HomeMy WebLinkAbout2000-P02565 - re-roof PERMIT
� CITY OF ORONO
2750 Kelley Parkway- PO Box 66 I'ermit Number: Po2s6s
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(612) 249-4600 Date Issued: 6iisioo
SITE ADDRESS: 2565 Kelly Ave
EXCELSIOR,MN 55331
P ID: 20-117-23-14-0019
DESCRIPTION:
Proposed Use: .
Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof
DETAILS:
Approved per resolution#:,
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
State Surcharge Fee: $ 10.00
TOTAL FEE: $331.25
APPLICANT: EVERETT SCHROEDER OWNER: E J SCHROEDER ET AL TRUSTEES
2565 KELLY AVE 2565 KELLY AVE
EXCELSIOR,MN 55331 EXCELSIOR MN 55331
THE UNDERSIGNID 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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� �I ���`,�� D BY SIGNATURE �
Copies: City,Applicant,Assessor,Finance Page 1
CI.TY OF ORONO � 6122494616 06/14/00 09:16 � :01/02 N0:371
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� Tot�l Fee: $ Datc Rcccivcd: ;v f .��lG �
Entered By: Permit#:
CITY O� ORONO - BUILD�IC� PERNIIT AP]?Y..ICA'TION
All finformatfon must b� submitted fn full bet'ore plan revie�cv will be started.
(plrase print atl inJormatfon)
__._ - � -----------
THE APPLICANT IS: (circle one) OWNER R CONTR.ACTOR
�oB srr� annx�ss: ��.S kr 1�,� �f�- ��: s�S_3�%
x� oF owiv�R: ��-�,e t� �����1�� -- P�o�: cno�) �7�1—�����
:�SGS (work) .� ' --�, �t�
NIATLING ADDRESS: /�,�1��,�L. CITY: � :� ,�zl✓ ZIP: .S".53� .
, „� pHONE: �-�C�c)
COVTRACTOR: �r�. �,�. k'c ���-- s —�Z
CONTACTPERSON: �� MOBILE/PAGER: .
MAII.ING ADDRESS:S� G��:�/��� �- crrY: ��� ,� zte: .�J,�� .
STA'I'E x.�CENSE: � iS(!�
AFC��CT/�NG�IEER: pA���
I�L iII.,ING ADDRESS: CITY: ZIP:
N��: �EGISTR.ATIOh'#
TYPE OF '�VORK: New Addition Accessory Strueture
Move 12cmodel/Alteration � Land Alteration
PROPOSED'k'VO�tK (describe in deta�: ��c v�' r���� �� `� ��'�14i�
STORYES: � SQ.FEET OF E�CS FLOOR: ��(� i�
N4. OF BEDROONIS: 3 GAR�►GE STALLS: ATT. _� DET.
ESTItii IATED CONSTRUCTION VALUATTON (excluding lancn: $�-�O � _
I h�reby apply for a buildis�g perm.it and I acknowled�e that the information above is complete and
accurate; �.hat the work will be in conformance wich the ordinances and codes of che Ciry and wich
� the State Building Code; chat I understand this i� aot a perm.it and work is not to start without a
perznit; and that the work will be in accordance w�ch thc approved plan.
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A�'PLICA.NT'S SIGNAT'URE: `� / .` �� DATE: �c%�.�/''� ��-�
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1YOTE! Pur�de_�f Homes events require separctte perm�t approval by Pol�ct Department and
� City Council GO days pr�or to the �vent. Non perm�tted events w�ll not be allowed.
CI.TY OF ORONO � 6122494616 06/14/00 09:16 � :02J02 N0:371
Sec.13.01 RIGHTS OF SU�JECTS OE DaTA �
Subd. l. T�af daca. lh� daha of icdi�idusl on wham chm dio o�ro�d or m be i�or.d sball be u sac lo�ch ia rhis secdon.
Subd.2. Iatormstlon reqtdred co Dt Y,1r�a ladl.tduat. An(ndividuxl as�ed�o Supp1Y ptivaca ot contidendal daa eoocsr�;,ag himxif shsll
ba informrd o!: (a)�he puryo�m and tamnded usa o[�s trqusaumd dna Wi�hin r�c collecrin�En�n ayeacy,potioczl dubd]vt�Ioo, or sramwide ryjce�;
(b)wtitther he caay reAua pr l�l¢g;lly Rqui�ed m rupply�he�equened d1a:(c)anY YxoWn coauqucacs srisinq from his iupplying or rc('usfng ro�upplY
privticn o�aoatldandal data:and(d)th�ide4dq of a�e�per�oas or enoces iuthortzs'i by i�sue or(cd¢ral law co recei�e che dara. Thi�nqulrcmaoc�b�lt
rtot apply when an ind(vidu3l 'a u{cad ro suppty tnveady�dv�dan, pur.cuan[ro sec�on 13.8Z. �ubdlvuion S, ID 1 IlW �tL�OC:[�C�t Of�Cti.
