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Home My WebLink About2001-P04599 - re-side PERMIT CITY OF ORONO 2�50 Kelley Parkway - PO Box 66 Permit Number: Poas99 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: ivv2ooi SITE ADDRESS: 3660 Livingston Ave WAYZATA,MN 55391 PID: 17-117-23-34-0030 DESCRIPTION: UBC Occupancy R3 Proposed Use: fcesiclentiai Buildin Census Code O/S-Building Permit Class: g Permit Type: Minor Alterations Permit Sub-type(s): Building- Re-Side DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: ra_cir�P anrl ra_rnnf 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: T G THOMA&J A KOBERNUS 610 13th Ave. 3660 LIVINGSTON AVB 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 ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. .� � ��. �-�- APP ANT I E NATU SUEDBYSIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 Total Fee: $ Date Received: //- 7- ��/ - Entered By: Pernut#: 9 0 �� j CITY OF ORONO - BUILDING PERMIT APPLICATIOl`d 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: �lU�� C/1 l✓ ZIP: Vr�g� r � � ��- ��S t'lrn NAME OF O�VNER: PHONE: (home) ��i'�`�` 'l > (work) MAILING ADDRESS��'p� CI'TY: l IP: � CONTRACTOR: �ONE: —�j �� CONTACT PERS N: OBILE/PAGER: MAII.ING ADDRESS: � C��UL� .5�JCITY: - ZIP: STATE LICENSE: # � / ,�c� ARCHIT'ECT/ENGINEER: ------�IH�:- MAII.ING ADD�tESS: _ -�'_. CITY: �----'" REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� STORIES: / SQ. FEET OF EACH FLOOR: '� 7 � NO. OF BEDROOI�iS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � C��C� ° o `� I hereby apply for a building permit and I acknowledge that the informati n above is complete n accurate; that the work will be in conformance with the ordinances and codes of the City and wi 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 lan. APPLICANT'S SIGNATURE: ATE: �'� ��J �� NOTE! Parade of Homes events require separate permzt approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGHTS OF S[JB.TECTS OF D�►TA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be sto�ed shall be as set foith in this secaon. Subd.2. Information reqirired to be given individual. An individual asked w supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and inrended use of the iequesud data wirhin the colleccng 3tate agency,polidcal subdivision,or satewide rysum; (b)whether he may mfuse oY is legally required to supply the requesud data:(c)any lrnown coasequence arising from his supplying or refusing to supply priva[e or con6dential dara;and(d)the idenriry of o[her pecsons or enrides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve dara,punuant to secdon 13.82,subdivision 5,to a law enfo�ement o�cer. , Tht commissioner of revenue mav place the nodce rewired under this subdivision in the individual income taz or prooertv tax refund instrucrions instead of on rhose forms. - Subd.3. Access to data by individual. Upon requesc to a responsible auchority,an individuat sha(1 be informed whether he is the subject of stored data on individuals,and whe[her it is classitied as public,priva�e or confidenaal. Upon his further requesc,an individual who is the rubject of storod private or public data on individuals shall be shown the data wirhout any charge to him and;if he desires,shall be informed of the content and meaning of rhat data. Aher an individual has been shown che privare dara and informed of ia meaning,the data need not be disclosed m him for six months thereafter unless a dispute or acaon punvanc co chis secaon is pending or addiaonal data on the individual has been coliected or creaced. The responsibie auchoriry shall provide copies of the private or public data upon request by the individual subject of rhe data. The responsible authoriry may require the requesdng person to pay the actual costs of making,certifying,and compiling the copies. The responsibte authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the reques�excluding Samrdays,Sundays and legal holidays,if immediate compliance is not possibte. If he cannot comply with the request wi[hin rhat time,he shall so inform the individual,and may have an addidonal five days within wluch to comply with the request,excludiag Saturdays. Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or comple[eness of pubiic or private data concerning himself. To exercise chis right,an individual shall nodfy in writing che responsibie authoriry describing�he nacure of the disagreemenG The responsible authoriry shail within 30 days either: (a)cornct rhe data found w be inaccurate or incomplete and aaempc to nodfy past recipienu of inaccunte or incomplete dara, including recipiencs named by the individual;ar(b)noafy the iadividual thac he believes the data w be correct. Data ia dispuce shall be disclosed only if the individual's statement of disagre�ment is included wi[h[he disclosed data. The decerminadon of the responsible auchoriry may be appealed pursuant to the provisions of the adminisaarive proceduro act relating W contesced cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "RiP,,hts of subjects of data",we would like to inform you that your reques[ 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 City deny the permit or license. 3. The information may be shared with ocher local, state or federal agencies to the extent necessary to process the pemut 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 Middle Last Address City State Zip Phone I understand my rights as stated above. „ Signacurc