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Home My WebLink About2002-P05700 - re-roof PERMIT GITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Pos�oo Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: ioi�i2oo2 SITE ADDRESS: 3403 Eastlake St L.ong Lake,MN 55356 PID: os-ii�-23-i4-oo60 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 pernuts required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 6,650.00 State Surcharge Fee: $ 3.85 TOTAL FEE: $ 143.10 APPLICANT: �'�'estern Cedar Supply OWNER: Mr. &Mrs. Hodge 9700 13th Ave 3403 Eastlake St Plymouth,MN 55441 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. fvl s� b�� APPLICANT PERMITEE SIGNATURE ISSUED B GNATURE � Cooies: 1-File(SiQnitures Requirecl), 1-Aoplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 ' Total Fee: $ �`�3./G Date Received: �G- 7- °�. Entered By: n'1 Permit#: /�'C' S 7�v CITY OF ORONO - BUILDING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER CONTRACTOR JOB SITE ADDRESS: ��03 �s� L.,� �fi�cf ZIP: NAME OF OWNER: �� Sw►�} J�� PHONE: (home) �.5�—y7y C�� q;� (work) MAILING ADDRESS: `�� 5'�L"�'�C CITY: � ZIP: SS 3 CONTRACTOR: �� 1Z,ap{ZYd� PHONE: �3�SS�I"�'3Dy CONTACT PERSON: /vl p,-C OBILE/PAGER: h l�'�— � MAILING ADDRESS: �� / CITY: /� ZIP: « STATE LICENSE: # ARCHITECT/ENGINEER: PHOl�'E: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New v Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: __�% � � Rei� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� Sc� �o 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 pernut 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: /� 7�� NOTE! Parade of Homes events require separate permit approval by Police Department and Ciry Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGHTS OF SUBJECTS 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 secaon. Subd.2. Information required to be given individual. �.n individual asked to supply private or confidenrial data concerning himself shall be infortned of: (a)the purpose and intended use of the requested data within the collecdng'state agency, political subdivisioo,or statewide system; (b)whether he may refuse oY is(egally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing[o supply private or confidenrial data;and(d)the idenary of o[her persons or enriries authorized by state or fedecal law to receive the data. Ttus requirement shall not apply when an individual is asked ro supply invesrieadve data, pursuant ro secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the nocice reauired under this subdivision in the individual income tax or property tax refund instructions insrezd of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, priva[e 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 wichout any charge to him and,"if he desires, shall be informed of the content and meaning of that data. Afrer 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 acaon pursuant to this secaon is pending or additional 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 authoriry may require the requesting person ro pay the accual cosu 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 comply with[he request,excluding Saturdays, 5undays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authority describing�he nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy pas[recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)noufy the individual that he believes the data to be correct. Data in dispute shal(be disclosed only if the individual's statement of disagreement is included with the disclosed data. The decermination of the responsible authority may be appealed pursuant to the provisions of[he adminisaadve procedure act relaang 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 reques[ for a pernut or license from the City of Orono or any of its departments s.ay 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 pertnit 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. 6. Your full name is required to process this application or permit. First Middle Last Address C�ry State Zip Phone I understand my rights as stated ab � Signature