HomeMy WebLinkAbout2001-P03946 - windows PERMIT
CITY OF ORONO
2raC�K�.;Iley Parkway - PO Box 66 Permit Number: Po3946
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: �i»i2oot
SITE ADDRESS: 507 Ferndale Rd N
Wayzata, MN 55391
P I D: 3 6-118-23-13-0007
DESCRIPTION: UBC Occupancy R3
Proposed Use: Kesidentiai
Permit Class: Building Census Code O/S- Buifding
Permit Type: Minor Alterations Permit Sub-type(s): W�ndows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 265.25 Valuation: $ 15,400.00
State Surcharge Fee: $ 7.70
TOTAL FEE: $ 272.95
APPL�C/�NT: W�ndow Lite Home Improvements(See C OWNER: Hamed&Azar Sajjadi
8400 89th Avenue N 507 Ferndale Rd N
#460 Wayzata MN 55391
Brooklyn Park, MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK 1N STR[CT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
�
�� - ��'"� v „C "� �/�K �/
APPLICANT RM1T E SIGNATURE ' IS'� ED BY SIGNATURE
�
Copies: 1-File (Signitures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
'?�� � cT�� rernuc�: �r' c ',`�'�/(,-
�ncered By: � . �
j2 <� �'�t�:��;> �/i�/ ���
,�/ CIT-Y OF ORONO - BLTII�DING PERN�IT APPLICATIOI�I �� ' �
/?7�j H��� �/�11 v/ �: . . , , ' I
,/�
� _All info �mation musE be submitted in full before plan rene�v��ill be started. .
. � .. (please prini all information). , . . . - . - . : .
";.� APPLIC:,�'T IS: -.. .,(circle�onej.� 0'�TNER CONTRACFOR � . .. . - � � . - ��
Y
,70B SIT'E AD JRESS. �,., r "YVII�.�o �c b,�c, ZIP: , ���� � i,
_��
vA11�� OF O����Ri ��cQ.c�- �ZQ.r .�LLi'►(�1__ PHONE: (home) 50�- -�53C�
� � (wor ) .
NL�,�G�n�r.�,ss: ,5�r�-� -�e,rnr�al� (�c��,crrY: z�: `�I.
CO�ACTC►R: - PHONE: R(- - .
C�ti'�TACT P�:`,RS O�: ' MO ILE�'AGER:
NIATL .T�i'G AI�DRESS: U CTTY: �3 �� ZIP: 5;�,3Q 1
STA'I'E L;CE�'SE: # � � �CP.Lk
� ARC�i'I'ECT'rE11TGIlYEER:� � . , �� � PHO�'E:.� � -� � .
11�IA.]�TNG AI:�DRESS: � � _CITY: ZIP:_
� �*�ME; R�GISTRA.TION�#
TYPE OF tiV�)R�: New Addition � Accessory Struccure
Move � Remodel/Alteration Land Alteration_
PROPOSED�'�YOR1�(describe in detai�: 0 �oP t��-�-�5
� � - (�9�
CD � C�'w� ��-n� '��
STO�ttES: SQ.�EET�F E����H FLOOR:
�0. OF BEI�RODl7S: � �GARA.GE STALLS: ATT. DET. � � • . . � . .
. . . . . . . . . , . � . . . . . ,� � � . �
EST .Il�i IATEI► C0�ISTRUCT�ON VALUAT�ON (exctudinD land): $ �.> > '`f�� �
I hereby appl�� for a building permit and I aclanowledge that the information above is complete and
accurate; tY�at the work wili be in conformance with the ordinances aad codes of the Ciry a.nd with
the State BuiI i�ng Code; that I understand this is not a permit and work is not to start without a
permit; and C`iGt the work will be ' accordance with the approved plan. �
APPLYCA.��"::''S SIGNATURE r�v►� DAZ'E: �� 6 /
NOTE! ar,rde o,�Home� events require separate permit apprnval by Police �epartment and
� Ci1y Counci160 days prior to tke event. Non permitted events wiil not be allowed.
T 'd 09E9- i6E-ZT9 a�it mopuim dSE �Zi TO �i ��C
����T�� � - ��' 3�a �-} �r�o�� �
�'otal Fee: $�����,�'��, �a�O?• �� Date Received: .
