HomeMy WebLinkAbout2007-P10908 - tear off/reshingle PERMIT
C�"`�Y OF ORONO
275� Kelley Parkway - PO Box 66 Permit Number: p10908
Crysial Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued:
4/20/2007
SITE ADDRESS: 2720 Ethel Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-24-0040
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Type:
Minar Alterations Permit Sub-type(s): Building-Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Tear off and reshingle
FEE SUMMARY: Permit Fee: $ 69.25 valuation: $ 2,000.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 70.25
APPLICANT: Owner/Self OWNER: Dennis&Cynthia Bremer
MN 2720 Ethel Ave
Wayzata,MN 55391
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.
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APPI.ICANT PERMITEE S[GNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, ]-Monthly Reports, I-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ DateReceived:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information ►nust be submitted in full bef'ore plan review will be started.
(/�lerrse prirtf ull irzf'ormrrtion)
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THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
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JOB SITE ADDRESS: �( �a t� C- � �e-� /-• ZIP: �� �� /
Wi❑ this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YCS �NO If�yes, a special e>>ent permil is reyi�irecl irilh Police De/�urhnent nnd C'ity Cottncil approi�al
<0 cfuv.s'pi•ior/o the erent. Shzrttle birs serrice iril/be reyuired ri��/ess ap�/icnn!denao��sh�ates
sufficienl on-srle parking is�arailable. ;b'on-permiltec!erenls i��ill no!he alloi>>ed.
NAME OF OWNER: �E n^� s ` �t��'��/ PHONF,: (home) '�- ys-��`/7 3�>�� 7
�Wo���:> ��.�-Y��- y��y
MAILINGADDRESS: ���� ���►�������jr CITY: l;N �>��� ZIP: S���y /
CONTRACTOR: �C� � PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAMC: RP;CISTRATION: #
TYPE OF WORK: New Home Addition Accesso►y Structure
Move Home Remodel/Altecation (ie: Siding, Windows) �
Any earth movement may require MCWD review and permits !
� PROPOSED WORK(clescribe in detai�: ►�� S�.,r<,L� ��✓� � �e m� ��(�Q�- ��� �.r, �ti�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHCD
ESTIMATED CONSTRUCTION VALUATION(excluding land): � ������
I heceby 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 and w rk is not to start without a pennit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: �� �-1� DATE: �_( ��� 7
31
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s«.i3.ua a�r,�rrs�>r si�a���;c-r•s or�a�i��
Subd I �IV�p�af data. �fhc rights of individual on whom thc data is storcd or to be stored shull be as set torth in this section.
Subd.?.. Inli�rmation rcyuired to be given individual. An individual asked to supply privnteor contidential data conceming himself shall be
intiirmcd of: (n)the purpose and intended use oY the requested data�vithin the collecting state agency,political subdivision,or statewide system:(b)
�chethcr he mnv rotLsc or is legally royuired to supply thc requested d.11a;(c)any kno���n consequence arising from his supplying or rcfusing to supply
pri����te or confidential data;and(d)tl�e identity ofoU�cr persons or entities authorized hy state or federal la���to receivethe data. This reyuiremei�tshall
not<ipply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a law enforcement ofTicer.
The commissioner ot�rcvenue mav place the notice rec�red under this sul�e�ivision in thu individual income ta�or roncrtv tax refund
instructions instcad of on thosc fonns.
Subd 3 nccess to data by individual. Upon request to.i responsibic autl�oriri�,an indi��idunl shall be intormed�vhether he is the su�ject of
stored datn on indi��iduals,and�vhether it is classit�ied as public,private or confidential. Upon his further request,an individual�vho is the su�ject of
stored private or public data on individuals shall he sho�cn the data�vithout any charge to him and.if he desires,shall be infonned ofthe content and
meaning o(th.it data. Atter an individual h�is bccn shown the pri��ate data nnd informed of its mcaning the datn nccd not be disclosed to him ti�r si�
months theroafter unless�dispute or action pursuant to this section is pending or addition�l d:uu on the individucil has been collectcd or created. l�he
resF�onsible authority shal I provide copies of the privatc or puhl ic data upon reyuest by the indi�•idual su�ject of the d�tta. 'I�he responsible nuthority
may requu�e thc rcquesting person ro pa��the actual costs of m�iking,certi�ying,and compilin�[he copies.
I�he responsible authorit��shall compl��immediately_if possible,�vith any request made pursuant tu�his subdi��ision,oncid�in fi��ed.i��s of
the date ofthe request,e�duding Saturdavs.SundaYs and legal hulida��s,il immedi�te compliance is not possible. If he clnnot romplc��ith the rcyuest
�cithin that time_he shall so intbrm the individual,and ma�'have an additional fi��e dnys���ithin which to comply wi[h[he reques[,excluding Saturda��s.
Sund,���s.�nd leeal I�olid�vs.
Subd.d. Procedure�chen data is not accurateor complete. An individual mny contestthe accurac��or completeness ofpublic or private data
concerning himself. To e�ercise this right.an individual shall notify in�vriting the responsiblu authority describing the naturc ofthedisagreement. 'fhe
responsihle authoritv shall within 30 days either (a)correct the data lound to be inlccurate or incomplete and attempt to notifi�past rccipients of
in�ccurute or incomplete dat2,including rccipients named by the individual:or(b)notit)-Uie individual that he believes the data to be correct Data in
disputr sh111 be disclosed only if the individuaPs statement of disagreement is included�vith the disclosed duta.
The detcrminntion of thc responsible�uthoritv may be appenlcd pursuant to the provisions of the cidministrui��c procedure act rclating to
contcstc�ct�ses_
DATA PRIVACY nDVISORY
In accorclance���ith M.S. I 3.04.Suhd.2_"Rights of subjects of data".wc���oulcl like to inlbnn��ou that your requcst
liir a permit or liccnse from the Cit�� of Or<>no or uny of its departments may rcquire you tu f�urnish cert�iin private or
cunlidential inlbrmation.
You arc notified that:
l. "['he information you f�urnish ���ill be used to determine your qualification {or the permit or license
requested.
2. You may refuse to supply data,but refusal ina}� rcquire that the Cit}� dci�y the permit or license.
3. The intormation may be shared with other local, state or lcderal agencics to the extcnt necessaiy lo
process the permit or license.
4. (f your rcquested pa�init or liccnsc req��ires Council action to approve, some iniormation may bccomc
public.
>. Yuu have certain ri�!hts under M.S. 13.04(nvailable upon request)to rc��ic�e private data on yoursclf.
6. Ye�ur full name is ra�uircd tu process this application or permit.
�Q h n.3 CGl�l Ct s ! f �-+-"�
First Middle L:+st
� I �� 1 J t�/11.3 Uc�(.�,�, �/'�
1ddress
��v,�..v 1'�'l�/ S`?�3 9/ �S;Z- Y�3 -i�'� ��
Cit� Statc 7.ip Phonc
i underst�ncl, y ights as stated above
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