HomeMy WebLinkAbout2001-P04601 - re-side PERMIT
C.!TY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po46oi
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: 11���2ooi
SITE ADDRESS: 3650 Livingston Ave
WAYZATA,MN 55391
P I D: 17-117-23-34-0029
DESCRIPTION: UBC Occupancy R3
Proposed Use: tcesidentiai
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 195.25
Valuation: $ 11,000.00
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 200.75
APPLICANT: Lake Wood Roofing&Siding OWNER: PATRICIA LYNN HOCKEL
610 13th Ave. 3650 LIVINGSTON AVE
Hopkins,MN 55343 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 CITY OF ORONO ORDINANCFS AND
STATE OF MINNESOTA B[JII,DING CODE REQUIREMENTS.
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APPLI A P RMI E I NA U ISS DBYSIGNAT[.JRE
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Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
Total Fee: $ Date Received: �/- 7�'/
Entered By: Permit#: v nc{���
CITY OF ORONO - BUII.,DING PERNIIT 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
JOB SITE ADDRESS: � OS l✓ ZIp; Lj �
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NAME OF O`VNER: PHONE: (home) �� ��o��
/ �� (work)
MAILING ADDRESSs�:�GZ.��`��pZ� CTTY: � IP: �
CONi'RACTOR: d�OivE: '�
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COi�1TACT PERS N: OBII.E/PAGER: -
MAILING ADDRESS: 4?v� .5��vCITY: ZIP:
STATE LICENSE: # /
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ARCHITECT/ENGINEER: 1 .
NIAILING�1�SS: CITY:
�Al����' REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
,
PROPOSED`VORK(describe in detai�: �
STORIES: / SQ. FEET OF EACH F'LOOR: '�� �
NO. OF BEDROO�IS: GARAGE STALLS: ATT. DET.
ESTII�IATED CONSTRUCTION VALUATION (excluding land): $ . �
%�� ��>�'i " �'�- `�
I hereby apply for a building permit and I acknowledge that the information above is complete
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Buildina Code; that I understand this is not a perm.it and work is not to start without a
permit; and that the work will be in accordance with the approved lan.
APPLIC��"S SIGNATURE: ATE: �'� (� ��� �
NOTE! ,P�rade of Flomes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SLfB.TECTS OF D�+►TA
Subd. 1. Type of data. 'Ihe righ[s of individual on whom rhe data is stoced or to be smcsd shall be as set fosh ia rhis secrion.
Subd.2. Information reqirired to be givm individval, An individual asked to supply private or confidential dara concerning himself shall
be iaformed of: (a)the puipose and incended use of che iequesied dara wf[hin the collectiag State ageacy,polidcal subdivision�or smtewide rysum-
(b)whether he may refuse oY is legatly required to supply the cequesced data:(c)aay lrnown consequeace arisiag fmm his supplying or refusing to supply
priva�e or confidendal data;and(d)the ideadcy of other pecsons or enrides authorized by state or federal law to receive the da[a. This requirement shall
not appty when an individual is asked to svpply invesugaave dan,pursuaat to secdon 13.82,subdivuion S,to a law enfoccement o�cer.
The commissioner af revenue mav olace the nodce reauired under chis subdivision in the individual income raz or orooem rax refund
instrucdons inscead of on those forms. . -
Subd.3. Access to data by individual. Upon rcquest to a responsible auchoriry,an individual shall be informed whether he is the subject
of atnred data on individuals,and whe[her ic is classified as public,privace or con6dendal. Upon his Curther request,aa iadividual who is the subject
of stored private or public da[a on individuals shall be shown rhe data without any eharge w him and;if he daires,shall be informed of the contenc
and meaning of chat data. Aher an individual has been shown rhe private data and informed of ics meaniag,the data need not be discloud to him for
suc months the:eafter unless a dispute or acaon pursuanc to chis secrion is pending or addiaonal dara oa the individual has been collecud or created.
The respansible authoriry shall provide copies of the private or public dara upon request by the individual subject of the dard. The responsible authoriry
may require the requesang person to pay the actual cosct of making,certifying,and compiling the copies.
The responsible aurhoricy shall comply immediacely,if pouibte,wich any request made putsuant to this subdivision,or withia five days of
the date of the requesG ezcluding Satucdays,Sundays and legal holidays,if immedia[e compliaace is not possible. ff he cannot comply with che request
wi�hic►rhat time,he shatl so inform che individual,and may have an addidonal five days within wluch to comply wi[h�he request,excluding Saturdays,
Sundays uid legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or pri�ate
dara concerning himself. To exercise chis righ�an individual shall nodfy in wriring che responsible auehoriry describing rhe naare of the disagreement
The responsible auehoriry shall within 30 days ei[her: (a)correct ehe dara found ro be inaccucate or incomplete and at[empc to n�dfy past recipients of
inaccurace or incomplete data, including recipients named by ehe individual;or(b)nodfy the individual thac he believes che data to be correct. Data
in dispuce shall be disclosed only if the individual's sacement of disagreemenc is included with the disclosed dara.
The deurminadon of the responsible auchoriry may be appealed pursuant to rhe provisions of the adminisnaive procedure act nlaring W
contesud cases.
DATA PRIVACY ADVISORY
In accordance wich M.S. 13.04, Subd.2, "Riehts 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 thar.
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 Ciry deny the permit or license.
3. The information may be shazed wich other local. state 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.
5. 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.
First �tiddle �t
Address
Ciry Sate Zip Phone
I understand my rights as stated above. „
Signacurc