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HomeMy WebLinkAbout2003-P07102 - re-roof � ' PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po�ioz Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: i2�i��2oo3 A SITE ADDRESS: 4os 1 xighwood Rd Mound,MN 55364 P I D: 07-117-23-44-0076 DESCRIPTION: Proposed Use: Residenrial Buildin Census Code O/S-Building Permit Class: g Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pennit Fee: $ g3.25 Valuation: $ 2,220.00 State Surcharge Fee: $ 1.65 T'OTAL FEE: $ 84.90 APPLICANT: Coty Construction Inc. OWNER: Mr. &Mrs. Vongries 1001 6th Ave St S 4051 Highwood Rd Hopkins,MN 55434 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-IE 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. .� � ,:,� r, ��� � �, ` , � ; ��_ _ �- j ��l �� , ��.� liti�-t �r-—�._ - , � APPLICANT PERMITEE SIGNATURE ISSUED BY S[GNATURE i Copies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 ! �, Total Fee: $ Date Received: ������Q3 Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------- ---- - --------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR/ JOB SITE ADDRESS: TC'rj'�� ,�/�/�i,v�r,r� ,�t✓� ZIP: NAME OF OWNER: ��O�v 6/'i�='S PHONE: (home) (work) MAILL\G ADDRESS: '�Q.�� �/�%7�f�v�cC/i� �/�ITY: (��iC'rING ZIP: .� CONTRACTOR: �U7'' �v/��T� v� �%C% ,/i;�' ' PHONE: y5� �'�,�..� ' �5�L^ CONTACT PERSON: /�IC. MOBILE/PAGER: MAII.ING ADDRESS: f�a�/ �j� I'/� ST f CITY: J�U�',��i��ZIP: ._� STATE LICENSE: # `� ,�5� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPO�ED�'ORK(describe in detai�: /�����95�/f �/�/i�J/CC�E�y UN C, �'ES� ����v�-G= STORIES: _�_ SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. c c,� ESTINIATED CONSTRUCTION VALUATION (excluding land): $ �Z�C7.'— _ 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. � �.`_..._...�'.._ _ , APPLICAI�T'S SIGNATURE: ,%'�������'�..�-� _ �bATE: � � L� ,, NOTE! Parade Qf Homes events require se�iarate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. y� � Sec.13.0� RIGHTS OF SUBJECTS OF DaT� Subd. 1. Type of data. The righu of individual on whom rhe data is stored or co be stored shall be as set forth in this secrion. Subd.'_. Information required to be given individual. An individual asked to supply private or confidenrial data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the colleccing'state agency, poliacal subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing ro supply privace or confidential data;and(d)the identity of other penons or enaties au[horized by state or federal law to receive the data. This requiremeat shall no[apply when an individual is asked ro supply invesdeadve data, pursuanc ro secrion 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav ptace the notice reauired under this subdivision in the individual income tax or propertv tax refund instructions insread of on those forms. Subd. 3. Access to data b�indi�idual. Upon reques[to a responsible au[hority,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is classified as public, private or confiden[ial. Upon his funher request, an individual who is[he 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 infoaned of the content and meaning uf rhat data. After an individual has been shown the private data and informed of ics meaning,the data need not be disclosed ro him for six months [hereaTter unless a dispute or acrion pursuant to [his secaon is pending or addidonal daca on the individuai has been collected or crea[ed. The responsible authoriry shall provide copies of[he private or public data upon reques[by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs 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 oY the date of the request,excluding Saturdays,Sundays and leeal 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 wi[h the request,exciuding Sarurdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individuat may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise this rieht,an individual shall nonfy in writing the responsible authori[y describing�he nature of the disagreement. The responsible authority shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipiena of inaccurate or incomplete data, inciuding recipiencs named by [he individuai; or(b)notify the individual that he believes the data to be correct. Da[a in dispute shall be disclosed only if[he individual's statement of disagreement is included with the disclosed data. The de[ermination of the rzsponsible au[horiry may be appealed pursuant to the provisions of the administradve procedure act reladng [o 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 reauest for a permit or Iicense 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 permit or license requested. ?. 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 permit or license requires Council action to approve, some information may become public. �, You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. First �tiddle Las[ Address C�ry State Zip Phone I understand my ri� s as stated above. � � , � ;, —t____-- Signature