entered By: ,�/�"L-- Permit#: /�O �-f���-
CITY OF ORONO - BUILDING PERMIT APPLICATION
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 OR CONTRACTOR
JOB SITE ADDRESS: �.3 S � �✓',n `�)G�� 2 ZIP:
NAME OF OWNER: /��yr� ��, ��i��S PHONE: (home)
(work)
MAILING ADDRESS: �'yq�,� CITY: �, /1 a Nv ZIP:
CONTRACTOR: �'� ,�,'S�,a,�i -� `'J�- PHONE: �'rlS�2� �jo ��c� 1
CONTACT PERSON: Gc��; � MOBILE/PAGER:
MAILING ADDRESS: f `-/�v � jZc,� CITY: C�9�✓ ,g}J�.� ZIP: S53%7
STATE LICENSE: # 3 712.
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: /�t'A� ^ C'�'� f �{- f�oc�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � ��'9 vo
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.
APPLICAlVT'S SIGNATURE: �-�'�'�-- DATE: � r ( 3/ 0 I
NOTE! Parade of Homes even s equire 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 RIGHTS OF SUB.TECTS OF DaT,1
Subd. i. Type of data. The rights of individual on whom[he data is stored or co be scored shall be as set focth in this secaon.
Subd.2. Information required to be given individual. ?.n individual asked to supply private or confidenrial data concerning himseif shall
be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, political subdivision, or statewide system;
(b)whether he may refuse oY is legally required to supply[he requested data:(c)any{mown consequence arising from his suppiying or refusing to supply
private or confidential data;and(d)the identi[y of o[her persons or entides au[horized by state or federal law to receive the data. This requirement shall
no[apply when an individual is asked to supply investieaave daci, pursuant ro secdon 13.82, subdivision�, to a law enforcement o�cer.
The commissioner of revenue mav place the norice reouired under this subdivision in the individual income tax or propem tax refund
instructions ins[ead of on chose forms. _
Subd. 3. Access to data by indi�ldual. 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 conftdenaal. 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 charge to him and, if he desires, shall be informed of the con[enc
and meaning of[hat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hun for
six months thereafter unless a dispute or acdon pursuan[to this secaon is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately, if possible, wi[h any request made pursuant to this subdivision, or within five days oY
the date of the request,excluding 3aturdays,Sundays and leeal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform[he individual,and may have an additional five days wi[hin which[o comply with the request,excluding Saturdays,
Sundays and tegal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate
data conceming himself. To exercise[his rieht,an individual shall nonfy in wriung the responsible authoriry describing�he narure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to no[ify past recipienu of
inaccurate or incomp(ete data, including recipients named by the individual;or(b)notify the individual[hat he believes[he data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
Ttie determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relacing 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 reauest
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the pernut 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 with other local, state or federal agencies ro the extent necessary to process
the pemrit or license.
4. If your requested pernut or license requires Council action to approve, some information may become
pubiic.
j, 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 permit.
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I understand my rights as stated above.
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Signature �