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Home My WebLink About2003-P06513 - re-roof ��` � 1�� PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P06513 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: �igi2oo3 SITE ADDRESS: 1950 Fox Ridge Rd Long Lake,MN 55356 PID: 03-117-23-13-0010 DESCRIPTION: Proposed Use: Residenrial Buildin Census Code O/S-Building Pernut Class: g Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 125.25 Valuation: $ 5,275.00 State Surcharge Fee: $ 3.15 TOTAL FEE: $ 128.40 APPLICANT: Westurn Roofmg OWNER: David&Ellen Phelps 9700 13th Ave 1950 Fox Ridge Rd Plymouth,MN 55441 Long Lake MN 55356 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. k� �S�G�—� `o� ��rn�-- ��- APPLIC`ANT PERMITEE SIGNATURE 1 SUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � ` ' Total Fee: $ j� �° �� Date Received: 7-�v� Entered By: �-�2- Permit#: �' �„ �/_� �CITY OF ORONO - BUII�DING PERNIIT APPLICATIOle1 All information must be submitted in full before plan review �vill be started. (please print all information) THE APPLICANT IS: (circle one) OWNER O CONTRACTO JOB SITE ADDRESS: l�Sc� �X�,�� ,(� znP: �35� NAME OF OWNER: ��cJC Phe�PS� PHONE: (home) (work) �5/- S'S�-��_ NiAII,Il�TG ADDRESS: Si,,.+.,� CITY: � Zg': SS 336 CONTRACTOR: �y{t,.�n �� PHONE: �3-S%/-o3dy CONTACT PER50N: �j��c MOBILE/PAGER: �l'� �8►2-Y �S- MAILING ADDRESS: �1�� /3r`f� �/ CITY:�y.�,,�_ZIP: �SS� STATE LICENSE: # d� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: rJ�,�; REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� /QPfCxS� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. c� ESTIMATED CONSTRUCTION VALUATION (excluding land): $ S �� 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: � � 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. . _.. . Sec.13.04 RIGHTS OF SUBJECTS OF DATA 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 reqirired to be given individual. An individual asked to supply private or confidendal data concerning hicnself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'statc agency,polidcal subdivision,or statewide system; (b)whether he may refuse oY is legally required to suppiy the requested data;(c)any Imown consequence arising fmm his supplying or refusing to supply private or confidenrial data;and(d)the ide�tiry of ocher perso�s or enrities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesagaave data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund instruc[ions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shail be informed whe[her he is the subject of stored data on individuals, and whe[her it is classified as public, private or confidenaal. Upon his furthec request,an individua! who is the subject of stored private or pubtic data on individuals shall be shown the data without 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 data need not be disclosed to hirn 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 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, cerrifying, and compiling ihe copies. The responsible authoriry shall comply immediately, if possibie, 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 possible. If he cannot comply with the request within that time,he shall so inform the individual,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 conceming himself. To exercise this right,an individual shall noafy in wridng the responsible authoriry describing[he narure of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to nodfy pas[recipienu of inaccurate or incompiete data, including recipients 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 individuai's statement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the admuustraave procedure act relaang 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 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 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 pemut 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 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 permit. First Middle Last Address Cih, State Zip Phone I understand my rig state e. Signatu e