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Home My WebLink About2007-P11090 - re-roof PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: p11o90 Crystal Bay,`M�nnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 6/8/2007 SITE ADDRESS: 3405 Crystal Bay Rd Unit# Wayzata,MN 55391 PID: 17-117-23-44-0022 DESCRIPTION: 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: Pernut Fee: $ 125.25 valuation: $ 6,000.00 State Surcharge Fee: $ 3.00 TOTAL FEE: $ 128.25 APPLICANT: CNS Construction,Inc. OWNER: Catherine Sweet 2150 Dodd Rd. 3405 Crystal Bay Rd St. Paul,MN 55120 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. L I� �n �w� � PPL T PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: l-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 c,s/o�/�007 io:�2 Fax � f�oo2looa � ��: �� '� `� , ��u.-� V �! ►,�i� , `J' Total Fee: S � Z�•� Date Received: �0 '1 '�1 Entered By: C YY1.11/1 Permit#: A � �1090 CITY OF ORONO - BUYLbT1�G PERMIT APP'L.ICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS; (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 3� ��I�I ��Y TG! . Z1P: ��7 Will this be a arade of Hnmes,Remodelers Showcas@ Hame or other Display Home? ❑ �e3 ��0 Ify�es,a specia!event permit is required with Police Department and Ciry Councr!approva! 60 duys prior!o fhe eve�t, Shutcle bus yervrce will be required r�nless applican!demonstrales suf�lclent on-site parking is available. Non-permttted evenrs wr!!not be allowed. NAME OF OWNER: , V� PHO : (home) N� (�k) MAILINGADDRESS; 3�� S�I TY; ZIP: ~ CONTxtACTOYt: �� (�O/) C`, PHONE: �� `00 `r CONTACT PERSON: MOBILE/PAG • — — 1V�A.XLXNG ADbRESS: CITY: ZTP: STATE LICENSE: # 2D�Q EXPIRATION DATE: 3 ARCHTTECT/ENGINEER: r 1�I� , PHONE: MAILING ADDRESS; C�'�'Y: ZIP: NAME: REGISTRATION: # T'Sr'pE OF'VVO�tK: New Home Additivn Accessory Structure Mvve Home Remodel/Alterahvn (ie: Siding, W�ndows) �~ . PROPOSED WORK(describe in detailj: s �� _r�;c- STORIES: SQ.FEET OF EACH FLOOR; NO. OF BEDROOMS: GARAGE STALLS; ATTACHED DE'�'ACHED_ ESTIMATED CONSTRUCTION VALUATION(eacluding land): S � I hareby apply for a building permit and I acknowledge thaC the information above is complcte and accurate; that the work will be in eonforn�anee with tlie ordinances and codes of the City and with the State Building Code;that I understand this is not a permit and work is no wit a pennit;and that tlia work will bo in accordancc with lhc approved plan. , APPLICANT'5 SIGNAT'C)RE: DATE: � 31 0.��o7r:oo7 7o:a2 Fax r�oo3roo� 6ec.13.04 R[GFrl'S OP SYl�ECT3 OP'DATA Subd,1. Typo of dalu, The nghU of individua]�wl�om Ilie deta is etored or to be etored ehall be ae aet forth in lhie ewtion. 5ubd,2, Infotmation roquuod W be givmi ineli�idual.An individual auked[o aupply prive[c o�conFidcn[ial dffia concerning himaelf shall Ue informed of: (a)the puipoee und inDendod uae of tho rtqueated deta wi[hin lhe collec�ing 3[olc agcncy,poli[ical subdivi8ion,er etetewidc yyy[cm;(b) Whoeherha mey rat4ye oriy legally rcquired to eupply the roquea�ed date;(o)any lcnown aoneequence arieing&om hie auppiying or�fuaing to eupply pri�nte or oonfidantial data;and(d)thc idenlity of other pe�sone or entitiee autharizedby etaoe a federel law ta�eoeive the dala.Thie isquisement ahall not apply when an individual ia n�ked to eupply invn�tieauve dat�pu�suant to seaion 13.92,9ubdivi9ion 5,to e lew enforcament officcr. 