HomeMy WebLinkAbout2001-P03748 - re-roof _ PERMIT
CI`fiY �F ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3�as
Crystal Bay, Minnesota 55323 Pet'mit Type: MinorAlterations
(952) 249-4600 Date Issued: 4i3o�2oot
SITE ADDRESS: 405 North Arm Dr
MOUND,MN 55364
P I D: 06-117-23-32-0003
DESCRIPTION:
Proposed Use: Commerciai
Gensus 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: $ g3•25 Valuation: $ 2>500.00
State Surcharge Fee: $ 1.25
TOTAL FEE: $ 84.50
APPLICANT: Seamans Construction(Do not issue more OWNER: LAKEVIEW GOLF OF MTKA INC
75 Pleasant Avenue 405 NORTH ARM DR
Tonka Bay,MN 55301 MOLIND MN 55364
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. II
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� APPL AN PERM TEE I NATURE ISSUED BY SIGNAT[JRE �
Copies: City,Applicant,Assessor,Finance Page 1
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�T�tal Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII..DING 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
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JOB SITE ADDRESS: ` I�j ��/.`��,�,c , . ZIP: � � ��L/
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NAME OF OWNER: ,u <<��i i P��v �a ��- ��o PHONE: (home)
(work) %� � �/�� 2���d�
1��IAII�INGADDRESS: ���� ����a�� �• CITY: �'����,,� ZIP: �i � ��/
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CONTRA.CTOR: � ��r'S ���vs, PHO�IE: ���Z � �� �I�
CONTACT PERSO : � ��� ��-��w� MOBILE/PA�ER: . � � `` "
11AII�ING ADDRESS: a u � CITY: � ZIP: �
ATE LICENSE: # "- � -���
ST v��/ a y
ARCIi1�'ECT/ENVC=Il�TTEFR: PHO�'E:
MAILING ADDRESS: CITY: Z�:
N�v�; REGISTRATION# �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detai�: �� �-oa � ��-�- � �a l�%
STORIES: SQ. FEET OF EACH F'LOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT�. � DET.
ESTLI�IATED CONSTRUCTIO�i JALUATION (excluding lan.d): S �
c70 G%�
I hereby apply for a building permit and I acknowledge that the information above is complete ancl
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Buildin� Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will in accordanc wi the approved plan. '
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APPLICANT'S SIGNAT . � DATE: G a
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.
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Sec.13.04 RIGHTS OF SLIB.TECTS OF D�Ta
Subd. 1. Type of data. The rightt of individual on whom�e dara is stnr�3 or co be stored shall be as set forth in this secaon.
Subd.2. Information req�rired to be givw individual. �,n individual askcd to supply priva[e or confidendal data concecning himself shall
be informed of: (a)the purpose and incended use of the reqnested dam wi�in the collecang State agency,poliacal subdivision,or statewide sysum;
(b)whecher he may cefuse oY is legally required to supply che requested daa:(c)any lmown consequence arising from his supplying or refusing to supply
privace ar confidendal data;and(d)the idendry of ocher persoas or enrides a�chorized by sute or federal law to receive the data..This tequ'uemenc shall
not apply whan an indir•idual is asked to supply invesdgadve data,purru�t[o secaaa 13.82,subdivision 5,co a law enforcement o�cer.
'Ihe commissioner of re�•enue mav place che noace rewired erder chis subdivision in the individual income tax or orooern tax refund
inscruccions inscezd of on those forms.
Subd.3. Access to data by indi�zdual. Upon tequest to a responsible auchoriry,an iadividual shail be informed whecher he is the subject
of stored data on individuals,and wherher it is classified as public,privac-.or confider.rial. Upon lus fur[her reques�an individuai who is the subject
of scored private or public data on individuals shall be shown che dara wiaouc any c'narge to him and,-if he desires,shall be informed of the content
and meaning of�hac dara. Aftor an individual has been shown the priva:r dac�and ic:ormed of ics mcaning,the dara need not be disclosed to him for
siz monchs rhereaiter unless a dispute or acrion pursuane to[his secdon is canding or addiaooat data on the individual has been collecred or created.
The responsible authoriry sha!!provide copies of the private or public da�a ccon reques:by the individual subject of che dara. The responsible auchoriry
r..ay requir�che requesring person to pay the actual coscs of makin¢,cerying,and compiling the copies.
The responsible au[horiry shall comply immediacely,if possible,wieh any r_quest made pursuant to this subdivision,or wichin five days of
the dac:of the requesc,ezcluding Samrdays,Sundays and legal holidays,if im.mediau-,compliance is not possible. If he cannot comply with the requesc
wiehin that time,he shail so inform[he individual,and may have an addirional Five days within which to compiy wi�h the request,eacluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data Ls not accurate or eomplete. ?.n individua!may contest the accuracy or completeness of public or pri�•ate
daca concerning himself. To exercise chis ri¢ht,an individual shall nodfy ia wridng�e respocuible au[horiry describiag�he nature of the disagreemeat.
The responsibte auchority shall wichin 30 days eicher: (a)correct the dara fcund to be inaccucate or incomplece and aaempt to nodfy past recipients of
inaccurate or incomplete data, inctuding mcipiencc named by[he individc�l;or(b)codfy the individual thac he believes the data to be correcG Data
ia dispu�e shall be disclosed only if[he individual's stacemenc of disagre:�enc is ir.cl•ided with che disclosed daca.
The de�erminaaon of the rasponsible authoriry may be appeal:d punuanc to[he provisions of ehe admuusaarive procedure act reladng to
concested cases. .
DATA PRIV:�CY ADVISORY
In accordance with M.S. 13.04,Subd.2, "Ri;hts of subjects oi data", we would like to inform you that your reQuest
for a permit or license from the City of Orono or any of i� deparments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to de;ermine rour qualification for the permit 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 shazed with other loc�l, stace 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 cenain ri,Phts under M.S. 13.04 (available upon request) to review private data on yourself.
6, Your full name is required to process this aoplica[ion or permi[.
Fitst Middle Lasc
Address
Ciry Srate Zip Phone
I und s d my ri hts stated ab e.
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