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Home My WebLink About2002-P05024 - re-roof ' PERMIT �ITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P05024 Crystal Bay, Minnesota 55323 Pet-mit Type: Minor Alterations (952) 249-4600 Date Issued: 4iioi2oo2 SITE ADDRESS: 1080 Ferndale Rd w Wayzata,MN 55391 PID: 02-117-23-43-0007 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: I NOTICES/REMARKS: T__C Tl_ I�.��.. a�vv��vrua. FEE SUMMARY: Permit Fee: $ 50.95 Valuation: $ 1,325.00 State Surcharge Fee: $ p.7p �, TOTAL FEE: $ 51.65 APPLICANT: Western Cedar Supply OWNER: Charles&Sherry Kushell 9700 13th Ave 1080 Ferndale Rd W Plymouth,MN 55441 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. . . �- / I/l �� (._._� �, �(./�-'�-f. ��/��(_ (_-« � APPLICANT PERMITEE SIGNATURE ISSUED BY S[GNATURE Copies: 1-File(Sienitures Required). 1-Applicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 , . � Total Fee: $ lj�/ti (��/ Date Received: `�- /c� C� _�-- Entered By: -��r� Permit#: C?�� ,3 �% CITY OF ORONO - BUILDING PERMIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �O� �l�"l0�C �� 'sfi ZIP: NAME OF OWNER: �—I ir� �(u,s'�e-//�f PHONE: (home) J�-2 ' �1�6�03a � (work) — MAILING ADDRESS: ��,� CITY: ZIP: CONTRACTOR: Lc�/'.1 Cro��(� PHONE: �6 3-Sy/'G��l CONTACT PERSON: /�(iq�C MOBILE/PAGER: (o/�-a�3�-Y�S`.� MAILINGADDRESS: �f7oo t3n� � CITY: � ZIP: ,s�yy STATE LICENSE: # o�o/T��6,G 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�: �c��d�` �� 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 permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: y'/o� O� 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. . L Sea 13.04 RIGHTS OF SUBJECTS OF D�TA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or confidenrial data concerning himself shall be informed of: (a) the purpose and intended use of the requesced data within the collecting"state agency,political subdivision,or sratewide system; (b)whether he may cefuse oY is legally required to supply the requested data;(c)any known consequence arising fmm his supplying or refusing ro supply private or confidential data;and(d)the idenriry of other persons or enrides authorized by state or federal law to receive the data. This requiremen[shall not apply when an individual is asked to supply invesriearive dara, punuant ro section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav piace the nodce required under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is classified as public, private or confidenaal. Upon his further request, an individual who is the subject 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[hat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or pubiic data upon requesc by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making, cer[ifying, 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 no[possible. If he cannot comply with the request within that time,he shail so inform the individuai,and may have an addiaonal five days within 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 private data concerning himself. To exercise this right,an individual shall nodfy in wriang the responsible authoriry describing che nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The de[erminarion of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relaring to con[ested 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 furnish certain private or confiden[ial information. You are notified that: 1. The information you furnish will be used to determine 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 pernvt or license. 4. If your requested permit 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. 6. Your full name is required to process this application or permi[. First Middle Last Address ��ty State Zip Phone I understand my rights as stated above. /n� Y�'� Signature