�ntere�By: , �n , Permit#: �
� ' � ��
CITY OF ORONO - BUILDING PERMIT APPLICATIOI�I ` '�� �
� . � ..,,;� ;
All in�orma�ion must be submitted in full before plan revie�v �zll be started. ' `�` �� �
� - (please prirt all information) . . . . ��00 � I
1-gE APpLICANT' IS: � � (circle one) .� O�TNER CONTRACTOR � . .. �
?OB SITE ADDRESS: �� �YVI r �' ►� � � �IP: �.�a.3c� I !
�__ .- _ _ _.
�A.I1�IE OF Oti��Rs ��c� {�"ZC�.Y �t��`►C.�'.1 _ PHONE: (home) q�� -�53f' I
. � (wor�)
�
Iti G AUDF�SS: � fiP ' G�0.�� �� n . CTTY: L �ZTP: ��.3 � I
I�LAIL . ,
CO�ITRAC`I'OR: � PHOYE: �7(��� ) �����3 1�
CO�,�'ACTPERSON: L-' � �d `vl MO ILE�PAGER:
jVIAU, .l"\i'G AD' DRESS:� �' °� `f�'l,Lr�L 1,i CjTY• G�l` �1 ZIP:�
STATE LICE��SE: # � ° � �� � � ����-k
ARCHI'I'ECT�E\TGI.NEER:� � � �� � PHONE:.� -
i1�SAILT�i'G ADAktESS: CTTY: ZIP: __.
� ,���+ REGISTRATION#
1\Tt�17'J-�l:
TYPE OF '4'�ORK: New Addition Accessory Structure
Move � Remodel/Alteration Land Alteration
POSED'S'�ORT�(describe in detai£�: r G�-� `,� � � ������
PRO � � , � � � C�.s�_k�'
� �� � _
�'��. � � � �"��_ j C� YYI.c�rt�1 � =c�u�
STORIES: `� � SQ.FEET OF E���,C��'LOOR: .
�70. OF BEDROOI�IS: GARA.GE STALLS: ATT. DET. . . -
� . . � ��i
ESTIi�L4TED CONSTRUCTION VALUATIOY (excludina lanc�: $ ��� '��` . '
I hereby apply for a building permit and I acknowled�e that the information above is complete and
accurate; that the work will be in conformance with the ordina.nces and codes of the Ciry and with
the State Build�*�� Code; that I understand this is not a perrnit and work is not to start without a
permit; and th�c the work will be ' accordance with the approved plan.
�
, � ��;,� . . �.� 4-�c,z� DATE: � �C� � 6 �
APPLICA�.�"T S SIGi�IATURE. - � ; � �
NOTE! �Parade ,�Home� events require separate permit approvaI by Police D e�arlment and
� City Counci160 days prior to t he even t. N o n p e r m i t t e d e v e n t s w i l l n o t b e a l l o w
C�� �?5� -� �G9- S��/� -
. �
Sec.13.Q4 RIGHTS OF SLTSJECY'S OF DATA -- - • �
Sutd. i. Tppe oI data. T'he righct of iadividual on whom the data is scor:3 or ro be smr:d shaIl be u sec forch in chis setrion,
` 5u�d.2. Iatormation reqtrired te be givea iadiriduaI. An iadividuaI uked to supply priva�or eonfideedal daca eoaceming h�r�,c��s�,n
be ia,ormed o,: (a)the purpase aad inc:ndcd use of the rtqu�dan wic4ia the eolIecdng 3�c:agecey�poliricaI sutdivisioa,or scimw?de rist�•
(b)whe�`.e:he r.3�r.Fuse or is.le3aily rquir_d to suPPlY.the rquesc:d dati:(cj aay f�owa ea��quccce arisia3 from his sicpplyiag or refusiag tc�suppiy
privac�or eo:i::d:r._sI dat3;a:.d(�t�e idenary of a�erpccsoes arecrides auc�orized by snc�or F:�e_':_a:�r_c:ive the d3a. This r_quircceat s�='I
not a�piy w:.ea art i.dividuaI is uked to supply invudgadve daa.pursuaat to s<cda¢13.82,suMivision 5,oo a Iaw enforcemert o�cer. .. -
'Iha ce:zmissioner of rever.u� mav tace.che rtodce te�uir_d urtder this sutdivision in the ir:dividual ir.come e�x or orooectv taz teFur.d
inmucaons i.�sread of en chose fornu,
Subd.3. Aee�to data by iadiridual. Upan requesc co a czsponsible auchoriry,an'mdividuaI shail be informed whecher he is che subjeet
o!s2orcd dan on individaaLs,aad whe�her it is etassiFied u publie,privat�or eoaP.deaaat. Upaa hu fur�her r_quest,aa iadividaaI who is the subjecc
of stor.d Qriva�or public daca on iadividuals shall be showa ehe daa wichaut nny charge ta him and;it ha desiru,shali be infocmcd of�e eaaceat
and m:aniag of�at daea. Ahet an individuaI has beea shown[fie priva�.dae ar.d informed o[ics meaaiag,the dam ne:d not be disclosed w hica far
siz mondu ther_afcer un]ess a d'upuu or acaon pursuant W this secdan is p<nding ac addidooal dac�on the individual has been eollecc:d ar ercat-,d.
