HomeMy WebLinkAbout2001-P04420 - windows � ,
PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P04420
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(952) 249-4600 Date Issued: ioiioi2ool
SITE ADDRESS: 1160 Heritage La
Wayzata,MN 55391
PID: 10-117-23-13-0003
DESCRIPTION: UBC occupancy R3
Proposed Use: tcesicientiai
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): W�ndows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Thic ic a cPrnnfl inctallmPnt nf�xrinrinax�c
FEE SUMMARY: PermitFee: $ �gl•25 Valuation: $ 9,230.00
State Surcharge Fee: $ 4.65
TOTAL FEE: $ 185.90
APPLICANT: Renewal By Anderson OWNER: Erwin& Sandra Bullock
350 73rd Ave NE 1 160 Heritage La
Fridley,MN 55432 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 BUII,DING CODE REQUIREMENTS.
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PPLI ANT PERMITEE SIGNATURE �ED BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1
"- � ."Oct•� 2 � 2001" 3 � 21PM ELDER-JONES BU I LD I NG PERM I T SERV �i�4���No � 2919� LP � 2.�w rvv:a��
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� � �' To'�hal Pe�: � �C'J � Date Recelved; /`�"'' -�'�
Ente�ed HY: ,,, _ _ Permit�Y: �,� �,��"C'
�;ti.�-r�� f�".3 Z''l ' ,
�TTY OF 4RON�0 - BUILDIIYG P�RMYT A►PPLICA7'YON
Ap�1t�4orcnadon mu�t be eu�mitted in t1u11 before plan review wfU b� �t�rted. .
� �, . �p�ease pr7nt al�l�ormurlvn) � .
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T�iE APl'I:ICANT IS: , (c�rcle one) �OI�VN�R O ONTRACTO
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JQB SYTE ADD��3: �I�.QO -Q.i i�O� , Zl'�': S�� � ''
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�, NAdVIE OF OWNER��..F�a `�� L�o � ��C�, P�'ONE: (home)_`�5a•��-1•�"'o�1r�
(work) .
MA.ILING ADD�RESS: � C1TY: 3.�:
Rez�e�val B ,A,zadexsen ' ( ' � C� "/ /l
CQIVTAACTaR: ,�_____ y E: �' � �
�-.COIVTACTP?�RSON: . 350-73rd Ave_� �; t � �
k�Xidley,MN 55432
� MAi�.1NG AU�?R�� 763-502-4777 Zi�:
�8'rAT� LICEN3E: �Y � #MIVZo130983 �,� �
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• A,BCH�TI�CTI$N'GINE�R: PHONE: ,
�ViA�I.ING ADDRFSB: G9TY: ZIP: ' ,
NAME: - BFGISTRATION� � �
TXP� OF 'VVORK: NBw Addition Aoce�e�ory St►uct�ue
Mave � Romode1/A1tetQtian I.and Alteration .
P`ROP�SE.D�I�VORK(desc�be in detai�:��o,�� 1�,�,J� �,�;���_
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s�r�a�s: sQ.��T o��Cx�t.00�
I�O. OF B�DROOMS: GARAG� STAt,LS: ATT. DET.
FSTIMA7'ED CQNSTRUCTION VALUA'I'�ON (txcluding 1en�: $ ~ d��
I hesrreby epp�y toc a building permit and I acknnwledge tt�at tt►e informe�ion above I�coa�ptete a�l
accuratc; tbat the wock will be In conf��maacs'v�ith thc orc�lnartc�s°e�nd �ades of the Cicy and with
, ' the 3tste Bulld�ng Codo; that I understand thi: is not a permit�nd w,ork i� not to start a+�Lhaut a �
� pern�it; and that the work wil!be �in accordance w�th the approvod plan. ' �
kPP'LiCANT'S SIGNATUAE: Dt�TL; .�C� �O �
11�OTE1 ,p',c�d�.��eve�ts r�qt�re�e,parnts permit approvol by Pol�ce Deparb�te►�'ond
G3fty Couacil 60 Qapa p�1nr to the event. Non�pe►�,t�te+d eveRts wilr no!be allawea�
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$�c.13.04 ttIGNTB OF�UBJRC78 OF DA'i'A
8ubd, 1. T�cC dab. 2he rlybls of lndlv�url oA Whom dte Aie�U-�cored oe m be=�ted�dall bs ae set br�In�!s secdan.
