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Home My WebLink About2008-00315 - siding CITY OF ORONO PERMIT NO.: 2008-00315 2750 KELLEY PARKWAY � ORONO, MN 55356- �ATE IssuEv: 10/2U2008 - 952 249-4600 FAX: 952 249-4616 ADDRESS : 3409 EASTLAKE ST PIN : OS-117-23-13-0036 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT 000 BLOCK 008 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : SIDING ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 3,000.00 NOTE: REMOVE SIDING&INSTALL NEW,DOOR SWAP,REMOVE WINDOW&FRAME IN AND ROCK. APPLICANT PERM[T FEE SCHEDULE 88.50 WIZARD SERVICE STATE SURCHARGE(VALUATION) 1.50 318 XERXES AVE N MINNEAPOLIS, MN 55405- TOTAL 90.00 Minnesota State License#: 20230902 PAID WITH CASH 90.00 OWNER SCHULTZ, MR. & MRS.ANDREW 3409 EASTLAKE ST LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMEIVT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and becomc null and void if construc[ion authorized is not commenced wi[hin 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revo d at an�ti or due cause � , - ��%"�� 'j �� a .''-�'�-� -�-' --' %�� : � `��' �`',!� � �� "�� A plicant P r 'itee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. ! 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 information) ------------------------------------------------------------------------------------------------------------------------ � THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR � JOB SITE ADDRESS: .�`f� � �� f- /,,�/�- �-��.��zIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a special event permil is reguired with Police Department and City Council approval 60 days prioi•to the event. Shuttle bus service will be required unless applicant demonst��ates sufficient on-site parking is available. Non-permitted events will not be allowed NAME OF OWNER: �`-Lc iv�� /��-r�, �1.' 1�`/�� PHONE: (home) (work) MAILING ADDRESS: �j ZJ C'`i L��%�� -`��<< �'fCITY: ��'C;'`� '= ZIP: CONTRACTOR: E �" '��/%��'/� ��/��, C�` PHONE: �-1�� _3`7�/- )%G`� CONTACT PERSON: ,�� ,�,.� / << MOBILE/PAGER: MAILING ADDRESS:_�is �=p'�1..-_ � , �";,�r CITY: %'��'�; ZIP: >;�,t�� STATE LICENSE: # �?�` �?�C jc' �--- EXPIRATION DATE: � �i �- u�',�L 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(describe in detai/� �' �� z'� � ` � � . '-J� �G' '>l �/ �C�� f—�/L�� f Z'1 LL fl,":_-`�/ y� � C=� � ��.� � ') %T/ ' /�-��i�?��t;c:' �J � L '. ,L�.��7u� ,<-- �L�✓H., �r.' '''�lL*M'� '�� z 1`'"� STORIES: � ��— SQ.FEET OF EACH FLOOR:� �� '�`,L � NO. OF BEllROOMS: L GARAGE STALLS: ATTACHED DETACHED Z- ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��c — 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 witl�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 wark will be in accordance with the approved plan. �/�A /�/� APPLICANT'S SIGNATURE: /� -�� ,�ny.,�_.Z'�-- �ATE: /L; -� — � ;� 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA � Subd. 1. Type of data. The righu 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 or confidential 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 o[her persons or entities authorized by slate or federal law to receive the data. This requirement shal I 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 may olace the notice required under this subdivision in the individual income tax orpropertv taa refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shal I be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. 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 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 action pursuant to this section 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 authority may require the requesting person to pay the actual costs of making,certifying,and compiling[he copies. The responsible authority 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 additional five days within which to comply with the request,excludine 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 notifi�in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either (a)correct the data foimd 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 disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act rela[ing to contested cases. DATA PRNACY 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 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 ar 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. First Middlr Last l_� ��7`��L-—' Address City State Zip Phone I understand my rights as stated above. `/� � �� --L--�-—��`'--/ Signa ure Reset Porm 32