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Home My WebLink About2005-P08692 - re-roof PERMIT C I TY O F O RO N O Permit Number: 2750 Kt�lle��rkway - PO Box 66 P08692 Crystal Bay, Minnesota 55323 Permlt Type: Minor Alterations (952) 249-4600 Date Issued: si6i2oos SITE ADDRESS: 1729 Fagerness Pt Rd Wayzata,NII�155391 P I D: 17-117-23-22-0035 DESCRIPTION: Proposed Use: Residential Pernut 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: ._,_ ._„--�-- ----- ---� --:,, -�--- �--- -�r �----- -------�---� ..�. ...— �.::�.�:: �v v'..t:cc -.... ..._ _:��.— .., , .... ..... .,..:t; .c.,. .,.. ...,.ccb.,..,. . ..,.... FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 70.75 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. � �� _ � ��yyj �� n ��j PPLICANT PEKMI"1'EE SIGNATURE ISSUBD BY S[GNATURE V Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine. 1-Finance Page 1 c �-R. 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 print all i�iformation) THE APPLICANT IS: (circle one) OWl\TER OR COl�'TRACTOR JOB SITE ADDRESS: I��L1 �'i�?�� rC`�S a`�- T �2L� ZIP: C,S�� ( Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �=� If yes,a special event pe�-mit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bzrs service will be reqarired unless applicant demonstrates su�cient o�z-site parki�7g is available. Non permitted events will not be allowed. NAME OF OWNER: ��,Fj(� ��"fl l� PHONE: (home) S�' �—�7/7 3� (work) Q� —y�{ ? —16 v7 MAILING ADDRESS: C�� '�("�5 '�ITY: 6��-C7 ZIP: SS`�t i CONTR.ACTOR: P . CONTACT PERSON: ER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE• EXPIR.ATION DATE: ARCHITECT/ENGINEER: HONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration ✓ PROPOSED WORK(describe in detai�: l�= � C�� ,��f !4�"/� ��l �v� v"�Z�� S/�irv�L�s STORIES: � ` � SQ.FEET OF EACH FLOOR: �� NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED�-- ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /�`� 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 ordinanees and codes of the City and with the State Building Code;that I understand this is not a permit d work is not to start without a pernut;and that the work will be in accordance with the approved plan. APPLICANT'SSIGNATURE: - DATE: � �� 31 �. � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the d2ta is scored or to be stored shall be as set forth in this section. 5ubd.2. Information required to be given individual.An individual asked to supply private or confidentia]data concerning himself shall be infottned of: (a)the purpose and intended use of the requested data within the collecting state agency,poli[ical subdivision,or sta[ewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shali not apply when an individual is asked to supply investigative data,pursuant to section]3.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or propertv tax refund instructions ins[ead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is the subject of s[ored data on individuals,_and whether it is classified as public,private or confidentiaL Upon his further request,an individual who is the subject of stored private or pubfic data on individuals shall be shown the da[a withou[any charge to him and,if he desires,shall be informed of the content and mea�ing of that data. After an individua]has been shown the pnvate data and informed of its meaning,the data need not be disclosed[o 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 private or public 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,certifying,and compiling the copies. The responsible authority shall comply immediately,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[hat time,he shall so inform the individual,and may have an additional five days w-ithin which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when da[a is not accurate or complete.An individual may contest the accuracy or completeness of public or pnvate data conceming himsel£ To exercise this right,an individual sha11 notify in wiiting the responsible authonty describing the nature of the disagreement.The responsible authonty shall wi[hin 30 days either: (a)conect the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomptete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be coirecL Da[a in dispute shall be disclosed only if the individual's statement of disagreemen[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 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 fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to deternune 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 permit or license. 4. If your requested permit or license requires Council action to approve, some infomlation 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. Fi�� Middle Last Address City State Zip Phone erstand my rights as stated above. gn ure 32