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Home My WebLink About2003-P06310 - re-roof ' �' PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po63io Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: s�i3�2oo3 SITE ADDRESS: 1035 Heritage La Wayzata,MN 55391 PID: 10-117-23-13-0009 DESCRIPTION: Proposed Use: Residential 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: PermitFee: $ 83•25 Valuation: $ 3,000.00 State Surcharge Fee: $ 2.00 TOTAL FEE: $ 85.25 APPLICANT: Edward A. Sylvers OWNER: Blair&Nancy Bjerke 2526 W. 60 St. 1035 Heritage La Minneapolis,MN 55410 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. � ,�''�� ;��1C^---- ��n-- Z APPLI ANT PE ITEE S G A URE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1 . � Total Fee: $ Date Received: �-� �—�'3 Entered By: � '�(,� Pernut#: T'�)� 3� � CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER OR C NTRACTOR ` � � JOB SITE ADDRESS: �Cj� � ��;,.�� , i��''ZIP: 5 J'� � `�� NAME OF OWNER: PHONE: (home) (work) MAII.ING ADDRESS: CITY: ZIP: ��i% � —, CONTRACTOR: ��,� < ,� �Z c��/�'� S� PHONE: � ��' - �S ° `� `'.��6 CONTACT PERSON: £',� MOBILE/PAGER: �; � -> --%�c.�_ �, S'�'v MAILING ADDRESS: 2 � '� � Gu�.��5'�- CITY: �. / � ZIP: �-�y/p STATE LICENSE: �# 2 O � ��` %'�"/ 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�: � ,= ;��a-Y /�d:�� _ STORIES: SQ.F'EET 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 acc d ce with the approved plan. APPLICANT'S SIGNATURE: - DATE: /,��.... J : Lf NOTE! Parade o�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. / . Sec.13.04 RIGHTS OF SLJB.TECTS 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 reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and in[ended use of the requested dara within the coilecting'state agency,polidcal subdivisioo,or sratewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown coasequence arising fmm his supplying or refusing to supply private or confidential data;and(d)the idenriry of ocher persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigaave dara, pursuan[to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the norice reauired under this subdivision in the individual income tax or propertV 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, private or confidenaal. Upon his further request,an individual who is the subject of stored private or public data on individuals shal!be shown the data wi[hout 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 him for six months thereafter uriless a dispute or acdon pursuanc to this secrion 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 subjecc of the dara. The responsible authoriry may require the requesting person to pay the acrual costs of makine, 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 addidonal 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 notify in wriang the responsible authoriry describing[he nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccunte 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 statemen[of disagreement is included with the disclosed data. Ttte determination of the responsible authority may be appealed pursuant to the provisions of the administrarive 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 Ciry 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 deternune your qualification for the pemut or license requested. 2. You may refuse [o 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 pemut or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5, You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this appiication or permit. Firs Middle Last Address C�ry State Zip Phone I understand my ri state above. si '�'