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Home My WebLink About2001-P04610 - re-roof CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Poa6io Crystal Bay, Minnesota 55323 Pet-mit Type: MinorAlterations (952) 249-4600 Date Issued: 11�9i2ooi SITE ADDRESS: 2215 Bayview Pl Wayzata,MN 55391 PID: 17-117-23-44-0026 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Census Code O/S- Building Permit Class: 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: $ g3•25 Valuation: $ 2,200.00 State Surcharge Fee: $ 1.10 TOTAL FEE: $ 84.35 APPLICANT: Owner/Self OWNER: Robert&Johanne Hazard MN 2215 Bayview Pl 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. r 'f;�,�,J�..� C;��['/�Cki' � APPLICANTPERMTEE NATURE ISSUE BYSIGNATURE Copies:1-File(SiQnitures Repuired), 1-Apolicant, 1-Monthlv Reports, 1-Assessin¢. 1-Finance Page 1 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) ----------------------------------------------------- ---�-------------- - - - - - - -------------------------------------- T�iE APPLICANT IS: (circle one) �QWNER�R CONTRACTOR JOB SITE ADDRESS: �:� /✓�' ��Vi��-� ��Q�� ,v��z��ZIP: S`�5��9 / NAME OF OWNER: ��,�E y�� /�� PHONE: (nome) 9s�-y7/- 79� 9 (work) MAILING ADDRESS: .��/s ��G%�� ,1��Q _ � CITY: � zlz 2 ZIP: .J.J"��> / CONTRACTOR: �S,E�f PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAII.ING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF `VORK: New Addition Accessory Structure Move Remodel/Alteration_� Land Alteration PROPOSED WORK (describe in detai�: �S c Y c SG � � � � 1�'E -, , STORIES: ��_ SQ. FEET OF EACH FLOOR: NO. OF BEDROOl�1S: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ,�,3, �'�� 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. ��-;fr� APPLICANT'S SIGNATURE: � , ��J ��_ �_ DATE: /l�j �; / _ 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 STJBJECTS OF DATA Subd. 1. Type of data. "Ihe righcs of individual oa whom che data is stored or co be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be givea individual. An individual asked to suppiy private or confidenual data concerning himseif shall be informed of: (a)the purpose and intended use of the requested data wi[hin the collecdng"state agency, polidcal subdivision,or sratewide rystem; (b)whether he may refuse oY is legally requicEd to supply[he requested data;(c)any irnown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the idenriry of o�her persoas or endaes authorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigadve dara,pursuant to section 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�•enue mav place the norice reauired under this subdivision in the individual income tax or propertv tax refund instructions instead of on[hose forms. Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject of scored data on individuals,and wherher it is ciass�ed as public, private or confidendal. Upon his further requesc, an individual who is the subject of stored private or public dara 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 chat data. Aftzr an individual has been shown the privare data and informed of ics meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acaon pursuanc to this secrion is oznding or addiaonal data on the individual has been collected or created. The responsible au[horiry shali provide copies of the private or public data upon request by the individuai subject of the dara. The responsible authoriry may require the requesring person to pay [he actual costs of makine, cerrifying, and compiling the copies. The responsible authoriry shall comply immediately, if possibie, 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 wirhin that time,he shall so inform che individual,and may have an addiaonal five days within which to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Ptocedure when data is not accurate or complete. An individual may contest the accuncy or completeness of public or pri�•ate data conceming himself. To exercise chis right,an individuai shall noafy in writing the responsible authoriry describing rhe nature of the disagreemenc. The responsible auchoriry shall within 30 days ei[her: (a)correcc che data found to be inaccurate or incomplete and attempe to norify past recipienes of inaccurate or incomplete data, including recipients named by [he individual; or(b)nodfy the individual thac he believes the data to be correcc. Data in dispuce shall be disclosed only if the individual's stacemenc of disagreement is included wirh the disclosed data. The de[erminarion of the responsible auchoriry may be appealed pursuan[ro the provisions of the adminis�dve procedure act relacing to contested cases. DAT� PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Riahts of subjects of data", we would like to inform you that your reauest for a permit or license from the Ciry 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 determine your qualification for the perm.it or license requested. 2. You may refuse to supply data, but refusal may require tha[ the City deny the permit or license. 3. The information may be shared with o[her 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 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. � G " r �Cr First � b1i�1�Q � Last � l Address � � C�� 5��-�� - - - `'� � Ciry '. l State Zip Phone I understand my ri�hts as stated above. Signatu