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Home My WebLink About2002-P05908 - re-roof � � CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: pos9os Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 12�i3�2oo2 SITE ADDRESS: 121 Chevy Chase Dr WAYZATA,MN 55391 PID: 36-118-23-41-0016 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernlit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: � 139.25 Valuation: $ 6,500.00 State Surcharge Fee: $ 3.75 TOTAL FEE: $ 143.00 APPLICANT: �'�'esturn Roofing OWNER: LOUIS B OBERHAUSER 9700 13th Ave 121 CHEVY CHASE DR Plymouth,MN 55441 WAYZATA MN 55391 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. �� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURF, Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 , •i. Total Fee: $ Date Received: �Z "� � �� Entered By: �1�� Pemut#: � �� CITY OF ORONO - BUILDING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. - (please print all information) �-_ ---- ----------------------------------------------------------------------�- ` - - - ----=�-�------------------- THE APPLICANT IS: (circle one) OWNER OR`E-�IN�'R,ACTOR � ---__ _._---__ JOB SITE ADDRESS: ��{ C�vr��`�Se ��v� ZIP: �S ��l NAME OF OWNER: �� C�{'��' PHONE: (home) y'Sa-/o�/- �.�2 f/ (work) MAII.ING ADDRESS: j�'j;�� CITY: we 7� c ZIP: 55� CONTRACTOR: r,t,�s-�r� ��.�i'nG� PHONE: �� —S//-�5�Y CONTACTPERSON:��/f 1�}rG MOBILE/PAGER: hlati�a ��5 MAILING ADDRESS: � , /,3 J` -- � CITY: ZIP: ,5s,�/� STATE LICENSE: #_�� , ARCHITECT/ENGINEER: PHOI�TE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New (� Addition Accessory Structure Move Remodel/Alteration Land Alteration �- n PROPOSED WORK(describe in detai�: 1 - �- ��'Q'�( _ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� j�� I hereby apply for a building pernut 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 permit; and that the work will be in accordance with the_approved plan. APPLICANT'S SIGNATURE: �` DATE: / � 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 RIGHTS OF SLIBJECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom che data is stored or to be stored 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 concerning himself shall be informed of: (a)-the purpose and inrended use of the requested data within the colleccing'stace agency, poliacal subdivision,or statewide system; (b)whether he may refuse ot is legaily required to supply the requested data;(c)any Imown coasequence arising from his supplying or refusing to supply private or confidential data;and(d)the ideaary of other penons or enades authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara,pursuant co secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or properN taz refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a respoasible au[hority,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her it is classified as public, priva[e or confidenaal. Upon his funher request,an individual who is the subjec� of stored private or public data on individuals shall be shown che data wichout any charge to him and,-if he desires, shall be informed of[he content and meaning of that data. Ahzr an individual has been shown the privace 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 addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of[he private or public data upon request by the individual subject of the data. The responsible authoriry may require the requescing person to pay the actual costs of making, cemfying,and compiling the copies. The responsible authoriry shall comply immedia[ely, if possible,wi[h 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 chat time,he shall so inform the individual,and may have an addidonal five days within wtuch to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An mdividual may contest the accuracy or completeness of public or private data concerning himself. To exercise[his righc,an individual shall nodfy in wriring the responsible authoriry describing che nature of the disagreement. T'he responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual thac he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreemenc is included with the disclosed data. The decerminacion of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relaang 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 permit or license from the City of Orono or any of its departments �,ay 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 perm.it or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with ocher local, state or federal agencies to the extent necessary to process the permit 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 M.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this applica[ion or permit. First Middle Lasc Addmss Ciry Srate Zip Phone I understand my ri;hts as stated above. / Signature ORONO ADM2�3IS�RATN� �FF=�S INFORMATION DISCLOnA�EPR CTICES B.CT � 2�4SNNESOTA GO • gEQIIES2'F�Z NO�E- A. Request Frequency - Private D a infor�rcedi of itsSmeaninJ. the have been supplied the aata an ou for six r�on'r..iis thereafter data aeed not be disclosed t� 1'endinq vr adaitional data -on unless 'a dispute or action is p you .has been col.I.ected. B, you may be reauired to pay actual costs in making, certifying and/or compiling the co�ies o= infornation requested. � Date of Request: . � �-_-� �, 1 �1 -f--�,. �,_ , ,,",,� ,. Requester Name: - . City: p�ddress: zip" �. � � ��f �� '' '"�L ��c.� :>�'� • �.� � `,� .a.� �.��- ,f Home Phone-�� ?1 3 � y' � �(D� Busi.nes s: Description of =nf�rma�on Reuueste3: c� ��. �� ..__... t _, '`� �,� '�<...-..e'. '7 ��y `-!''. ; '� geques�er'. s Signature: ,. ._r.�,�--.. .-_ .._ .,. ...� Bgy0y7 INFOFLMATION TO BE FII�LED IN BY DEPAR�MENT �NI'Y Handled Bys D ep art�ent= Mai1 Phone gequest Type= _In Pe'-"son . — — Subjec� o= Data Not Subject of Data gequested $y= ` ested is Classified: �unZi� Private �fo�ation Requ .--- Conf idential Noa-?ublic =rotected Non-Public Denied P_nproved in_Pat Request is: Aporoved — Remarks/Ca�ents: Anth orize3 Signature: / ` = S Fees:• X Total Due ._ No. of Pages Rate per Page