The URL can be used to link to this page

Home My WebLink About2002-P04949 - re-roof -� PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P04949 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 3is�2oo2 SITE ADDRESS: 3541 Lyric Ave WAYZATA,MN 55391 PI�: 17-117-23-43-0103 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 83.25 Valuation: $ 2,200.00 State Surcharge Fee: $ 1.10 TOTAL FEE: $ 84.35 APPLICANT: �'�'� F. Smith Construction OWNER: DONNA M LIEN 5975 Lynwood Blvd 3541 LYRIC 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 SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. ! � �C�rn�� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 � ' • � Total Fee: $ ��5 Date Received: � -�,—,�''�—G',�� Entered By: ,��_ Pemut#: _�c1 �f j y�7 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 (�R CONTRACTOR --�_�__..___ JOB SITE ADDRESS: ��-( � � �2 - L ZIP: Ss� C � NAME OF OWNER: ��V`'h 1--� P Y`' PHONE• (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �1�i � �". S�M � � �I C O e�-�� PHONE: `�S�- - �{ 7� - (��.� CONTACT PERSON: "��;� MOBILE/PAGER: � MAILING ADDRESS: S� �S- �y N;.�,�,� ��C��CITY:y'L��,,.,�/ ZIP: SS�G �� STATE LICENSE: # ,S �� 5' ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAlVIE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe in detain: ( �/� �� 7 �2-e V=-�Li �� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMAT'ED CONSTRUCTION VALUATION (excluding land): $ Z Z `�' `> � 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 Ciry and �vith 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 b in accorda c i the approved plan. APPLICANT'S SIGNATURE: DATE: � �— � i `� � NOTE! Parade of Homes events require separate permit 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[JBJECTS OF DATA Subd. 1. Type of data. The righrs of individual on whom the data is stored or ro be stoisd shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requesred data wirhin the collecting§tate agency,political subdivision,or stauwide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidential dara;and(d)the idenriry of other persoas or enddes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigaave dara,pursuant to 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 taz refund instmctions instead of on those forms. Subd.3. Access to data by individuai. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the dan wichout any charge to him and,-if he desires,shall be informed of the content and meaning of diat dara. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for siz months thereafter unless a dispute or acdon pursuant to this secrion 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[he data. The responsible authority may require the roquesdng person to pay the actual cosu of making,cerdfying,and compiling the copies. The cesponsible auchority shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot comply with the request within that time,he shall so inform the individual,and may have an addiuonal five days within which to comply with the request,excluding Saturdays, Sundays and tegal holidays. Subd.4. Procedure when data is not accurate or complete. An individua!may conust the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shail nodfy in writing the responsible auchority describing�he nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, including recipiencs named by[he individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individuai's statemenc of disagreement is included with the disclosed data. The de[erminadon of the responsible authoriry may be appealed pursuant to the provisions of the administracive procedure act relating to contested cases. DATA PRNACY 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 with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested pertnit 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. W �-�-�'' � �'�''` ' �� First Middle Last � �i '-7 C` �`i rti � a-6� ,� �✓D Address� � �� j� L�"�� — 6s-�� c3 L W C�ty State Zip Phone I unde tand my ri s as ed ve. Signature