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Home My WebLink About2005-P08925 - windows PERMIT CIT,Y �F ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p08925 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 7/7/2005 SITE ADDRESS: 3516 Ivy Pl Unit# Wayzata, MN 55391 PID: 20-117-23-42-0022 DESCRIPTION: _ _ ___� Proposed Use: Residential Census Code ; " O/S-Building Permit Class: Building �" - Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 209.25 valuation: $ 11,922.00 State Surcharge Fee: $ 6.00 TOTAL FEE: $ 215.25 APPLICANT: Justus Lumber Company OWNER: James& Sherry White 330 l lth Ave S. 3516 Iry Pl Hopkins,MN 55343 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 O NO ORDINANCES AND STATE OF MINNESOTA BU(LDING CODE REQUIREMENTS. 1 �� 7� �,�:�c C � � � ��"�e� � /2c� APPLICANT PERMITEE SIGNATURE / I SUED BY SIGNATURE � Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, l-Septic) Page 1 � - PERMIT CITY OF ORONO Permit ►vumber: 2750 Kelley Parkway- PO Box 66 P08925 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 7/7/2005 SITE ADDRESS: 3516 Ivy Pl Unit# Wayzata,MN 55391 PID: 20-117-23-42-0022 DESCRIPTION: Proposed Use: Residential Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 209.25 valuation: $ 11,922.00 State Surcharge Fee: $ 6.00 TOTAL FEE: $ 215.25 APPLICANT: Justus Lumber Company OWNER: James&Sherry White 330 l lth Ave S. 3516 Ivy Pl Hopkins,MN 55343 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. � �'1 `�f ..�- .�-� C� �� APPLIC 'PE �ITEE SIGNATURE SSUED BY SIGNATURE Copies: 1-File(Signa[ures Reguired), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 r • , • Total Fee: $ Date Received: �'' ? r�%'� Entered By: Permit#: �� j.��' CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (plectse print all infof•nzation) ----------------------------------------------------------------------------- - - - - ------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �,�(� �V'� � I C�C� ZIP: Will this be a�arade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS ��NO If yes, a special event permit is regui��ed with Police Depaf-t�sient and Citv Co�inci/approv�al 60 days pf�ior to the event. Shuttle bus servtce wtll be requared uriless applicant den��o�zstrntes suffcieitt oiz-site parking is available. No�z perrnittecl events will not be allowed. NAME OF OWNER: � ( (�l �� -�(� PHONE: (home)d1eJa• �-{1 I �I�J`(� (work) MAILING ADDRESS: �_(��_ ��c�CITY: �1/C� �'1 D ZIP: SS3G CONTRACTOR:��}�`�� ;��2Q� PHONE:q 5a� �� . a�y � CONTACT PERSON: � C34� MOBILE/PAGER: �01a � �n8�� C��3� MAILING ADDRESS: ��j O �`�' � Sa. CITY: ��' 1 ZIP: �3 STATE LICENSE: # ��a� ��3co�i EXPIRATION DA E: � a, � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration �_ PROPOSED WORK(desci�ibe in detai�: � � ��QZ,,� v '�- � �� S'I'ORIE�: SQ.�'EE'I'OF EACI��OOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTI01�i VALIJATION(excluding land): $ �� , �� . � v I hereby apply for a building permit and I acknowledge that the inforniation above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State�uilding Code;that I understand this is not a permit and work is not to start witliout a perniit;and that the work will be in accordance with the approved plan. �- APPLICANT'S SIGNATURE: DATE: � � „ • - , > Sec.13.04 RiGHTS OF SUBJECTS OF DATA 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 section. Subd.2. information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed oE (a)the purpose and intrnded use of the requested data within the coltecting state agency,political subdivision,or statewide sysiem;(b) whether he may refuse or is legapy 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 shall not appiy when an individuai is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue ma�nlace the notice reauired under this subdivision in the individual income tax or prQnertv tax refund �tructions instead of on those 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 whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or pubtic data on individuals shall be shown the data without any charge to him and,if he desires,shall be infortned 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 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 immediate(y,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. [f 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 with the request,excluding Sahudays, 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. "fo exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagee�nent. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate 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. 'Che determination of the responsible authority may be appealed pursuant to the provisions of the adminisdative 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 infonn 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 aze notified that: 1. The information you fumish will be used to determine your qualification for the pemut or license requested. 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 pernut 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 this application or permit. �l./� �I�`1 Yl �,� ��<�� First Middle Last �� 1��' �t�e- �� • Address ��K-t Y� �Yl n �3� ��1�� a�►�l City Statc Zip Phone I understand my rights as stated above. Sign e