'Tt�e oomminaioner of ravenue m�v nlace rhe notice rcc�uircd under thv eubdivieion in thc individuel incomc tex or pronertv tax refund inawc�ion9 ine Gead of on thoae fame. Subd.3. Acoeae ta data by individual. Upon requeetw r rcaponeiblo autl�ority,an individunl ahnll be informod whetharhe is the eubjovt of etorcd dnta on individuala,and whether it ia oleea�ed ss public,pnva[c 0�confidential. Upan hia tLAher rtqucAl,ar�individuel who u rha aubjec[af etorcd pri�nte or publio data on individunla aktel I be ahoum lha data wid+ou�eny cherqe to him aad,if he desirey,xhall be i�ormed oPthe con�cn�and meaning of that data. After nn individual hae been ahown ihe privn�o dntd und informed oF iw meaning,the delu nobd noC ba dieolwed to him fvr�ix months thaeafter unleee a&epute or avtion pu�auunt lo lh�a aeclion ia punding or eddiLionel de�n on the individuql ha been uvlleutcd or creel�ri The re�poa9iblc au�horiry 9hs11 provide copiea of tlie private or publie dnta upon requeat by the individu al eubjeot of the deta, 1�e reepanaible nulhority may�oquire lho requax�ing pereott to pay tltc aetual costs of making,certifying,and compiling the copiea. Tho reeponaibla euLhority aha11�omply immedietcly,ifposeible,with eny eequcet Mede pursuen�to thi�eubdiviwion,or within fivedaya of the date ofche requeel,excluding Saturciays,Sundaye and legnl holidaye,if immediate eomplianae ie nolpoaeible.Ifhe oennoteomplywith the requeet w;thin thac timc,he ehell ao inform the individual,and may have an additional five deye within whieh to aomply with the tsqueet,exoluding Seturdeys, 5undaya ond legel holidayy. Snbd.4, Prooedurewhendata�Anotaccurateorcoanplcu. Anindividualmaycontcetd+caccuracyacomplerane��ofpublicorprivaledete aonoemin g himwelr'.To arerciaa thiy ngh�,en individual ahall eo[ify in writing Ihc roaponeiblc euthority deacribing thc nawce of thc dioa8rcemen�.The rraponaiblc authoriry yhell wi�hin 30 daye eidur: (a)correct U�e da�a found to be inaocure�e or incompLer.e end e[�cmpt to notifj�peel roaipiente of inaaouralo vt Inoor[�plaw deta,lnoluding recip��nu namcd by Uu individual;oe(b)notify tht iadividuel 01et he bel levo8 the de[d tp ba�orr'ec4 Da[91tI diaputa ahall be dieoloaed only if thd individuel'y�tetemenl of disagrecmant iy jncluded w�Ut tho diyolo9ad deta, The determinntion of the roaponeible au�horily maY bo appeoladpunuunt to�ho provisivne of the adminiettalive provodure eotrelating lo oonteeted caaea, DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforxn you that your request for a pemzit or]icense from tlle City of Orono or any of its departrnents may require you to funush certain private or confidential infom�ation. You are notified tlwt: 1. The inforn�ation you fw-nish will bc usEd to determine your qualification for the pernut or license cequested. 2. Xou may refuse to supply data,but refusal may require that the City deny the pemut or license. 3, The information may be shared with other local, state or�ederal ager►cies to the extent necessary to process the pernvt or license. 4, IF your requested permit or licex�se requires Council action to approve, some information may become public. 5, You ha�ve cercain rights under M.S, 13.04(available upon request)io review privat�data on yowself. 6, Your full name is required to�roeess this application or perrr�it. [yry� MldJle J,eet Addreee Clry S�atc Zlp Phon�e I underet my ri t s st te �e. Sl�ne re .,z.,,� . .z,,,z 2,, ,a.;;",,,.i,,, i�i`•�i�ii�„ F'r;3i�i;'i',��""i'�'i,i;gri';�,j.�i'�:.,i;>. : ;>:��slJi''>.::;i�:; 5.,;,;,;,,;,.•<�;>,.�;<; ��•� < !: <� ��s:<:,:;s<v,�;�-,, 32 4 ,5;;r=;r�o-si;�f'SiS�;�.,,�',�,�Yi�„�1 ��€��::Cii:...�:�<;,,,:;,:; F �'I'�_:i">��)5:.��=�_�. .�.,.j> �jyi�'ry��?n'�i¢>i��i�'y�w\I1C%r:Ztiv��>tiySC�,�}:,.,��;;>;i>,�;�;�3�;��i,��.�,.� ' Group Send Report � Time : May-04-2007 11:58am Tel line : +9522494616 Name : CITY OF ORONO Job number . 210 Date . May-04 11:51am Document pases . 001 Start time . May-04 11 :51am End time . May-04 11:58am Successful Fax number �4734435 Unsuccessful Pages sent Fax number �6515529886 000