HomeMy WebLinkAbout2002-P05459 - windows PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P05459
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations �
(952) 249-4600 Date Issued: s�i�2oo2
SITE ADDRESS: 184o Fox Street
Wayzata,MN 55391
PID: 03-117-23-42-0008
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential �
Permit Class: Building Census Code O/S-Building IG
Permit Type: Minor Alterations Permit Sub-type(s): Windows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 331.75
APPLICANT: Sarber Brothers Construction OWNER: John&Linda Massopust
11979 Winnetka Ave N 1840 Fox Street
Champlin,MN 55316 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.
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APPUCANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Apolicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
� � w PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P05459
Crystal Bay, Minnesota 55323 P2CCTlit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: g�i�2ooz
SITE ADDRESS: 1840 Fox Street
Wayzata,MN 55391
PI D: 03-117-23-42-0008
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Sub-type(s): Windows
Permit Type: Addition/RemodeURepair Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25
Valuation: $ 20,000.00
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 331.75
APPLICANT: Sarber Brothers Construction OWNER: John&Linda Massopust
11979 Winnetka Ave N 1840 Fox Street
Champlin,MN 55316 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.
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APPLICANT PERMITEE SIGNATURE SUED BY SIGNATURE �
Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1
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Total Fee: $ � •�;��� �5 Date Received: /��j D -C��-
Er�tered By: - � Permit#: /� c'� �/��>
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��{�/(� ;�.�:, ,; 5� - ZIP: J�s J�C� �
NAME OF OWNER: Johr�, �'�c.S S� �'�-�S c � PHONE: (home) �S� - �l 73 �7�-��
(work)
MAILING ADDRESS: S�yti� CITY: ZIP:
CONTRACTOR: �c�r�e� ��������S C c����- L L c PHONE: 7(,,� ' �l�7 -,�7/ � �-
CONTACT PERSON: I�;,,,;� MOBILE/PAGER: ��3 - ��(,-. - �fU7�
MAILING ADDRESS: �t�j ?`i ��;n n �e }/f�� �,,�.� ,l/.CITY: C�u,,•,�l;y, ZIP: SS'3l L
STATE LICENSE: # C -d(� ,�(�(,G t� �� �,I--�
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�: /1p.,,, ;;�,,;hF'c�,,; �- S/•z r `,,<<�/:
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ a(}� �(��� �'"
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.
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APPLICANT'S SIGNATURE: ��-�.� ; ��,._---- DATE: 7 ' �� �'� �
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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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 section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data 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 or is legally required to supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of other persons or entities authorized by state 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 mav place the notice reauired under this subdivision in the individual income tax or vropertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public, priva[e or confidential. Upon his further request,an individual 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 no[be
disclosed to him for six months thereafrer uriless a dispute or action pursuant to this section is pending or additional 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 cosu of making,certifying, 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 possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five days within which to comply with the request,
excluding Samrdays,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 notify in writing ihe responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify
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 correcL Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant ro the provisions of the administrative procedure act relating
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 �ity 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 permit 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 permit or license.
4. If your requested pernut 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
Ciry State Zip Phone
I understand my rights as stated above.
/�!���'�t ��,_ __._
Signature
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI SCHEDULED IL?-7,J-0� =UCi ,r,�
PERMIT N0. (O SR COMPLETED
ADDRESS_L��G� �G X S'"I•
OWNER CONTR. SG�;/�r� �'3✓�s: ('c�.�,
TELEPHONE NO. ��� ����ZP �I G �6
� DESCRIPTION �f�ta d��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 L BD� 12 WATER HOOK-UP 17 SITE INSPECTION
Q 14 SEWER HOOK-UP 06 PROGRESS
� EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP OR�ER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next� spection 24 hours in advance. (952) 249-46��
OwnerlContra r s t :
Inspector.
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