HomeMy WebLinkAbout2004-P08137 - windows PERMIT
�CriY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po813�
Crystal Bay, Minnesota 55323 Pet'mit Type: Minor Alterations
(952) 249-4600 Date Issued: l2iioi2oo4
SITE ADDRESS: 51 Hackberry Hill
Long I.ake,MN 55356
PID: 33-118-23-44-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Windows
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 32.65
Valuation: $ 750.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 33.65
APPLICANT: Wilson Services OWNER: Barbara Cameron
2743 Magnolia Lane N 51 Hackberry Hill
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.
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APPLICANT PGRMITEE SIGNATURE ISSUED BY SIG ATURE
Copies: 1-File(SiQnitures Required). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ Date Received:
Entered By: Permit#: �(, ) �I,� f'�'
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�it all information)
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THE APPLICANT IS: (circle o�ze) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 51 Hackberry Hill ZIP: 55356
Will this be a Parade of Homes, Remodelers Showcase I-Iome or other Display Home?
❑ Yes �To If yes, a special event per�yiit is required with Police Department and City
� Council approva160 days prior to the everzt. Non per•�yzittecl events tivill rT�ot
be allowed.
1
NAME OF OWNER: PHONE: (home) 7h"�-559- 1 6
(work) 612-701=9725
MAILING ADDRESS:2743/�'Iag lia Ln.N. CITY: PlY• ZIP:55441
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CONTRACTOR: Wilson Services PHONE: 612-701-9725
CONTACTPERSON: ��,,,,.0 �ilson MOBILE/PAGER: �,1 ?-h4fi-7899
MAILING ADDRESS: 2743 Magnolia Ln.N. CITY: Ply. ZIP:55441
STATE LICENSE: # 02789
ARCHITECT/ENGINEER: N/A PHONE:
MAILING ADDRESS: N/A CITY: ZIP:
NAME: N/A REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition Move
Remodel/Alteration xxx Land Alteration
PROPOSED WORK(descrihe in detain: Add egress window in basement wall,replace
h10�. ha1n�,� c�inrin�T /N�'��'� �f 5�2.:�c= ,Do��- /
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 750.o0
I hereby apply for a building permit and I aclrnowledge 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: ��✓� �� l-�� . DATE: 10/25/04
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Sec.13.04 HIGHTS ON'SUBJECTS OF DATA
Subd.1. Type of data. Thc rights of individual on whom the data is stored or to be stored st�all be as set fo�th in[his section.
Subd.2. Information required to be given individual. An individual asked to supply private or con�dential da[a concerning himself shall be
in(ormed oL• (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or state�vide system;(b)
whether he may refuse or is legally required to supply the requcsted data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other pe�sons or entities authorized b}'state or federal law to receive the data. This requiremenf shall
not apply when an individual is asked to suppl,y investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement of[icer.
The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or nropertv tax refund
instructions instcad of on thuse 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 whcther it is classi�ed as public,private or confidential. Upon his furthcr request,an individual who is thc subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be inCormcd of the content and
meaning of that data. After an individual has been shown the private data and intormed of its meaning,the data necd not be disdosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional 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 authority may
requirc the requesting person to pay the actual costs of making,certifying,and compi�ing the copies.
Thc responsible authority shall comply immediatcly,if possiblc,with any request madc pursuant to this subdivision,or within fivc days of the
date of the request,excluding Satw•days,Sundays and legal holidays,if inunediate compliance is not possible. If he can�wt comply with the request avitl�in
that timc,hc shall so inform thc individual,and may have an additional five days within which to comply with thc request,exduding Saturdays,Sundays
and legal holi�ays.
Subd.4. Procedure whco data is not accurate or complete. Ao individual may contest the accuracy or completeness of public or private data
concerning himself. To esercisc this right,an individual shall notify in writing thc responsible authority describing thc naturc of thc disagrcemenL Thc
responsible authm•ity shall rvithin 30 days eiU�er. (a)correct thc data found to be inaccm�atc or incomplete and attempt to notify past rccipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notifV the individual that he bclieves the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagrecment is included with the disclosed data.
The Jctermination of[he responsible authurity may be appealed pursuant to the provisions o(the adminislrative procedure act relating to
contested cases.
DA1'A NRIVACY ADVISORY
In accordance with M.S.13.04,Subd.Z,"Rights of subjects of data",we would like to inform you tliat yoor request
for a pernrit or license fro�n the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You arc notifed tliat:
1. Tlie information you furnish will be used to deterrnine your qualification for the pernut or license requested.
2. You may refuse to supply data,but refusal may require that the City deny thc 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 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 tliis application or permit.
Charles D. Wilson
First Middlc Last
--���I� �Sf�9�'� �Fl �l
Address
Ply. Mn. 55441 763-559-2316
City State Zip Phone
I understand my rights as stated above.
C��� � L-���_
Signature
. �
CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Pog13�
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: 12iloi2ooa
SITE ADDRESS: 51 Hackberry Hill
L.ong Lake,MN 55356
PID: 33-118-23-44-0016
DESCRI PTION:
Proposed Use: Residential
Pernut Class: Building Census Code O/S-Building
Pernut Type: Minor Alterations Pemut Sub-type(s): Windows
DETAILS:
Approved per resolution#: �
./
Separate pernuts required: r ,�
` l/lx
l / v
NOTICES/REMARKS: ��� �� ��
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FEE SUMMARY: PermitFee: $ 32.65
Valuation: $ 750.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 33.65 •
APPLICANT: Wilson Services Barbara Cameron
2743 Magnolia Lane N OwNER:
Plymouth,MN 55441 51 Hackberry Hill
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAdCE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STWCT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUGD BY SIGNATURE
Cooies: 1-File(Siunitures Required), 1-Aoplicant 1-Monthlv Renorts, 1-Assessin�, 1-Finance
P�„o 1
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JUN 2 , ��45
�Vil�on Ser����s CI T y�F�R4N
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Page�: �iY;���G48-7899
To Whom it may concern;
Please cancell Permit ��P08137,it was issued
for egress window that will not be installed.
Thank You !
Chuck Wilson
6/23/05
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