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Home My WebLink About2002-P05037 - re-roof PERMIT LI �Y OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Poso3� Crystal Bay, Minnesota 55323 Per'mit Type: MinorAlterations (952) 249-4600 Date Issued: 4�is�2oo2 SITE ADDRESS: 200 Leaf St I.ong Lake,MN 55356 P I D: 04-117-23-22-002 6 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 125.25 Valuation: $ 5,700.00 State Surcharge Fee: $ 2.g5 TOTAL FEE: $ 12810 APPLICANT: Western Cedar Supply OWNER: Louis&Colleen Bellamy 9700 13th Ave 200 Leaf St Plymouth,MN 55441 Long Lake MN 55356 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. __._---- _ �. i `� �-^ �; c:'%:�12�r. ,;�>.� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required). 1-Apnlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � ' Total Fee: $ Date Received: ��- /S- v L- Entered By: Pernut#: �`<'3' CITY OF ORONO - BUILDING PERMIT APPLICATIOleT 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 �___.__�_..a�_._.. JOB SITE ADDRESS: � f� � _- ZIP: NAME OF OWNER: �� I C/�t C. ' PHONE: (home) I S� - `f 7� - c�'�� (work) MAILING ADDRESS: CITY: � ZIP: CONTRACTOR: G��S`�z.rh �oG-��, PHONE: � � _ S%/ �v�a� CONTACT PERSON: ��,�C OBILE/PAGER: � ► �- ag� ��,SS MAILING ADDRESS: `�7o c, i �3�` F�°� CITY: � �ZIP: , � � STATE LICENSE: # D�J�7 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�: �j�"c�oFvC`i"C51 cf� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ S, ��C� 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 pernut 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: ��"��v<< NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and Ciry Council 60 days prior to the event. Non permitted events will not be allowed. .+n � Sec.13.04 RIGHTS OF SUBJECTS OF D�TA 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 secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data conceming himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecting'state agency,political subdivision,or sratewide system; (b)whether he may refuse oY is lega(ly required to supply the requested data;(c)any lmown consequence arising fmm his supplying or refusing to supply private or confidential data;and(d)the ide�riry of o[her persons or enriaes authorized by state or fedecal law to receive the data. Ttus requirement shall not apply when an individual is asked to supply invesrigadve dara, pursuant co secdon 13.82,subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the nodce required under this subdivision in the individual income tax or propertV tax refund instructions 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 whe[her it is classified as public, private or confidenaal. Upon his further request, aa individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to hun 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 its meaning,che data need not be disclosed to hitn for six months thereafter unless a dispute or acrion pursuan[to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or pubiic data upon request by the individual subject of the dara. The responsible authoriry may r�quire the requesting person to pay the acrual coscs of making,cerufying, 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 of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with the request within that time,he shatl so inform the individual,and may have an addiaonal five 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 concerning himself. To exercise[his right,an individual shall nodfy in wridng the responsible authoriry describing�he nature of the disagreement. T?ie responsible authoriry shall within 30 days either: (a)correct[he data found to be inaccurate 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 dispute shall be disclosed orily if the individual's statement of disagreement is inciuded with the disclosed data. The de[ermination of the rzsponsible authoriry may be appealed pursuant to the provisions of the administtacive procedure act reladng 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 fumish 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. 2. You may refuse to supply data, but refusal may require that the City deny the pemut 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. (, Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. ��s� � Signa re