Subd.�. Worm�tlae eiqtd��d io be R(we Iodlvtdu�i. M I�iWduol atked m apply priv�te or oon�ideep�l dota tonasrnlnB Altn6elPaball
be InfoRnod oA (�d�e purpose and Inunded ute of dte�equasu�doai wid►iu du coli�nslns lTam 0genay,palldcal aubdlvisian,or�ntewida sy�tem:
(bI Wh�ther he ms,y s4lhte oT it le�vly t'�qYIRd w auPP�Y Ihe raquene+!dou;!cl�rry knou►n consequaaoe acf�ing fmm hls sUpplylna or mlliaing ro suPP�Y
pdv�m or ooMdondol dwc�;snd(d)J�a Idendry of od�er peis�on�ar enddea aud�ariud by use or hde�al I�u►m roeelve�e da►�. 1'h!t roqul�smoae ahall
noc�pply wAen an lndiriduall�nskcd ao mpply ln�eio��dre daa,purivant w��cdcn'13.61,Nbd�Yision S.[o�I=w enfonemen�0lPioar.
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'�,q��m�l�nac Q(mvenue t� v olacs�he Mdcc �mt�ad under thi��ub Ivls n�in �he indlvldual incQme �t„Qr orodercv raR�
... ., ttuct�p�i4�4�YLn�JlB.�a['ml� , � - ' , „ ;
SuDd� 3, AcceN�o data by individual. Upon roques�ro a rospneuiDle autlu�rih.an lndi•Wual iftill be i�fo�med wheth�r he le d�a aubJeot
ot�tared d�n on indlvldutlr.and whed►or i�is elafalfled�i publ�C.p�ivue or conPldenual. Upon 6i�Ntd►er tequea�,�n lndiv(duAl aha��the wbj�[ '
o��rod pJiarc a�pubilo da�e on Indlv4Auel��lutl b�ehown d+e•dau wl�ou�en�aMr`e w hlm ond;V hc deslt�a,eh�ll 6e infetmed oi tl�e eonronc
ond nie�nln�o!d�at daa. Ah�r on Iadi�iduv ha9 be:s ihown th�p�ireu dirr rnd�om�u!oI t�oneanlr+t,tlu dao naad tu►t 6�dieelneed W.hlm Par
dx a�ond►s thero�l4a�unleN a dicpu[a or�otioe pursuarn oo�h1s iecdon is pendina o�addidonel�an�he lndlvlduvl bqi 6een oollec�ed qr crm�d.
7Ue r�spuAeihb�u�hpdq�ball pro�ide copia of dte prir�oe ot pvbllc dara uPnn requen Er�he indlvldngl�ubjece of die AQca. The ritpr+nslble au�horly
m�y eequi�o r1►o raQue�dng porenn ro pry�he aeaal eos�s�P nwklns.nroiyino.�nd a►n�llln�dse copi��.
The rorponsihle wtho�iq�.rhell cqmply immedl4celY,U poesible.�f�h�y nquae�mad��ursuant u��Is su�li�ision,or wlthln fl�e dtyr af
��dotn of the tayuau.excludln�8ia�i.Sundoy�ond Icg�J.holWays,If lmm�dlom oomplhnee i�not po9sihlo. 11�Ae camnv�su�nply wkh d�o nqws� .
vwlddn dut dme,he ebel{w lNbrm rha ladividual,and m�y hsve tn addl�ion�l five d�yd Wld�b�Whlch w comply Wlth►hs reqltmat,��eludlag�aatrdays,
9undtys�nd le�d hotld�yt.
�ubd.4� ptoO�AU��t�h�t11 dsls it not AC�UrOta or�au1p�N0. An indlv�,l�al m�y oonien tAe�ccut�ray or eompleroboas oPpubll�ol'prir�ce
d�a¢onaern�ns him�elG '(b exercise��t tf�ht..n indi4lAuel ihall no6ly In we1Mo ehc reaponst�le wdwd9+desc�'bin�ihe ee�ro oP d�o Aue�nem�nc. .
� Tbe 1e�p�nrlble�uUlo�iqr dldl withln 30 daya ehher. (�)eo�reet ifie dRm found a b.inaautoue or incumplerc end aaampt no nocdfy p�u r�slplente af•
i�meeuMre or ineoropl�te dpn, Ineludln�{n�iplentr mmed by the indiv�dual:or(b)nool�r tho indivfdual diet hs belleves the dow co be¢o►�t. Da�a
in dl�pu�t ih�ll be disctotad on�y!f ths Ind(vidual'�eu�art�n�of diwpraeman�f�Includad with U�e dlscloted dda�. �
'�lu dearmina�lon nf�he rn�yoasihlo au�oriry mq bo appealed pu�au�n�eo tlu p�oylsiono o��he adm�nisuadva proealure aee�eladn�m
wiue�ted eare�, � .
