HomeMy WebLinkAbout2001-P03740 - re-roof f ,
� PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3�ao
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(952) 249-4600 Date Issued: 4i2si2ool
SITE ADDRESS: 2660 Lydiard Ave
EXCELSIOR,MN 55331
P I D: 21-117-23-23-0031
DESCRIPTION:
Proposed Use: ftesidentiai
Permit Class: Building Census Code 434
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof
C.i-lt.�nh,���-�� .r�c....$/1
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 44.85 Valuation: $ 1,200.00
State Surcharge Fee: $ 0.60
TOTAL FEE: $ 45.45
APPLICANT: John Haley#1 Roofer OWNER: B J BAUER&J J BAUER
7600 W. 27th. St.#203 2660 LYDIARD AVE
St. Louis Park,MN 55426 EXCELSIOR MN 55331
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 BUII,DING CODE REQUIREMENTS.
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APPLI ANT PERMITEE IGNATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII..DING PERMIT A.PPLICATION
All information must be submitted in full before plan review �vill be started.
' (please print a11 information)
TIiE A.PPLICANT IS: (circle one) OWNER OR CONTRACTOR
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JOB SITE ADDRESS: .:-` G,�o� ��/G%( �c:� (�� CZ,�/�-._ ZIP: �� � �I
NAME OF OWNER �, d�(�C� �. I. �a-V�� PH0�1E: (home) ���-`� ��-���c$`7
(work)
l�IAII.I�i TG A.DDRESS: ��GQ G�/c.t �� . CITY: C�I�OII C� ZIP: SS I
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CONTRACTOR: " 70�/1 /�zlu� �"� �c���� PHO�IE:
CON'TACT PERSON: Jo kn f-��.Iz:��,_ ��IOBILE/PAGER: _
MATLING ADDRESS: 7�0�'1 � �7 S'�-� e�� CITY: `�l c�,� '�1C ZIP: S.S`=��2�
STATE LICENSE: # �� /�.Z�sS�C?
ARCHITECT/ENGINEER: PHO\TE:
MAILLVG ADDRESS: CITY: Z�:
N��: REGISTRATION# �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �h,'y�'�;✓1� �c-�jc�5 L� —
STORIES: SQ.FEET OF EACH FLOOR:
NO. O� B�DROOMS: GA.RAGE STA.LLS: ATT�. � DET. � - � - .,
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ESTII�i IATED CO�'STRUCTION VALUATIO\ (exclud.ing land): S ��>� �
I hereby apply for a buildin� permit and I acknowled�e 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 Buildin� 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 accordance with the approved plan.
ANT'S SIGNATURE: ���-'�_- C' � � DATE: ���S-� I
APrLIC �
1�'OTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. 1Von permitted events will not be allowed.
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Sec.13.0-1 RIGH'IS OF SUBJECTS OF DaTa
Subd. 1. Tvpe of data. "Ihe righcs of individual on whom th�data is s�:_3 or to be scored shall be as set forth in this secaon.
Subd.2. Information reqirired to be given individual. An icdividual ask�co supply privace or confidendal dara concerning himself shall
be informed of: (a) the purpose and incended use oE the requesicd dara wi�in the collecdng'stace agency,poliacal subdivision,or statewide sysrem;
(b)whe�her he may rtfuse oY is legaily required to supply che requested daa;{c)any lcown consequeace arising from his supplying or refusing to suppty
priva�e or conndendal data;az:d(d)the idendry of other peaoas or enddu a�choriz�d by state or federal law to receive the data..'Ihis requiremenc sball
not apply when an individual is asked to supply invesrieadve data,punLc�o szccoa 13.83, subdivision 5, to a law enforcemen�o�cer.
The commissioner of re�•enu� mav place the norice rauired ��d-r this subdivision in che individual ir.come tax or oropem tax refund
inscructions inscezd of on�hose forms.
Subd. 3. Access to data by indiridual. Upon requesc to a r_s�oosible ae�:oriry,an individual shall be informed whe[her he is the subject
of scored data on individuais,and whe�her it is ciassified as public,priva�or confid�nrial. Upon his further requesc, an individual who is the subjecc
of scored private or public data on individuals shall be shown[he dara wi�ou�any ci�rge to hirn and;if he desires, shall be informed of the contenc
and meaning of chat data. Aft�r an individual has been shown�h�priva��aa and iL;ormed of ics meaning,[he data need not be disclosed to him for
siz mor.�hs �hereafter unless a dispute or acaon punuanc to this secaon is;.ending o;addiaonal data on the individual has been collecced or creaced.
The responsibie au�horiry shall provide copies of the privace or public da3 L�on reqses:by[he individuai subject of rhe da�a. The responsible authoriry
rr,ay require che requesring person ro pay the accual eos�s of making,ce=.::ing, and compIling the copies.
'Ihe responsible auchoriry shall comply immedia�ely, if possib!:,wi�h an}•requesc made pursuant to this subdivision,or wichin five days of
th�dat�oE the reques�,excluding Sacurdays,Sundays and legal holidays,i;ir..media�e compliance is not possible. If he cannot comply with the request
wichin thac rime,he shall so inform che individual,and may have an addi�eral five da:s wichin which to comply wi[h the tequest,excluding Sacurdays,
Sundays and legai holidays.
Subd.4. Procedure when data is not accurate oc complete. ?.n individual may concest the accuracy or completeness of public or pri�•ace
da�a conceming himself. To exercise�his right,an individual shall nodiy ia�xridng c=responsible authoriry dzscribing che na�ure of the disagreemeac.
Tne responsible auchoriry shall wichin 30 days either: (a)comct[he dae icund to be inaccurate or incompiece and attempt to noufy past recipiencs of
inaccuca�e or incomplete data, including recipients named by[he individ��;or(b) codfy the individual thac he believes the data to be coaece. Data
in dispuce shsil be disclosed only if the individual's stacemenc of disagre_�:nc is i.c:�3ed wich the disclosed data.
T1ie decerminarion of the rzsponsible au�horiry may be appea�_�punuaL:to the provisions of the admiivsaadve procedure act reladng to
contested cases.
DATA PRIV:�CY AD�ZSORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects o�data", we would like to inform you that your reauest
for a permit or license from the Ciry of Orono or any oi is depar.�.ents may require you to furnish certain private or
confidential information.
You are notified that:
1, The informacion you furnish will be used to de:emune�'our qualification for the permit or license requested.
?, You may refuse to supply data, but refusal rsay require tha[ the Ciry deny the perm.it or license.
;, The information may be shared wich other Iocz, state or federal agencies [o 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.
�, You have cenain rights under M.S. 13.04 (z•.ailable upon request) to review private data on yourself.
6, Your full name is required to process this applicacion or permic.
Firsc �fiddle Lasc
Address �
Ciry State Zip Phonz
I underscand my ri�hts �s stated above.
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Signantre