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Home My WebLink About2005-P08785 - re-side PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p08785 Crysta!�ay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/27/2005 SITE ADDRESS: 1729 Fagerness Pt Rd Unit# Wayzata, MN 55391 P�� 17-117-23-22-0035 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 111.25 valuation: $ 5,000.00 State Surcharge Fee: $ 2.50 Misc. Fee: $ 1.50 TOTAL FEE: $ 115.25 APPLICANT: Owner/Self OWNER: Mr. &Mrs. Martin MN 1729 Fagerness Pt Rd 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. x, ��"-�'�( AP ICANT PERMITEE S[GNATURE ISSUED BY SIGNATURE � Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 ♦ - 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 pf•i�zt all information) ------------------------------------------------------------------------------------------------------------------------ �'"l THE APPLICANT IS: (ci��cle orze)�OW1V�R OR CO'.�TTRACTOR _ ,� JOB SITE ADDItESS: ZIP: Will this be a Parade of Horzies, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a s�ecial event perrnit is required with Police Depm-tment and City Council approval 60 dayspr�ror to the event. Slzzrttle bars service will be reqtrired z�nless applicant demo�zstrates si ff cient on-site par�king is available. Non permitted ever�ts will not be allowed. NAME OF OWIVER: �.I � (�w �� N PHONE: (home) �'S`�- �I T I 7 3� (work) `��i�t 2!6`�j7 MAIT�,ING ADDRESS: �?� �=�'2s��} �'� G��CITY: C�CZ�N 0 ZIP: `�S��t ( CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CIT�': ZIP: NAME: REGISTR.ATION: # TYPE OF WORK: New Addition Accessory.Structure Move Home Remodel/Alteration � PROPOSED WORK(describe in detai�: �� S� �l�L � STORIES: �� SQ.FEET OF EACH FLOOR: �� U NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED� �v ESTIMATED CONSTRUCTION VALUATION(excluding land}: $ �j(� I hereby apply for a building pemut 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 ork is not to start without a perniit;and that the work will be in accordance with the approved plan. APPLICAIVT'S SIGNATURE: DATE: S�� 7 � 31 . Sec.13.04 RIGHTS OF SUBJECTS 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 forch in this section. 5ubd.2. Information required to be given individual.M individual asked to supply private or confidentia]data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide sys[em;(b) whether he may refuse or is legalty required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply priva[e or confidential daca;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall not apply when an individual is asked to supply investigative da[a,pursuant to section 13.82,subdivision 5,to a law enforcemen[officer. The commissioner of revenue maV nlace the notice required under this subdivision in the individual income taY or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shafl be informed whether he is the subject of stored data on individuals,,and whether it is classified as public,pnvace or confidentiaL Upon his further request,an individual who is the suoject o: stored private or public data on individuals shall be sno«m the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the pnvate 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 pnvate or pubfic 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,ceRifying,and compiling the copies. The responsible au[horityshall comply immediately,ifpossible,with any requesc made pursuant to this subdivision,orwithin five days of che date of the request,excluding Saturdays,Sundays and legal holidays,if immediate comptiance is not possible.If he cannot comp!y with the request within that time,he sha11 so inform the individual,and may have an additional five days widlin which to comply with the request,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 public or privace data conceming himself.To exercise this right,an individual shall no:ify in wiiting the responsibie authority describing the nature of the disa,greement.The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate o;incomple�e and attempt to notify past recipienes of inaccuratc or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the dafa to be correct. Data in dispute sFall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible au[hority may be appealed pursuant to the provisions of the administrative procedure act rela[ing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subj ects of data",we would like to inform you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you fumish will be used to deternune your qualification for the pem:it 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 pernlit or license. 4. If your requested permit or license requires Council action to approve, some information rnay become public. 5. You have certain rijhts 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 Ntiddle Last Address C��, State Zip Phone I understand my rights as stated above. S gna e 32