'tha c^^^m;;�,�0er�(q�'4nur m�v k�- �e n4d4� rottvlr�Q urtda���s subEi�uion in tha indivi u�1 lncome ¢r qr araaar� �x re�ur.d
j�cr.,�a�ions i�sca�d Qf an aaa (arms.
9ubd. �. Ac�a�to d�ta by ladlridual. lipon nquost oo a reipors.flbl�au�hariry.in indlvi�ival zhall be tnfocm�d whechcr ho�s ihc subjecc
af�rared data on 1ndlvidu�, �n4 wh�;har it is clauifled ai pubtic, pn�am o�conf.ds�d�l. Gpoa A;s tUrshar request aa indi�iduat who u�e subje:c
nf srarvd privv�a or pubtie dus on tndividuals shatl ba sCown d�s dura wichout any c`urgm w him and.'if he dairz�, thsll bc Inforsned of tha coate�c
nnd meaniaQ ol chat daa_ ARar nn indi�idual hu 6cen�howe�he pn�au dsm and inlortnad of ics meaalaa, taa dad pe�d aoc b¢dlscla9¢d w him for
siu mondu dter�aRer unles� a di�puu or tcdon punvane m thit socdon ia pendin`or addlcoaa! d�a on�fis indi�idual haa beee collcc�ad or creamd.
The teapon�iblo zuthoriLy�h�il pro�ida copies ot d�a privare or public da�a upon ce�ues�by�e itdivldusl subJec�of dte d�e►. 'fl�e cesponsible�uthonry
mny tsquira the nquo�dnp p�reon te pdy the�cnu!cosn o(makrn�.oer�il�rin�.sr.d compilinQ �he copi�s.
'ZT�a ratpoi+.sib{o au�isoriry ihall compty icnmodiacaly, U posaibie, Wi�h uy tequert ssde putsu�nt w tAis svbdi�i�ion, or wi�hin ltve d�ye of
tha da�a o(c!►e raQui�t,e:celudln�SieuAays,Sundays and l�gal halldayi,U immedace compliscce is not po�sib(s. If he eannot comply w{Q��ha reques�
wirhin rhac drue,he ahall�o irilortn tlta iadividual,snd may havm an addidoCnl Ave day�within wtiieh to eamply wita tha cvquest, excludina Saturdsys.
Sunday�a�nd leysl holidays.
5ubd.4. R�acedure�Eea dzla{�not uctsrat�or eomptet�. An i�di�idu�l aiay contest ths accu�cy or complaeness of pubtic or prn'ate '
dao eoRceming hirnealf. To mxorcbe ehls r;ah�an Indiv(dusl shall nodly in wricn;�:e rerpoasibis auehoriry daicribinp the n�mre of che di�aoreemenc. .
Tha rs6Daruibla authoriry 3haJl w{thl�t 30 d�y�eit�er. (a)comeu�he daa laur.d ro Ce inac:u�sm ot lneomplrte snd iasmpt to nod°y put�eeiyiencs of
lnoccurate or ftuomPlaee dav, includln�ncipiena nuned by tha indlvldual; oc(D)aadfy U:o indlvidus! �tuc he belteve� r,he dacl to be eorrecc. Dau
fn dirpute nAlll ba duc!o�ed oNy i!ihe lndlri4uil'� �a�smane of disuqtaxmmnc u ir.clud�d a{�ebe dlsclosed dao.
The decemtinadon oP�ha respons�bim �uehortry miy ba tpyeal�d yursvi.[ro the pro�isions o!tha �dminist�clve p�vicedure ut rel�ring ro
aonm�red csees.
I?A'x'� P�.IV�,�Y .�D�ISORY
In aecordaace wich M.S. 13.04, Subd. 2, "Righcs�P subjects o(da�a", we would like to inform you thac your reques�
for a permit or llcense from che Ciry of Orono or any of i�s depa.�meacs may require you to furnish certain privace or
confidcndal lnformatinn.
You are noclfled char:
1. The infocmatioa you furnish wili be used to decermine your qualification for the permit or licen.ge requestcd.
�. You may refuse to supply daca, but rtftisal ma� rtqulre thac the Ciry dany thc p�rmic oc lic�nsc.
3. The inFocusa�ion may be shared wic�othec local, s�aie oc federal agtncies to the ezten�n�cessary to process
the p�rmit or licanse.
�l. [f your requesred permic oc licease requires Council action to approve, some isifocm�cio❑ may become
public. �
3. You ha�e cercaia righes under M.S. 13.04 (availabie upon reques�) �o review pcivace data on yoursc]f.
6. Your 1`ull name is required ro process chis applicacioa or p:rm.ic.
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