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Home My WebLink About2007-P11701 - re-side PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P117o1 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 11/20/2007 SITE ADDRESS: 1705 Concordia St Unit# Wayzata, MN 55391 PID: 17-117-23-22-0021 DESCRIPTION: Proposed Use: Residential Census Code O/S -Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved perresolution#: Separate permits required: NOTICES/REMARKS: Warranty Work-Reside with vinyl siding FEE SUMMARY: Permit Fee: $ 83�25 valuation: $ 2,730.00 State Surcharge Fee: $ 1.40 TOTAL FEE: $ 84.65 APPLICANT: Protective Home Covering OWNER: Janet Jacobson Sachs 5700 205th St. E. 1705 Concordia St Prior Lake,MN 55372 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 PBRMITEE SIGNATURE 1 SUED BY SIGNATCRE Copies: 1-File(Srgnaticres Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 • Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ ��__ THE APPLICANT IS: (circle one) OWNER OR C�9Ai�'-��'QR JOB SITE ADDRESS: \� l �-`�� " "� � <_.��c ��, ��.c� ��_ ziP: �� 5 3�:�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS �IO If yes, a special event pennit is reyuired with Police Deparhnent and City Council approval 60 days prior to the event. Shuttle bus service wrl/be reyuired unless applicant demonstrates suf�icient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: ��-H � PHONE: (home)�/>�' �`� �'�3`-�� . �- (work) MAILING ADDRESS: � 1�--� C��'{: <<�p��'� ��' CITY:C-t'_t..►'�� ZIP: =:a 3 3� -�,; C; `�C� CONTRACTOR: � ��:��<�V� Nu.r-� ��;.£��+t,�- PHONE: �(,��- �,3.3 } CONTACT PERSON: 1jT�. �- � MOBILE/PAGER: E/� -_�, E�n -3 � 't �% MAILING ADDRESS: .�?��` -��"�+�� `�}- i CITY: 4,��... ��>k t' ZIP: —�5�7,,� STATE LICENSE: # 1�/��-{ EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATlON: # TYPE OF WORK: New Home Addition Accessory Structure Move Hoine Remodel/Alteration (ie: iding, indows) �� Any earth movement may require MCWD review and permits ! PROPOSED WORK(describe in detain: i',�� -; y ��c.,Z� — �5��_ �-��L'%��'� �i<<�`-� � � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_ E �� `-� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ _ � ��r5c:�,1 -��il�' I hereby apply for a building permit and I acknowledge that the information above is complete and accur�te; 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 wi 11 be in accordance with the approved plan. APPLICANT'S SIGNATURE: `�M--��" �-'�-��`� DATE: '" � �� r � �— � 31 ♦ ♦ Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. Thc rights of individual on whom thc data is storcd or ro be storcd shall be as sct forth in this scction. Subd.2. ]nformation rcquired to bc given individual. An individual asked to supply private orconfidential data conceming himsclf shall bc informed of: (a)the purpose and intcnded use of thc rcquested data within the collccting state agency,political subdivision,or statcwidc system;(b) whe[her he may rcfuse or is legally rcquired to supply thc requested data;(c)any known consequcncc arising from his supplying or refusing to supply private or co�fidcntial data;and(d)thc identity of othcr persons or cntitics authorizcd by state or fedcial leu�to rcccivc thc data. This requircmcnt shall not apply when an mdividual is askcd to supply invcstigative data,pursuant to scction 13.82,subdivision 5,to a law cnforcemcnt officcr. The commissioner of revenue mav alace the notice required under this subdivision in thc individual income tax or property tax rcfund instructions mstead of on thosc fornts. Subd.3. Access to data by individual. Upon rcqucst to a responsible authority,an individual shall be informed whethen c�is the subject of stored data on individuals,and whcther it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored privatc or public data on individuals shall be shown thc data without any charge to liim and,if he desires,shall be infonncd of the contcnt and meaning of that data. After an individual has bcen shown the privatc data and informed of its mcaning the data nccd not bc discloscd to him for six months thercafter unless a dispute or action pursuant to this section is pending or additional data on thc individual has been collected or creatcd. Thc responsible authority shall provide copies of the private or public data upon requcst by the individual subject of thc data. Thc responsiblc authority may requirc thc requesting person to pay thc actual costs of making,certifying,and compiling thc copies. Thc responsible authority shall comply inunediatcly,ifpossible,with any request made pursuant to this subdivision,or within fivc days of the date of the request,excluding Saturdays,Sundays and Icgal holidays,if immcdiate compliance is not possible. If he cannot comply with thc 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 accuratc or complete. An individual may contcst the accuracy or completcness of public or privatc data concerning himself. To cxercise this right,an individual shall notify in writing the responsiblc au[hority describing the naturc of the disagrecmcnt. Thc responsible authority shall within 30 days cither. (a)correct the data found to be inaccurate or incomplctc and attempt to notify past rccipicnts of i�accurate or incomplcte data,including recipicnts namcd by the individual;or(b)notify the individuai that hc bclievcs thc dat�i to be con�cct. Data in dispu[c shall bc discloscd only if thc individual's statcmcnt of disa�;rccmcnt is includcd�rith thc discloscd data. Thc determination of thc responsibie authority may be appcalcd pursuant to thc provisions of thc administrativc proced�re act rclating to contes[ed 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 departmcnts 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 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 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 becomc 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 l,ast Address C��y State Zip Phone I understand my rights as stated ab e.~ �� S� e Reset Form 32