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Home My WebLink About2001-P04200 - minor alterations CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po42oo Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: sii6�2ooi SITE ADDRESS: 2700 Kelly Avenue Excelsior,MN 55331 P I D: 21-117-23-23-003 3 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minar Alterations Permit Sub-type(s): Building- Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 153.25 Valuation: $ 8,000.00 State Surcharge Fee: $ 4.00 TOTAL FEE: $ 157.25 APPUCANT: Bob Rettmann OWNER: Mr.& Mrs.Rice 14575 Louisiana Ave S 2700 Kelly Avenue Prior Lake,MN 55372 Excelsior MN 55331 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. / ��`�/ / � f/ � ' �� f�� - � ��(_, - ;`��-,s-�('�� p. _ LI ANT P MITEE SIGNATURE ISSU BY SIGNATURE Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Revorts. 1-Assessine. 1-Finance Page 1 Total Fee: $ Date Received: Entered Ry: Pernut#: CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER O�CONTRACTOR� ___ _ JOB SITE ADDRESS: �%G' � ��GC-" %�(.i' ZIP• ��-�3 -� � NA1�1E OF OWNER: ti�� f� %�=�� PHONE: (home) �'�:� � �� )/_ `�'� ;'`�' (work) ��'�''�- MAILING ADDRESS• �z 7='��> ,� ,��.�y ,-Zr;� CITY• .,v�,_�,�i�.�,;� ZIP• _s s-_� � , CONTRACTOR: �°��s ,z��rr..-,��,� ,;,� PHONE: � rz --tf s�T-�� 1 CONTACT PERSON: `��` �IVIOB��AGER: � �Z -1/�'- ��`J MAILING ADDRESS: /�t�rs� c��,_,;�.ti;� ,�� c C�TY: :'%�ra�r ;-4/cc ZIP: �-��T Z STATE LICENSE: # <-�o �s�� / ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New _ Addition Accessory Structure Move ; Remodel�Alteration Land Alteration PROPOSED WORK(describe in detai�: >��- .G�`� ��= STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� `'�J 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 th� approved plan. , � � DA'TE: ;r—� - �� APPLICANT'S SIGNATURE: � � �� , NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. i Sec.13.04 RIGHTS OF SUB.JECTS OF D?�T?� Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. An individual asked to supply priva[e or confidenrial data conceming himself shall be informed of: (a) the purpose and intended use of the requested data wi[hin the collecting'state agency, political subdivisiou,or statewide system; (b)whecl:er he may refuse oY is legalty required[o supply the requested data;(c)any k�own consequence arising fmm his supplying or refusing to supply private or conr"�dencial data;and(d)the identity of other persons or enrides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdeadve dara, pursuanc to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re enue mav place [he norice reauired under this subdivision in the individual income tax or propertv tax refund instruc[ions instzad of on those forms. Subd. 3. Access to data by indi��dual. 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 confidendal. 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. Aftzr an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hicn for six mon[hs[hereafter unless a dispute or acrion pursuant to this section is oending or addiaonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the acrual cos[s of making, certifying, and compiling ihe copies. The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the date of the request,exc(uding Sacurdays,Sundays and legal holidays, if immediate compliance is no[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,excluding Sarurdays, Sundays and legal hotidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data cor.cerning himself. To exercise[his rieht,an individual shall nodfy in writing the responsible authori[y dzscribing[he nature of the disagreeme�t. The res�onsible authoriry shall within 30 days either. (a)correct the data found to be inaccu[ate or incomplete and attempt to nodfy past recipienu 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 dispuce shail be disclosed only if the individual's statement of disagreement is included with the disclosed data. Tfie de�erminarion of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 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 a�encies to the extent necessary to process the permit or license. .�. 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. 6, Your full name is required to process this application or permit. � � -;i-ti� ti. ti. �'06 !,.� ,�_�_�. � First �fiddle Last , �{- 7�- , i � %�4,�'� � 'r ' ; �} � �-> _ .� � � .�d res��l/�,•Z [ /7�� I''I �- � � -?��. � '�� _� l:� Ci[v State Zip Phone I understand my rig�as stated �ve;,y i;� / . ` �I �L � Si¢na[ure � �