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Home My WebLink About2002-P05161 - re-roof CITY OF ORONO PERMIT 275G�KEIIey Parkway - PO Box 66 Permit Number: Posi6i Crysial Bay, Minnesota 55323 Permit Type: 1vlinorAlterations (952) 249-4600 Date Issued: sisi2oo2 SITE ADDRESS: 2725 Ethel Ave Wayzata,MN 55391 PID: 20-117-23-24-0015 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 DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: I FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,900.00 State Surcharge Fee: $ 1.95 TOTAL FEE: $ 85.20 APPLICANT: Rainguard Construction OWNER: Linna Haugesag 12008 Pennsylvania Ave N 2725 Ethel Ave Champlin, MN 55316 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WO IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING QUIREMENTS. �" __ ,�� .�L �-�'ti't�� PLICAN :RMITEE SIGNATURE ISS ED BY SIGNATURE Copies: 1-File(SiQnitures Required). 1-Avplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: � Entezed By: Permit#: , CITY OF ORONO - BLTII�DING PERNIIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------�-_--_---_--------------------------------- � THE APPLICANT IS: (circle one) OWNER O CONTRACTORI �---- JOB SITE ADDRESS: �� .��..e � � ZIp; NAME OF OWNER: � � ��o � PHONE: ome � � (h ) �7/.37�� (work) MAILING ADDRESS: �-'-^`— CITY: ZIP: CONTRACTOR: ��-�'� �� ,�5�fv� � �— PHONE: �"3 �{2 I ��5 7 CONTACT PERSON: S�,,� � ��t MOBILE/PAGER: MAILING ADDRESS:) I ,�� „�., ✓� CITY: ��..�.1� �w ZIP: �}'� 1 STATE LICENSE: # C� � ARCHITECT/ENGINEER: PHOVE: MAILING ADDRESS: CITY: ZIP: NA1�IE: REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED`VORK(describe in detai�: � C�- a�� ,,� � ,.; SZ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �; �� ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 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 i the ordinances and codes of the City and with the State Building Code; that I understand ' �is ot a pemut and work is not to start without a permit; and that the work will be in acc � e ith the approved plan. APPLICANT'S SIGNATURE: ' DATE: � v �-- NOTE! Parade of 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 SUB.TECTS OF D,�TA • Subd. 1. Type of data. The righcs of individual on whom the data is s[ored or to be stored shall be as set forth in this secdon. Subd.2. Information reqtirired to be given individual. An individual asked to suppiy private or confidendal data concerning himself shail be informed of: (a)the purpose and intended use of the reques[ed data wichin rhe collecang'state agency, polidcal subdivision,or statewide system; (b)whether he may refuse oY is legaily required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the idenriry of other persoas or endaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigarive data,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�•enue mav place the noace reauir�d under this subdivision in the individual income tax or propertv tax refund instructions insczad of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible auchority,an individual shall be informed whether he is the subject of stored data on individuals, and wherher it is classified as public, priva[e or confidenaal. Upon his funher 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. Afrzr an individual has been shown the private data and informed of irs meaning, the data need not be disclosed to him for six monchs thereafter unless a dispute or acrion pursuanc to [his secaon is pending or addidonal data on the individuai 6as been collected or created. The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay[he actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediatety, 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 addirional five days within which to comply with the request,excluding Saturdays, Sundays and legal hofidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or private data concerning himself. To exercise[his rieht,an individual shall nodfy in wriang the responsible authoriry describing�he narure of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccumte or incomplete data, inciuding recipients named by [he individual;,or(b)nodfy the individual thac he believes the data to be correct. Data in dispuce shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. The de[erminarion of the respensible au[horiry may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 confideatial 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 o[her local, state or federal a?encies 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 ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. ^-� , �� U �-.�- .3'�-'-. First n I � iddle Last �� J��S� lv��r� � �� — Addr � / _ �� l r VJ �� Y � City Stace Zip Phone i � j I understand my ��- �st ed above. G Signature