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Home My WebLink About2003-P06419 - re-roof • •�►� � PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po6419 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 6i12i2oo3 SITE ADDRESS: 1305 Elmwood Ave Mound,MN 55364 P I D: 07-117-23-41-0030 DESCRIPTION: Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Pernut Sub-type(s): Building-Re-Roof Pernut Type: Minor Alterations DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: n_ _.__rt__'_' ...'___�ir_'�__'._ o_ c'�:�____ H, ..v �� Yl'� il.L/7 [.�-�") �7� .._- �t�-� .�O .....:".....LG ..G.. ...........L....J.....:b �'..�_ � c FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 5,000.00 State Surcharge Fee: $ 3.00 TOTAL FEE: $ 114.25 APPLICANT: Owner/Self OWNER: Chales Carlson � 1305 Elmwood Ave Mound MN 55364 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. � � . ,/,�� . � „ ��,E�c�—� �>��z��✓l ��j . APPLICANT PERMITEE SIGNATURE [SSUED BY SIGNATURE Copies: 1-File(Si¢nitures Required), 1-Applicant, 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1 .. �- ��+ . Total Fee: $ Date Received: Entered By: Pernut#: CITY OF ORONO - BUII.,DING PERNIIT APPLICATION A11 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: � 3�.� /��!�,L��-�r}Co, �/L� ZIP: J�,� �, �� NAI��tE OF OWNER: ��'r��/°�SZ>>'1 PHONE: (home) ��o��' �� .=- . (work) � �S�L�� .��y;3'��(rt� l MAILING ADDRESS: �;.- CITY: ��y�D ZIP: c CO\�RACTOR: PHONE: COti�TACT PERSON: �� A �- fr�� , , NIOBILE/PAGER: M.AILING ADDRESS: CITY: ZIP: ST�iTE LICENSE: # ARCHITECT/ENGINEER: PHO�TE: MAII.ING ADDRESS: CITY: ZIP: 1�'A_ILE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe in detai�: �� /1.�'�.�z��/��„ `2/,Gyi/,�i� , �'�"?.'��j-� - ;= l/ � STORIES: � SQ. FEET OF EAC FLOOR S �� NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET. /' EST�IATED CONSTRUCTION VALUATION (excluding land): $ �L�� ,L� 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 Buildin� Code; that I understand this is not a permit and work is not to start without a permit; and that the work wilI be in accordance with the approved plan. � � APPLICANT'S SIGNATURE: �� _��y�, DATE: � ,✓t�- 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. 5 .. �"F"4 ., .. � Sec.13.04 RIGHTS OF SUB,TECTS 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 secdon. Subd.2. Informadon required to be given indiridual. An�individual asked to supply private or confidential data concerning himseff shall be informed of: (a)the purpose and intended use of the requested data within the collecang state agency,polidcal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing ro supply private or confidenual dara;and(d)the idendry of other persons or enaoes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. Tht commissioner of revenue mav lace the notice re uired under this subdivision in the individual income taz or ro em tax refund instrucaons instead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether 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 without any char�e to him and, if he desires,shall be informed of the content and meanin�of that data. Aher 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 acdon pursuant to this secaon is pending or addirional data on the individual has been collected or created. The responsible authoriry shall 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 the actual cosu of making,certifyin�, and compiling the copies. The responsible authority shall comply immediatefy,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and lega!holidays, if immediate compliance is not possible. If he cannot comply wieh the request within that time, he shall so inform the individual, and may have an additional five days within which to compiy with the requesc, excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic oc private dara conceming himself. To exercise this ri�ht,an individual shall notify in writing the responsible authoriry describing the nature of ehe disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to noafy past recipients of inaccurate or incomplete dara,including recipienu named by the individual;or(b)noafy the individual that he believes the data �o be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinaaon of the responsible authority may be appealed pursuant to the provisions of the adminis�ative 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 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 or federal agencies to the extent necessary to process the pemut 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 Middle Lasc Address C�ry State Zip Phone I unde tand my rights as stated ve. Sig re 6