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Home My WebLink About2002-P05610 - re-roof f � CITY OF ORON PERMIT � Permit Number: 2750 Kelipy Parkway - PO Box 66 Pos6io Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 9i13i2oo2 SITE ADDRESS: 785 Ferndale Rd N Wayzata,MN 55391 PID: 36-118-23-11-0012 DESCRIPTION: UBC Occupancy R3 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 permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,950.00 State Surcharge Fee: $ 2.00 TOTAL FEE: $ 85.25 APPLICANT: Sela Roofing&Remodeling, Inc. OWNER: Michelle&Thomas Cullum Jr 4100 Excesior Blvd. 785 Ferndale Rd N St. Louis Park,MN 55146 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � ,' . �,--- _ � /^; � � � �� "� �(. - �,..: (,�'.,/(,[ (��1 �l�iP� �� APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 � . . Total Fee: $ CCS,S, a � Date Received: -�-r_/3 -Uc� Entered By: Permit#: �S�G� /D CITY OF ORONO - BUILDING PERMIT APPLICATIOl� All information must be submitted in full before plan review will be started. (please print all information) --------------------------------------------------------------------------------�_=_-----�-------------------------- THE APPLICANT IS: (circle one) OWNER OR ONTRAC. TO� ; - JOB SITE ADDRESS: �1 � �, ��V`;� (�u j� �,�. ,/�i�� ZIP: �• ` � ,�i � , __.� � , NAME OF OWNER: "--� ^!' �'� / '^�' PHONE: (home) i��•,�' ;-'�%' �`-��'� (work) MAILING ADDRESS: CITY: ZIP: n CONTRACTOR: �-,'�� ;��z�t. � PHONE: �� , �-S �� ,�� CONTACT PERSON: MOBILE/PAGER: � �� CITY: ZIP: MAILING ADDRESS: � �.;� /_��.�r �-��311'- STATE LICENSE: # ,� �;�;`r, ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK describe in detai � �� 1' '� �� '� � �� /�l, f � �%'c"� I—��;—�— �;, r3'!'� r�. �"q� — /�' � / " ' STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 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 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 pernut; and that the work will be in accozdance with the approved plan. =__ � -� , APPLICANT'S SIGNATURE: �, � ��— DATE: � - �� NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. , � Sea13.04 RIGHTS OF SUB.TECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom the data is stored or co be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial dara concerning himself shall 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 refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply private or confiden[iai data;and(d)the idenriry of ocher persons or enriaes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrieadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re enue mav plac� the notice reauired under this subdivision in the individual income tax or pro�ercv tax refund instructions insread 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 stored data on individuals, and wherher it is classified as public, private or confidendal. Upon his furtt�er request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout 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 private data and informed of its meaning,the dara need not be disclosed to hun for six months thereafrer unless a dispute or acrion pursuant to this secdon is pending or addidonal 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, cer[ifying, and compiling the copies. The responsible authoriry 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 possibie. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal five days within wtuch to comply with[he request,excluding Saturdays, Sundays and legai holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private da[a concerning himself. To exercise this rieht,an individual shall noafy in writing the responsible authoriry describing rhe nature of the disagreemeot. The responsible authoriry shall within 30 days either. (a)correct[he data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipiencs named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to contested cases. DAT� PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rijhts 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 furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to deternune 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 agencies to the extent necessary to process the pernut or license. 4. If your requested permi[ or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. First Middle Last Address Ciry State Zip Phone I understan rights as stated above. C � - .� � `(��' ��"l /� - -� Signature