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Home My WebLink About2007-P10979 - re-roof , PERMIT C: `Y JF ORONO Permit ►vumber: 27;� Kelley Parkway- PO Box 66 P10979 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/9/2007 SITE ADDRESS: 1975 Fagerness Pt Rd Unit# Wayzata,MN 55391 PID: 18-117-23-14-0006 DESCRIPTION: Proposed Usc: Residential Census Code O/S -Building Permit Class: Building Permit Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pemut Fee: $ 23.50 valuat;on: $ 500.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 24.00 APPLICANT: Owner/Self OWNER: 7ohn Purdy ETAL � 1975 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. , �1 �� ,� �.- :�j� � � �. �,,��.C�� "�I'1 C��l APPLICANT PERMITEE SIGNATU ISSUED BY SIGNATURE //�� / Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 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 info�•rriatiori) ------------------------------------------------------------------------------------------------------------------------ -- --� THE APPLICANT IS: (cn�cle one)�OWNER� CONTRACTOR �� — JOB SITE ADDRESS: ��7S �I"�0 .��Z1U�JS �T• �� ZIP: S�S,�}1/ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS �NO lf t%es, a special event pernrit is r•eq:rired ivith Police Departn�ent and City Co2�ncil approval 60 dc�vs pr•ia�to tl7e event. Shuttle birs service tivill be reqaiir•ed unless applicant cteirionstr�ates su�cient on-sile parlcing is availabfe. Non-�ermitted eve��ts will not be a!loined NAME OF OWN�R �� O(�1'l� �C��1�� PHONE: (home) �S Z– y 7("��(U � � 1�'J (work) �Z �-�{7/ � �712 MAILING ADDRESS: ��75 ��D�1`v�-�t� CITY: ��rikJ ZIP: �S�'l/ CONTRACTOR: cQ� 1�.�l<<�t f�Z-t� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) � Any earth movement may require MCWD review and permits ! PROPOSED WORK(�lescribe i�t detain: �51-{-(N�LE j�p�F D� �E'1� �X l S1 I �Co Z – �'�� -2 l4CoE -- D��Ct-f'��J ��2UY'�( /-K"�USE STORIES: l SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: O GARAGE STALLS: ATTACHED DETACHED Z. o� ESTIMATED CONSTRUCTION VALUATION(excluding land): � - �� • I hereby apply for a buildin�permit and I acknowledge that the information above is complete and accurate; that the�i�ork will be in conformance �vitl�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 witt�o�it a pennit;a�d that the work�vill be ii� accordance��ith the approved plan. APPLICANT'S SIGNATURE. � DATE: �� 31 ,. � Sec13.04 RIGHTS OF SUBJECTS OF DATA Subd. I. Type of data. The rights of individual on��hom the data is stored or to be stored shall be as set forth in this section. Subd.2. Infonnation required to be given individual. An individual asked to supply private orcontidential dataconcerning himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may retLse 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 identiry ofother 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 investieative data,pursuant to section 13.82,subdivision 5,to a la��enforcement officer. The commissioner of revenue mav olace die notice required under this subdivision in the individual income tas or orooertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed�ihether he is the subject of stored data on individuals,and whether it is ciassified as public,private or confidential. 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 charge to him and,if he desires,shall be infonned of the conten[and meanin�of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six rnond�s thereafter unless a dispute or action pursuant to this section is pending or additionai 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 authoriry 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 tive days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so infonti the individual,and ma�have an additionai tive days within which to comply with the request,esduding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness ofpublic or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authonty describing the nature ofthe disagreement. The responsiblc autliority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by die individual;or(b)notify the individual that he Uelieves die data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating 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 pern�it 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 detern�ine 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 information may become pubiic. 5, You have certain rights under?vLS. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First �'liddlc Last Address Cih� Statc Zip Phone I und nnd mV rights as statec above. � Si� • c;' � Reset Form ��