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Home My WebLink About2005-P09291 - re-side � PERMIT CITY OF ORONO � 2750 Kelley Parkway- PO Box 66 Permit Number: P09291 Crystal Bay, Minnesota 55323 Permit Type: 1vlinar Alterations (952) 249-4600 Date Issued: l0/12/2005 SITE ADDRESS: 3457 Crystal Pl Unit# Wayzata,MN 55391 PID: 17-117-23-43-0007 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: FEE SUMMARY: Permit Fee: $ 9�25 va�uation: $ 3,200.00 State Surcharge Fee: $ 1.60 TOTAL FEE: $ 98.85 APPLICANT: Owner/Self OWNER: Peter J Hill MN 911 W 47th. St. Minneapolis,MN 55419 THE UNDERS[GNE H REBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO O LL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BU G CODE REQUIREMENTS. :f' ��-" � � rr \� ~� ;, �� `��L( �/ L%9'�_ �l�� i APPLICAN E ITEE S[GNATU E ISSUED BY SIGNATURE /. Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 l r Total Fee: $ "I�� y� Date Received: %��i Z/U r Entered By: �� Permit#: �C�'j,��j CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pri�Tt a1!information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ,} / �� / ZIP: ��J � / Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a specinl event permit ts r�eqz�ired 1�vith Police Departhlent and Crty Council approval 60 days prior to!he event. Sharttle bus service wil!be required ttnless apphcant demorrstrates sTrfftcient o -site arking is nvailable. Non-per•mitied events wi1T not be allowed. --� ;�� n � � NAME OF OWNER: �/ � � � � !'� PHONE: (home) �,/ `. ,�y.� � � MAILING ADDRESS: J�/ � �� ~ � � CITY: (� (W�ZIP: ,s�// S/� CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STA'I'E LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WOIZK: New Addition Accessory Structure Move Home Remodel/Alteration �_ PROP SED WORK�C�CSCYIGL'[��y detai�: --C'�,0(_ O�� l��C� ,��1 - �� (�'�-�. /t/� l., �s<,�(�-f'on , r�l v� �✓�� - � ' S" •i�� ' STORIES: � �Q.FEE�'OF EACH FLOOI�: ��Q NO. OF BED OOMS: a GARAGE STALLS: ATTACHEI) DE'TACI-IEI➢ ES'TI10�IATIED CONS'i'1�UCTION 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 ofthe City and with the State Building Code;that I understand this is not a permit an rk is not to start without a permit;and that the work will be in accordance with the approved plan. � � � � / APPLICANT S SIGNATURE: DATE: / Q -I� " O� 31 Scc.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. Type of data The rights of individual on whom d�e data is stored or to be stored shall be as set forth in this section. ----. -----Subd?.[nformation-required.to be.given.individual.An individual_askecLtosuppl.y_priv.ate or.confidential dataconcerning himselfshall be _ _._____.�_ ii�formed of. (a)the purpose and intended use of tlte requested data widiin the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legal ly required to supply the requested data;(c)any kno��ro consequence arising from his supplying or refusing to supply private or confidential data;and(d)tlte ideiltity of other persons or entities authorized by state or federal law to receive the data. This requirement shatl not appfy when an individual is asked to supply investiga[ive data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or property ta�refund instn�ctions 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 srored data on individua(s,and whe[her it is classified as public,private or contidential. 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 charee to him and,if he desires,shall be infonned of die content and meaning of thlt data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six months thereatter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. 7'he responsible authoriry 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 compilin�the copies. The responsibie authority shall compiy immediately,ifpossible.with any request made pursuant to this subdivision,or�vithin tive days of the date oY the request,excluding Saturdays,Sundays and leeal holidays,if immediate compliance is not possible. Ifhe cannotcomply 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. S ubd.4. Procedure when dat�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 disagreement. The responsible authority shall widiin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify 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 correct. Data in dispute shall be disdosed only if the individual's statement of disagreement is included�vith the disclosed data. The determination of the responsible authoriry 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 infornl you tliat your request for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The infonnation you fiu•nish will be used to determine your qualification for tlle 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 w�der M.S. 13.04 (available upon request)to review private data on yourself. 6. ur full name is required to process this application or permit. �P.� � C��"�� First � `� � � /� 1tid�� Last �F � � � Addresss� )� �� / / � �� ,✓��/�� / Cih� State 'Lio Phone I understand mv ►•ia s as sta ed a ov , ✓� �'� Sirnaturc J'