The URL can be used to link to this page

Home My WebLink About2002-P05017 - re-roof � � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Posoi� Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 4i9i2oo2 SITE ADDRESS: 3415 Crystal Bay Rd Wayzata,MN 55391 P��: 17-ll 7-23-43-0118 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DEfAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 195.25 Valuation• $ 10,319.00 State Surcharge Fee: $ 5.20 TOTAL FEE: $ 200.45 APPLICANT: Lake Wood Roofing& Siding OWNER: 1'ausry Elshazly 610 13th Ave. Karen Elshazly Hopkins,MN 55343 3415 Crystal Bay Rd 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 �; � ��l �. �'� - ��/-C� l ,,/!'G--�.� ,�jY�l- APPLICA PERMITGESIGNATURE ISSUEDBYSIGNATURG Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 { l Total Fee: $ ;. `-� ' 'C)a `�1� Date Received: `� -`/_ c;�r� Entered By: �;� ._�,1�� Permit#: �'��'c;+� CITY OF ORONO - BUILDING PERNIIT APPLICATIOl� All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------- - - ----------------- --------------------------------- THE APPLICANT IS: (circle one) OWNER O�NTRACTO� JOB SITE ADDRESS: .� L�/S �r��5j<�� -,� (,J c<�� ZIP: �.S 3��/ � NAME OF OWNER: l<��5,^�/ ��r�.� .��`''<iz_�v PHONE: (home) 9s.7-�7/-��L (work) �:�.� - y 51- c�..z��c7 MAILINGADDRESS: J�//j Crv��,�,`�� CITY: ��,�-,.�Z� ZIP: 5 5 3`r/ C0�ITRACTOR: ��a�w�� c��,•ay v� .:�Q;Hs PHONE: `�5�-�"�.3�',3 5� S5� CONTACT PERSON: ��- i= :f�-��MOBILE/PAGER: ��z -�.��-�, ;;-c� MAILING ADDRESS:��i�, ��j�r �.-z=. 5c. CITY: /�G��.C� .�� ZIP: �s�r 3 STATE LICENSE: # ^�>� y g .3 ,3 � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration PROPOSED WORK(describe in detai�: %�,,, _�„f-� �—r�:��` �„sf- r�;��ri_ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��; 5i`i, -�� 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:�' �� -� DATE: �f � �� NOTE! Parade Qf 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. � f� � Sec.13.04 RIGHTS OF SUBJECTS OF D�TA 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 secdon. Subd.2. Information reqirired to be given indiridual. An individual asked to supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and in[ended use of the requesred dara witbin the colleccing'state agency,polirical subdivision,or sratewide system; (b)whether he may refuse or is legally required to supply the requested data:(c)any lmown consequence arising fmm his supplying or refusing to supply privace or confidenaal data;and(d)the idenury of ocher perso�s or enaaes authorized by state or federal law to receive the data. This requirement shall no[apply when an individual is asked to supply investieadve dara, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the nodce required under this subdivision in the individual income tax or properry tax refund instructions instead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whe[her he is the subject of stored data on individuals, and whether it is classified as public, private or confidenrial. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data wi[hout 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 the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to �his secdon is pending or addiao�al data on the individual has been collected or created. The responsible authoriry shali provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the acnial coscs of making, certifying, and compiling the copies. The responsible authoriry 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 cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal five days within which to compiy with the request,excluding Sarurdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate oc complete. An individual may contest the accuracy or completeness of public or private dara concerning himself. To exercise[his right,an individual shall nodfy in writing the responsible au[horiry describing rhe nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attemp[to notify past recipients of inaccurate or incomplete data, including recipiencs named by the individual; or(b)notify the individual that he believes the data to be correcc. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disciosed data. The determinarion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive 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: 1, The information you furnish will be used to determine your qualification for the pemut 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 pernut 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. (, Your full name is required to process this application or permit. First Middle Last Address C�ty State Zip Phone I understand my rights as stated above. � Sig amre