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Home My WebLink About2008-P12038 - windows PERMIT CITY OF ORONO 275U Kelley Parkway- PO Box 66 Permit Number: p12o38 Cr�stal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 6/4/2008 SITE ADDRESS: 2450 Countryside Dr Unit# Long Lake, MN 55356 P�� 04-117-23-11-0004 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 132.75 , � Valuation. $ 5,184.00 State Surcharge Fee: $ 2.60 Misc.Fee: $ 1.50 TOTAL FEE: $ 136.85 APPLICANT: Renewal By Anderson OWNER: L Kretchman&S Grande 1920 County Rd C.West 2450 Countryside Dr Roseville, MN 55113 Long Lake MN 55356 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. � /��; C.iiti �b�{( APPLICANT PERMITEE SIGNATURE UED BY SIGNATURE �% Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(Tf Septic, 1-Septic) Page 1 w � • !, (� ��Y \ 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 inforrrzation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �y Sb ��`(1�TS1(�1'�, ��.. ( � ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO /f yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficrent on-site parking rs available. Non-permitted events will not be allowed. NAME OF OWNER: �� -�. �(D�`�`C�. PHONE: (home)�-�b�• U�s'�Jy� /� (work) MAILING ADDRESS: , CITY: ZIP: Renewal By Andersen CONTRACTOR: 1920 County Road °C" West PHONE: CONTACT PERSON: . � AGER: MAILING ADDRESS: Roseville. M1V 5511� ZIP: — License #20li0983 STATE LICENSE: # 651-264-4777 DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits! PROPOSED WORK(deseribe in detain: C.� '' �� , STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� I hereby apply for a building permit and 1 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 ot to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: C�� ATE: 3l � . Sec.13.04 RIGHTS OF Sl'BJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private orconfidential data concerning himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is ciassif'ied as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shali bc shown ihe data without any charge to him and,if he desires,shall be informed of the content and meanine of that data. After an individual has bcen shown the private data and informed of its meaning,the data necd not be disclosed to him for six months thereafter unless a dispute or action pursuant ro this section is pending or additional data on thc 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 to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 notify in writing the responsible authority describing the nature ofthe disagreemenL The responsible authoriry shall within 30 days eithec (a)correct the data found to be inaccurate or ineomplete and attempt to notify past reeipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed oniy ifthe individual's statement ofdisagreement is included with the disclosed data. The determination oY the responsible authority may be appealed pursuant to the provisions of the administrative 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 furnish certain private or confidential information. You are notified that: l. 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 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. �C� � First 1liddle Last q�33- 3�0�`�' S�- . Address ��`� �`0�� Q�!'�O� 7 ��010 Crty State 7.ip Phone I understan y rights as stat a ove. �� SiQnatur Reset Form 32 / � �/ � � � ATE _/ TIME ✓ CITY O ORONO CALLED IN � � INSPECTION TICE SCHEDULED / D o2=� PERMIT NO. � COMPL TED ADDRESS �� OWNER C TR TELEPHONE NO T` � � DESCRIPTION —[� C� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING �ING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � Z W � W � j d + � �WORKSATISFACTORY:PROCEED ROJECTCOMPLETE W ❑ ORRECT WORK 8 PROCEED C SUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECT�ON TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �7 CITATION ISSUED ❑ INSPECTION RE�UtRED.CALlTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on sit : Inspector. " White Copyllnspector's File Canary CopylSite Notice