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Home My WebLink About2006-P10392 - re-roof PERMIT CITY OF ORONO Permit Number: 2750 K..;ley Parkway- PO Box 66 P10392 C��s:ai Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/2/2006 SITE ADDRESS: 4455 Forest Lake Landing Unit# Mound,MN 55364 PID: 07-117-23-24-0037 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Tear off and reroof FEE SUMMARY: Pernut Fee: $ 153.25 Valuation: $ 8,000.00 State Surcharge Fee: $ 4.00 TOTAL FEE: $ 157.25 APPLICANT: Bob Sons Roofing Mpls OWNER: Sanford&Margaret Erickson 4553 Xerxes Ave. S. 4455 Forest Lake Landing Minneapolis,MN 55410 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL 1MPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. 1 ,/ i i , ll... ' �`�� '- ,��IZ�L A PLICANT PERM EE SIGNATUKE SUED BY SIGNATURE Copies: 1-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page I � � Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan revie�v will be started. (please pf�int all i�zfot•�nation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR 0�1TRACTOR��::� � _ _ , ._ .— • — _ __ JOB SITE A.DDRESS: �� Z�� `� � c'ZIP: � J ��'� Will this be a Parade of Homes, Remodelers Sho�vcase Home or other Display Home? ❑ YeS � No If��es, a specin!event per�nil is req�rired ivit/7 Police Depnrtmenl atrd City Counci/npprovnl GO days prior to tl�e ei�e�7t. SlT:ittle birs se��vice tivill be r•equired crf�(ess applrcaret demonsti�ates sa ffrcient or�-site parking is a�-ailable. ��a�-pern�itted ei�e�7ls lvill not be allotived. i J /1 Q�� ' NAME OF OWNER: � -��'`�1 PHONE: (home) `f�°� �� 37 /� � /� „(wocic) MAILING ADDItESS: � � > 5��ti��i �;/��TY: � ��_ZIP: CONTRACTOR ��'`G�% �c�-.� ' PHONE: �l.Z ' �� '�� COi�'TfS.CT PERSON: "- � 1- OBIL�ER: G�� -/ MAILING ADDRESS: �/�y 3 x..�-�z�, `�- 5�— CITY: ��`� � ZIP:��I�__ STATE LICENSE: # ,,ZG�<��I �YPIRATION TE: 3.- 3 � �c� 7 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NANIE: REGISTRATION: # TYPE OF WORIC: New Home Addition Accessory Stcucture Move Home RemodeVAltecation (ie: Sidicig, Wiildo�vs) Ar:y earth movement may re,qui MCWD review and per�nits ! PROPOSED WORK(desa�ibe in detrcin: � � �c �'-ti'� STORIES: �_ SQ.FEE'�'OF EACH FLOOR: NO. OF BEDR�ONiS: GARA�E �TALLS: A�'TACH�I3 � ETACI-�iET�_ ESTIMATED CONSTRUCTION VAI,UATIO�'(exc(uding land): � -'z�� I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the�vork will be in conformance with the ordinances and codes of the City and with the State Buildino Code; that I understand this is not a permit and�vorl:is not to start without a peri��it; and that the�vork will bz in accordance with the approved plan. . , ; � ,,2 C�-� APPLICANT'S SIGNATUI2E: � � � I)ATE: �G� ` / 3� � • Scc.13.04 RLGHTS OF SUBJECTS OF DATrI 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 section. 5uvd.2. Information required ro be given individual. An individual asked to supply private or contidential data conceming himseffshalf be informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide sysrem;(b) whether he may reFuse or is legally required to supply[he requested data;(c)any known consequence arising Trom his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by sta[e or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may.place the notice required under this subdivision in the individual incotne tas or r�opertv taz refund instructions instead of on those fonns. Subd.3. Access to data by individual. Upon request to a�esponsible authoriry,an individual shall be informed�vhether he is the subject of stored data on individuals,and whe[her it is classitied as publ ic,privace or confidentiaL Upon his further request,an individual who is die subject of stored private or public data on individuals shall be sho�vn the data without any charge to him and,if he desires,shafl be informed of the content and meaning ofthat data After an individual has been shown the privare data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on[he 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 aufhoritv may require the requesting person to pay the actual costs of making,certitying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any requesc mnde pursuant ro this subdivision,or within tive days oF the date oftlie request,escluding Safurdays,Sundays and legal holidays,if iminediate compliance is no[possible. Ifhe cannot comply with the request within tl�at time,he shall so inform the individuai,and may have an additional tive days within which to comply with the reques[,e�cluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complece. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this ri�ht,an individual shal(notity in writing the responsible authority describing the nature of the disagreement. The responsibie aud�ority shall�vithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt ro notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he Uel ieves the data to be correc�. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the�dministrative procedure act relating to contesred 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 confidential information. You are notified that: 1. The information you fiu•nish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemlit 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 inforn�ation may become public. 5. You have certain rights under NI.S. 13.0�4 (available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. o;/�r�� r ��'�� First �Iiddic Last /-� '"3 � � :��55 �i'� ✓tlT`l � �� . d'�� p� Citv S;aic '/_ip Phore I understand v rights 1s a ed ve. � ` '�� Gr Z s��;��;�� Resec Form �-'