HomeMy WebLinkAbout2002-P05747 - re-side � '� PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway - PO Box 66 Pos�4�
Crystal Bay, Minnesota 55323 Pe►'mit Type: Minor Alterations
(952) 249-4600 Date Issued: ioi22i2oo2
SITE ADDRESS: 4315 Chippewa La
MAPLE PLAIN,MN 55359
PID: 31-118-23-42-0010
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Pernut Class: Building Census Code O/S-Building
Permit T e: Minar Alterations Permit Sub-type(s): Building-Re-Side
Yp Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUIIIIMARY: PermitFee: $ 265.25 Valuation: $ 16,000.00
State Surcharge Fee: $ 8.50
TOTAL FEE: $ 273.75
APPLICANT: Western Remodelers Inc. QWNER: GREGORY HALLDIN ETAL
2520 W. Larpenteur 4315 CHIPPEWA LA
Lauderdale, MN 55113 MAPLE PLAIN MN 55359
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUI ENTS.
��
` APPL NT PERMITE IG URE ISSUED BY SIGNATURE
Copies: 1-File(Sienitures Re�uired), 1-Apolicant 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
� a
Total Fee: $ � 7 :3 � 7� Date Received: 1����-�d�
Entered By: ��— Permit#: /�D.>7�f7
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 CONTRACTOR
.�-
JOB SITE ADDRESS: � 3� � C--��r�J,��'��FI �-1'� ZIP:
NAME OF OWNER: �1, ��� 1�� 1"�-��� � �,� PHONE: (home) `� 5�-- y�3
�-- IL p (work) '�0 � )
MAILING ADDRESS: u� � S C�1 ��U��'(d CITY: �` r�r, � ZIP:
CONTRACTOR: v��s i-�R�� R-�r���I Q s� PHONE: C� i -6� �- � �I � I
CONTACT PERSON: ;\c� S��� MOBILE/PAGER: 6i2 �I j�{ 2��
MAILING ADDRESS:� 52�� - ����j\l�l� /��� CITY: �j �����L. ZIP: SS/ �
STATE LICENSE: # � '-�
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�: '�'�S�R�� `�����/ �'(�XJ� �v '��J� S�/�� ti�
J � L w� ��c�„�---� ��\�-.r—�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� O� �=�
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 w' the a proved plan.
�
APPLICANT'S SIGNATURE: ` DATE: I �" Z� -� ���
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 RIGIITS OF Si1B.TECTS OF D�TA
Subd. 1. Type of data. The righrs of individual on whom the 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 confidenrial data concerning himself shall
be informed of: (a)the purpose and intended use of the requested dara wi[hin the collecting'state agency,polidcal subdivision,or sratewide rystem;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or refusing to supply
private or confidenval data;and(d)the identiry of o[her persons or enrides auchorized by state or federal!aw to receive the data. This requirement shall
not apply when an individual is asked to supply investigaave dara, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or property taz refund
instructions instexd of on those 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 whecher 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 shall be shown the data without any charge to him and, if he desires, shall be informed of the content
and meaning of rhat data. After an individual has been shown the private data and infoaned of its meaning,che data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or additio�al 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 authority
may require the requesting person to pay the actual costs of making, certifying,and compiling the copies.
The responsible authority shatl comply immediately, if possible,with any request made pursuant to this subdivision, or within five days of
the date of the request,exciuding 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 additional 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 this right,an individual shall nodfy in wri[ing the responsible authoriry describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipients of
inaccurate or incomplete data, including recipiencs named by [he individual; or(b)nodty the individual[hac he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible au[horiry may be appealed pursuant to the provisions of the administrarive 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 permit 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 that:
1. The information you furnish will be used to deternune your qualification for the permit 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 other local, state or federal a�encies 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 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 application or permit.
First Middle Last
Address
Ciry State Zip Phone
nderstand my rights as s ed above.
\
`,
�. �
Signatu