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Home My WebLink About2007-P10906 - re-roof PERMIT �CIT)Y OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P10906 Crystal Bay, Minnesota 55323 Permit Type: (952)�249-4600 Minor Alterations Date Issued: 4/19/2007 SITE ADDRESS: 250 Hollander Rd Unit# Wayzata,MN 55391 PID: 25-118-23-44-0014 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Pernut Class: Building Permit Type: Minor Alterarions Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Sepazate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 195.25 Valuation: $ 10,887.00 State Surcharge Fee: $ 5.45 TOTAL FEE: $ 200.70 APPLICANT: Midwest Roofing OWNER: R Jeppson&L Bradley 313 Jefferson Hwy 250 Hollander Rd 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. . �� APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � � Total Fee: $ DateReceived: 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 ONTRACTOR JOB SITE ADDRESS: 2� �o[/ah�,P�- ��X ZIP: S�-3g Will this be a P�rade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �iNo If yes, a special event permit is re9z�ired with Police Departnzent and City Council approval 60 days prior to the event. Shirttle bus service wil(be reguired unless applicant demonstrates su�cient on-site parking is available. Non permitted events wi/l not be allotived. NAME OF OWNER: ��+��,r �e0�Soh PHONE: (home)Q (work)61 Z 8'0`/ 8725 MAILING ADDRES5: CITY: ZIP: CONTRACTOR:/�' w o , Si ' .� PHONE:7(�3�y2�-�6 9�0 CONTACT PERSON: �tr�se � tit MOBILE/PAGER: MAILING ADDRESS: 3l3 Jr�'��'SOM 11u y CITY: PLi.a.�/ih ZIP:SS3/� STATE LICENSE: # 2 oO J o 2'�� EXPIRATION DATE: 3 =3I'' 6� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Hame Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) _�� Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detain: Tf�r o'm t4- 1�'r roe'� �ovse f��t��1 S9 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $�� $��7� � 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��ith the State Building Code;that[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: ��'�"�� DATE: - - O � . 31 r � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. 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 w be given individual. An individual asked to supply private orconfidential dataconceming himselfshall be infonned of: (a)the purpose and intended use of the requested data within the coilecting 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 identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal i 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 mayplace the notice required under this subdivision in the individual income tsx or rooe tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual sha(I be infornied whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the 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 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 thereatter 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 require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within that time,he shall so inform tlie individual,and may have an additional tive 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 conceming himsel£To exercise this right,an individual shal I notify in writing the responsible authority describing the nature of the disagreement. The responsible authoriry sfiall within 30 days either: (a)correct the data found to be inaceurate 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 correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination 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 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 reyuested. 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 permit or license requires Council action to approve,some inforrr►ation may become public. 5. You have certain rights under M.S. 13.04(available upon reyuest)to review private data on yourself. 6. Your full name is required to process this application or permit. • First Middle Last Address City State Zip Phone I unde stand my rights as stated above. • �ivC ignaturc ' Reset Form ' 32 �vl�� / DATE TIME CITY OF ORONO CALLED IN INSPECTION NO CE SCHEDULED �/D"D 7 � PERMIT NO. COMPLETED ADDRESS oZ Cx�t�-�Y-- OWNER CONTR. TELEPHONE N0. �� a 7 �l0 �7[� � DESCRIPTION �1�� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WO00 BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C o - � � Q �-S r�lC'-f��. '' �..,�nS ��,� �,�� 0 � W � Q � Z W � W � � a �/ W� ❑WORKSATISFACTORY:PROCEED �9.pROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED �� ISSUE CERTIFICATE OF OCCUPANCY � ❑Ct�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on si e: Inspector. d White Copyllnspector's File Canary Copy/Site Notice