' pATA PEtiVACY ADy,�ORY � �
. ln�caordeac� with M.S. 13.Oa� Subd.2, 'Righa of AubJects of da[a”, we would like co infarm yuu that yourrequeac
�Por a pormi� or ticanae trom tha Clry vF Orono or any o!'i�s depanmen�a may requlro yu�co Purn�sh cenaln privat� or
confidcntiel Information. -
'f�ou uo n�otiffed lhet, � � �
I. • Tha 1pPotmatian yau eurn�sh w�ll be uged to determit►a your qualificatlon for�he Per�onic or ltceaae requc,��eQ.
' 2. You may rofuso co eupply d�sa� but teL'u�s�1 niay requlce that the City deqy the permlt or ltco��te,
. 3. Tha informacion na�y be shered with otber local� atate or ftdeYal agcuciea to the exren��nec�seory to pmcaas
. tho Qerm��or lkxese, .
� 4. , rf yout requesced permi[ or fl'ce�se requirns Counc� eet�on [o appro�e� some infaRnaclon tr��y► beeomo , �
' pubik_
�.. You hsve cenain rights under M.S. 13,04 (ava�lable upoo requcst) to reviow private data en your�elf, ,
d, Your iruil name is requarad co pmcess this appl(cation or pBcmic.
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' I•uttderstand y rlghte ��e�a� a6ove. � ,� .
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� � l/l ' d OZ6Z ' �N n�3S 1fW�3d �N1011 �8 S3N0�-�3013 WdLZ � £ 100Z ' Z ' ��0
v; � � �, ��•��•v � v�c.�rr�wiu Vy/G�+i�o i�+.VV �y :UL/U� IVU:7LL
Tatal F�: S� Aate R�ceived:
Entered By: Permit�+:
CIT'�' OF ORONO - BUILDING PERMIT .�PPLICATION
Atl informatlon must be submitted in full before plan review will be started.
�� �please pr�nt all informatlon)
TH� APPLICANT IS: (circle one) OWNER a ONTRACT�R
JOB SITE ADDRESS: I� �.Q� -2t��Q ZI�': S�3 '�
�. NAME OF OWNER:�C�,, C� �,; -e o �v��0 C�� P�IONE: (home)`I�a.��-1•�-a(pa
(work)
MAILING ADDRESS: � CITY: ZIP;
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CONTRACT4R: Rene«�al B��Andersen E. •
. COIVTAGTPERSON: 3sc�-�3ra��e.N� t' -
Fridley, MN 55432 --
� � MAII..ING ADDRE55:,_, ��3-so2-4��� ZIP:
��fiA'f;� LIGENSE: a #�N2oi3o�s3
. ARCHITF.CT/ENGINE�R: PHONE:
MAIL�NG A.DbRESS: C�TY: ZIP: - --
NAME: REGISTRATIUN# �
1'YP'� O�' WORK: New Addition Accessory Sm�cture
Move Remodel/Alteratian Land Alteration
P'ROPOSTA VVURK(descrlbe in detai�: '�Q��,ouCQ � l�i���� ��,,,r�
-�-,��js�c�r�� _
STORIES: SQ.FECT OF EACH FLOO�t:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
� 2 a/
E;STIMA►1'�D CONSTRUCTION VALUATYON (excludin=lan�: $ ,� c�J�
I h�reby a�ply for a bullding petmit and I acknowledge that the informetion above is compiete Snd
accurate; that the work will be in conforn�ance with the ordinances and �odes of the City and with
, ' the State Building Code; that I uaderstand this is not a permit and work is not ta start without a
permit; and that ihe work will be in accotdattce with� the approved plan.
APPLYCANT'S SIGNATLIRE: DAT�: I!•�C. •�
NOTE! P�d�Homes evcnts raq�ufr� aepamte permit approval by Police Departtnte»t wtd
GYty Corrnell 80 days prtor to the event. Non perm�tted eveRts w�l!not be aYlowed.
�aroi ❑er� Ti.,�„ C,,., �A 1 . A�D��( D,. ;_ t mf_. _ r . _ ni � �nnv
TY OF ORONO � 6124730510 09/24/96 14:00 �1 :03/03 �N0:5?2
Ssc.13.04 ltl(�l'1TS OF SUBJEC fS OF D�'i'�1
Subd. 1. Type of dab. 'TNe tiyhts ot indlvidud oi��hom the data is aeored or co be scorrd shall ba as set fonh fn this seedon.
