The URL can be used to link to this page

Home My WebLink About2000-P02822 - re-roof � ' PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po2g22 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (612) 249-4600 Date Issued: siisi2oo SITE ADDRESS: 3559 Livingston Ave WAYZATA,MN 55391 P 1 D: 17-117-23-43-0048 DESCRIPTION: Proposed Use: Buildin Census Code 434 Permit Class: g Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 4,250.00 State Surcharge Fee: $ 2.15 TOTAL FEE: $ 113.40 APPLICANT: W F. SMITH CONST OWNER: D. BRYANT 5975 LYNWOOD BLVD 3559 LNiNGSTON AVE MOUND, MN 55364 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 CI'IY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � APPLI A T PE E SI A E ISSUED BY SIGNAT[.JRE Copies: City,Applicant, Assessor,Finance Page 1 r� � Total Fee: $ Date Received: Entered By: 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� CONTRACTORI� � �� . JOB SITE ADDRESS: �' � �—� U ��'��`� �_-��-� ZIP: NAME OF OWNER: �c� ,/ i¢�--�� PHONE: (home) (work) MAILING ADDRESS: . CITY: ZIP: � �� -� � �S.�� CONTRACTOR: �,� . � S�ti�1 �l-� ��✓`'�� PHONE: � CONTACT PERSON: MOBILE/PAGER: `��, —,�i� � MAILING ADDRESS: �5� 7 S ��-�,��v,��,�-, ��CITY: L'ti� �v-,-,�� ZIP: sss-� �� STATE LICENSE: # �RCHITECT/ENGINEER: PHONE: N1.=�ILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: � ��'JY' �=�� `� �� f��''��( STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 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 accord�{�ce with the approved plan. , ,= -- �� , - �. APPLICANT'S SIGNAT :�� ) ` ` ��-��-%' � DATE: `�:� _ ( S - `� �.� NOTE! Parade of Homes events require separate pernzit approval by Police Department and City Council 60 days prior to the event. Non permitted events wild not be allowed. , �► Sec.13.04 RIGHTS OF SUBJECTS OF DAT� Subd. 1. Type of data. The righcs of individual on whom the data is s[ored or to be stored shall be as set fonh in this secrion. Subd.2. Information reqirired to be given individual. An individual asked to supply privace or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within Ihe collecang'state agency,polidcal subdivision,or sratewide system; (b)whe[her he may refuse oY is legally required to suppiy the requested data;(c)any irnown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the identiry of ocher persons or enades authorized by state or federal law ro receive the data. This requirement s6a11 not apply when an individual is asked to supply invesrieadve dara, pursuant[o secdon 13.82, subdivision�, to a law enforcement officer. The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or propertv tax refund instructions inscead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe�her it is classified as public, priva[e or confidenrial. Upon his further request, an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the contenc and meaning of[hat data. Aftzr an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafrer unless a dispute or acrion pursuan[to this section is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual costs of making, cerafying, and compiling the 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,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additionai 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 individuat may contest the accuracy or completeness of public or pri��ate data concerning himself. To exercise chis right,an individual shall noafy in wriang the responsible authoriry describing[he nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt[o nodfy past recipients of inaccunte 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. The de[erminacion 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, "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 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. 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 wi[h other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested pernut or license requires Council action to approve, some information may become public. j, 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 permic. �,�; �-;�L,i2 �-�' �� n--, , �— �� First Vtiddl7e Last �� '� � C��'G4/(4�,;�:�� C� (/G�"� Addre� v 2/ �'Q / M✓� CS�� ( / �- —C�7 �� City State Zip Phone I understand my rights as stated above. �� Signamre