The tupaasible aut2:oriry shallprovide eopies of che privace or publie daa upon request by rhe iadividual subjecc o[che daa. Tne respoas4ble auehodry
may requir_ che r.quesdng person to pay the acata!cosu af ma.'cing,eerrifying,acd eamp�ing the eopia.
Ttie responsible auchoriry shaIl eampty imrardia�ety,if Qossible,wieh aay tequat ta3de pursua.nt ta �his subdivision,ac wichirt five days of
the da�:of ttse rcqc�esc,ezciuding Samrdays,Sundays and legal hoiidays,if ir,unedi��e campliacce is notpessibte. If he c3rsaot eompty with the request
wichin that dace,tse shall so inforra the individual,and may have an addidonal five days witfiin which to compiy wich the requesc,ezciuding Saeurdays,
Sundays�nd IcgaI holidays. _ . •
Subd.4. Pracedure when dsta is not aecurate or eomplete. An icdividual may eonc:sc che accurdcy o�eompie�aeu alpablic orpriti�ace
dara conceming ticroself. To ezercise�his righc,an ir.dividuaI shaIl nocify Ia wrida�die r_spoasble auchoriry descnbiag the Qature of the d"uagreemeac
The respoasible auehoriry shall wichin 30 days ei��cr, (a)correct rha daca Cound to be inaccurar�or ir:compiem aad accempc to aodfy past recipiencs of
ina;curace or incomplete data,including recipica�s narssed by�e individu�l:o�(b)coafy the individual thac he believes the dati to be correcc Da�
in dispace shall be disctosed onIy if�he individual's scacer,senc of disagreemeat is includ:d wirh the disdosed daca.
The de�crminadon ot the responsibte auchoriry may be appealed pursuanc ro the pruvisioas of tha adm.inisaaave procedum act retating co
eont�s..d cases. � . . .
DATA PRTVACY ADYISORY �
In accordance with M.S. 13.04,Subd.2, "Ri�hts of subjeccs of data",we wouId like to inform you that youc request
for a permic or license from the Ciry of Orono or any of ics depanmencs may require you to furnish certain private or
confidential information.
You are notified that:
1. The informatioa you furnish will be used to determine your qualification for che permit or license requested.
2. You may refuse to suppiy data, but refusal may require that the Ciry deny the permit or license. � �
3. The information may be shared wich ocher local,state or federal a�encies to the ettent necessary to process
t�e permit or license. '
4. If your requested permic or license requires Council action to approve, some informatiou may become
. pubiic, . . - . . . _ . .
�S. You have certain righcs under M.S. 13.04�(availabie upon request) to review private data on.yourself. . .
6. Your full narae is required to process this application or permit.
- - ��Y l�� L.I Y1 �I CJl'1'l . .
Firsc • , n �[iddle �t •
GI �� 1 �1 'k-�C.� .
. .�aa ,_..... ...
� � � � � � VY� 1�-� ��5 3 � � ��3 �) ,3�(-��l� �� -
Ciry Scue Zip hoae
1 stand my riQ as s ted above.
G % •
� ,
�'��"' -2 L� ��')/''� �
signacure