Subd.3. Inlonertlon riqu�rrd to ba�Iv�n iod(�Idu�. M[ndividurt as�ad to supply priveu or oonfidendal d�ta concartdng himaelf Rhall
be(nfortned of: (�)d�e purpose and imm�ded use oP the nquested date within the collecdn�6taue agenoy,polidtal aubdivision,or snteu+ide ryctem:
(b)w}�ether be msy rofl�se or i9 legally required co supply►he requesud dvu;(c)�ny knoum consequence ariaing from his supplyln�or reflising to supply
privsce or coaflden[ia!daa�;and(d)U�e idenrih of od�e�person�or enddes aurhorized by sum or feder�l law�o reecive�he da�a. Thts requireme�c shull
not�pply when on lndividuel ia asked�o eupply in�esrig�dve daa, pursunnt[o�ecdon 13.82, subdivision S.[o a law enforcemenc otPFcer.
a cum�,�sgner�(,rov_enue muv alace �he nocjce r�auired under is subdi�isic� in e ind(vidue�l income rax or orooer�v ux nll;nd
_ 11lE4�dont��sr�ad o!on�►o�o torms. "
SuDd, 3. Arcees to data by individual. Upon rcquesi to a rcspunsible authonry,�n iaAi�fdual shall be lnformed whother he le�he subJeet
ot�tared dan on indlviduals.�nd wh��ar ic is elissified as public, ppvate or conPldenual. Upon 6is tl�rther rcquest,an individuat who b�he subjtct
of�wred pri���e or Nublic da�a nn lndividuals slull be shown rhe da�wf�houc sny chzr`e u�him and;iF he deslres,ahdl be infortned of rhe wnten�
rnd meaning of diat da�. Af[er on indi�idusl his bein shown�he priv��n dara and ia[ocmed of iu meaning,the dmn need noc be diaclosed to hlm for
d:ewnrha thsreafior unlerr a dispu�e or�criun pursuan[oo ihis seeeian is pendfnQ or addidonal dara on ihe individual haa been oollec[ed or creareJ.
The r�apuoaible�uthpriry chrlt provide copiea of rhe privi�e or public dara upon requesc by�he indlviduat cubjeci of d�e da�a, Tt►e reypnnsible au�ha�iry
rt+ay requiro�he raquettin�pmrson ro pay�he actual coscs�f mak(ng.certif�ino.and compfling rbe eopi�s.
The responeible au�h�riry ch�ll comply immadiuely, if possible,wich aay requesi made pursuunt�4�his subdivision,or wiil►ln fi�e days of
�he dtre of the reyuest,excludinQ Stmtdays.Sundays ond Ieg�t holldays,iF immedla�e compliance is not possihto. INhe cannot comply with the roques�
wlrhin�ha�[fine,ho aha1)w inForm�ha lndividual,and m�y ha�e�n oddldonal five doys wi�hin which w comply wi�h th�requesc,excludlt�g Saaudays.
Sund�ye and le�wl holldaye.
Subd.4, Proeedure wh�n dnia:s not accurAte or camplcte. An inJf�idual m�y eonms�the accu�acy or complerenosa of public or priv�ce
d�u eoncornln�himself. To exercise rhis right.on indi'viduel shall nout�in writinB the roapcinsible�u�hud�y describin��e neNro of�ho d►cagroemcnc.
The teepen�lble authoriry sltell withi»30 days either: (v)correcc the dam found eo be inaccurxte or incumpleu And ot�empt ta nodfy pau reoiptents eE
inaeeunte or inc:umplete dpra, Includin�recipienta named by [he individual;or(b)nodty We individual chat ho belleves rhe darn co be oorrece. Data
ip d�tpwe ihsN be disclosod only if t]►a indlvidusl's su�emen�of disao�eemenc is includad wirh the di9closed dva. '
9'he detemtinn�ion of�he rrsponsible au�liariry may bo appealed pursuani eu th�pro�isionc of Ute adminixusdve proceduro act relarine w
aoncesrod e�ses. .
' DATA��A�Y A�Vi$OR`l
In socordance with M.S. 13.04,Sabd.2, "Righcs of sutijec[s of da[a", we would like co inform you thac your requesc
for a permi[ oc license from the City of Orono or any of its depaitments may require you to furnish cer[ain private or
confidential information.
Y'ou are nndfied thar.
1. The informetion you furnish wltl be used t�decermine your qualification for the permit orlicense requosted.
' 2. You may refuso to suppiy d:ua. but te[usal may require that the City deny the permit or licc�lse.
3. T'he information may be shared with othCr local, state or ftderal agencies to the excent ncctssary t�process
tha permit or license,
� 4. . Tf yout requeeced permit or license requires Council action to approve, some infarmatton traay becomc
' public.
S. You have certa�n righ�s under M.S. 13.04 (av�itable upon cequest) to review private data on yourself.
6. Yaur fitll name is required to process thls applica�ion or petmit.
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���y, Soa Zip Phon�
' I•understand y dghts � s�ace above.
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