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Home My WebLink About2002-P05 - re-roof � �, PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Poss36 Crystal Bay, Minnesota 55323 Permlt Type: MinorAlterations (952) 249-4600 Date Issued: si23izooz SITE ADDRESS: 1480 Bracketts Pt Rd Wayzata,MN 55391 P I D: 11-117-23-33-0005 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 573.05 Valuation: $ 42,979.35 State Surcharge Fee: $ 22.00 TOTAL FEE: $ 595.05 APPLICANT: Western Cedar Supply OWNER: Mark&Laurie Headrick 9700 13th Ave 1480 Bracketts Pt Rd 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. � � �,��---r'..,-�__ ��fiZ�� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 �°lS-�5.� • �i otal Fee: $ Date Received: ?� -�-'� -c��- Entered By: � 1�_- Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started, (please print all information) TIiE APPLICANT IS: (circle one) OWNER O ONTRACTOR , JOB SITE ADDRESS: �f�-C% ��/ �:;CLi'��S ��,^y/-�c�ZIP: NAME OF OWNER: /Z7�l� �J'�'�,c�i'�'c�i� PHONE: (home) �5�-y�G-p6 y� (work) MAILING ADDRESS: ��' CITY: � ZIP• CONTRACTOR: �'L�S'rc,��^ PHONE: CONTACT PERSON: /Z�-rC' MOBILE/PAGER: �1,��{� �/�SS MAILING ADDRESS: ��'`X� � S��i�e- CITY: l � , � ZIP::�`J.�f��/� STATE LICENSE: # ��,��/��a/' -j ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CI1'Y: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure � Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �^�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 35- ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � � 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. APPLICANT'S SIGNATURE: �i°�� DATE: U� �^� � , NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and City Council 60 days prior to the event. Non permitted events will not be allowed. � . . Sec.13.04 RIGHTS OF S[JB.TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be sto�ed shall be as set foith in this secdon. Subd.2. Information reqirired to be given individual. M individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and inunded use of the requesud data within the collecting�tau agency,poliacal subdivision,or sratewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the identiry of other persons or entides authorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve data, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the norice required under this subdivision in the individual income taz or property taz refund instructions instead of on those forms. Subd.3. Access to data by indiridual. Upon request to a responsible authority,an individuai shall be informed whether he is the subject of stored data on individuals, and whether it is classiFied as public, private or confidendal. 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 that data. After an individual has been shown[he private 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 section is pending or addidonal data on the individual has been collected or created. The responsible authority 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 ro pay the actual costs of making,certifying, and compiling the copies. The responsible au[hority shall comply immediately, if possible, with 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 canno[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 individuat shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccu[ate or incomplete and attempt to no[ify past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correcL Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsib(e authority may be appealed pursuant to the provisions of the adminisaative procedure act reladng 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 furnish certain private or confidential information. ' You are notified that: 1. The information you furnish will be used to detemiine 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 pemut 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 fuli name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. �5� Signature