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Home My WebLink About2001-P04203 - re-roof 4 ,� PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway- PO Box 66 P04203 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: si2oi2oo� SITE ADDRESS: 2745 Ethel Ave WAYZATA,MN 55391 P I D: 20-117-23-24-0016 DESCRIPTION: UBC Occupancy R3 Proposed Use: nesidentiai Permit Class: Building Census Code O/S- Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ ��1•25 Valuation: $ 4,453.00 State Surcharge Fee: $ 2.25 TOTAL FEE: $ 113.50 APPLICANT: Western Cedar Supply OWNER: BENJAMIN R& LISA A JENSEN 9700 13th Ave 2745 ETHEL AVE Plymouth, MN 55441 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. ' � � YV 1%( � `� �lh'�ti.-- �� APP I AN ERMITEE SIGNA'I'URE ISSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 E � Total Fee: $ / � . �L� Date Received: �'- �0 �U I Entered By: Permit#: p U�(�o�-' 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 O CONTRACT JOB SITE ADDRESS: � ��5 ��e� �jve ZIp; SS,��I � NAME OF OWNER: _ �,-t _}P�1 �/'� PHONE: (home)�� 7�"�C'3.� 7 (work) MAILING ADDRESS: S,�-,�-L�-- CITY: Urc� c� ZIP: — CONTRACTOR: �S�/'� ��d/f/� SLr�i 1�l PHOi�TE: `� 3 - s%/'-c`��'�Y CONTACT PERSON: i�>��.� OB E/PAGER: MAILING ADDRESS: �-�cx-� � 3 yz.P ,.1, . CITY: �1� ZIP: �S% STATE LICENSE: #� '��/_5�5� ARCHITECT/ENGINEER: PHOr�E: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: �%�'��r�� C STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. no ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��j �l s�' 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 permit and work is not to start without a permit; ar.d that the work will be in accordance with the approved plan. �— ��a� �� f APPLIC��1T'S SIGNATURE: . /�i1 � DATE: 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.13.0�3 RIGHTS OF SUBJECTS OF D�1TA Subd. i. Type of data. The righLs of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.?. Informatioo reqirired to be given individual. ?.n individual asked to supply private or co�denriai data concerning himself shall be informed of: (a) the purpose and intended use of the requested dara within the collecting"statP a�eocy, political subdivision,or sratewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or refusing to supply priva[e or conndential data;and(d)the iden[ity of other persons or enaoes authorized by state or federal law ro receive the data. This requirement shall not apply when an individual is asked to supply invesaeauve da�t, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav pla�e che noace reauired under this subdivision in the individual income tax or propertv tax refund instructions instzad of on those forms. Subd. 3. Access to data bv individual. Upon request to a responsible au[horiry,an individual shall be informed whether he is the subject of s[ored dara on individuals, and whe[her it is cfassified as public, private or confidentiai. Upon his further request, an individual who is the subjecc of stored private or public data on individuals shali be shown the data wi[hout any charge to hirn and, if he desires, shall be informed of the content and meaning uf[ha[data. Ahzr an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months[hereafter unless a dispute or action pursuant to this secdon is oending or additionai 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[he data. The responsible authoriry may require�he requesring person to pay the actual coscs of making, cervfying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days oI the date of che request,excluding Sa[urdays,Sundays and le¢al holidays, if immediate compliance is not possible. If he cannot comply with the request wi[hin that ame,he shall so inform the individual,and may have an addicional five days within which to comply with the request,excluding Saturdays, Sundays and leeal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or pm•a[e data conceming himself. To exercise this rieht,an individual shall notify in wridng the responsible authori[y describing che nature of[he disagreement. The responsible authority shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data ro be correct. Data in dispute shali be disclosed only if[he individual's statemen[of disagreement is included with the disclosed data. The de[erminarion of the responsible au[horiry may be appealed pucsuant to the provisions of the administracive procedure act reladng to contested cases. D.�T:� PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "RiQhts of subjects of data", we would like to inform you that your reauest for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or contidential information. You are notified that: 1. T'he information you furnish wili be used to detemune 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 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. j. You have certain rights under i�i.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. Firsc �fiddle Las[ Address Cirv Stace Zip Phone I understand my rights as stated above. Siena[ure '