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Home My WebLink About2002-P05177 - re-roof ' �' PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Posi�� Crystal Bay, Minnesota 55323 Pe►'mit Type: Minor Alterations (952) 249-4600 Date Issued: sii3i2oo2 SITE ADDRESS: 3s96 r.yri�a�e WAYZATA,MN 55391 PID: 17-117-23-43-0153 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Pernut Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 23.50 Valuation: $ 500.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 24.50 APPLICANT: WILLIAM A SWANSON OWNER: WILLIAM A SWANSON 3596 LYRIC AVE 3596 LYRIC AVE WAYZATA,MN 55391 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 COD QUIREMENTS. ` � �' .r �� L-.J<�� -,--n----.—_-� ;� U / G�� APPL CANT PERMITEE SIGNATURE [SSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessine. 1-Finance Page 1 Total Fee: $ Date Received: Entezed By: Permit#: CITY OF ORONO - BITII,DING PERIVIIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------- ---- ----------------------------------------------- THE APPLICANT IS: (circle one) WNER R CONTRACTOR JOB SITE ADDRESS: �> j(� Ly�r-��`... ;1�1'�Q, , C�,� �Z��'�! ZIP: �� '�� '� ( NAME OF OWNER: L�J. � �,r�,�� J ��><�� PHONE: (home) °�-�l'�l- �l�"� � (work)��-:> -�f`1�-�?E`��9 MAII,INGADDRESS: ,3:� , (�.�,-`�� , CITY: �,.�A•�2,,��-,� ZIP: �� s7_� CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAl�IE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration J< Land Alteration ( �� _ I �� ,� � c. �. � . �� r- � PROPOSED WORK describe in dezai `,�.�- -� , n �, �, ,. �� ::�� ,��y ;�-�,, �,��-�, �"�!;�l� ��.��.1� STORIES: J '/� SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � v C�`'--' 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 pemut; and that the work will be in accor with approved plan. �� , APPLICANT'S SIGNATURE. � / � DATE: � '�' d� _ NOTE! Parade o 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 D�TA Subd. 1. Type of data. The rights of individuai on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual uked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of[he requesud data within the collecting�tate agency,polidcal subdivision,or sratewide rystem; (b)whether he may refuse oY is legaliy requimd to supply the requested data;(c)any Faown consequence arising from his supplying or refusing to supply private or confidenaal data;and(d)the idenriry of ocher persons or enriaes auchorized by state or federal law to receive the data. This requ'uement shall not apply when an individual is asked to supply invesrigarive dam,pursuant to secaon 13.82,subdivision 5,to a law enforcemenc officer. The commissioner of revenue mav place the noace reouired under this subdivision in the individual income tax or oropem tax refund instructions inscead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is classified as public, private or confidendal. Upon his further request,an individual who is the subject of stored private or pubiic data on individuals shall be shown�he data wichout any charge to him and,if he desires, shall be informed of the contenc and meaning of�hat data. Afrzr an individual has been shown the privace data and informed of its meaning,the dara need not be disclosed to hirn for six months thereafter unless a dispute or acnon pursuan�to this secrion is oending or addidonal data on the individual has been collected or crea[ed. 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 requesring person to pay the actual costs of making,cervfying,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 Saturdays,Sundays and►egal holidays,if immediate compiiance is not possibie. If he cannot comply wirh the reques[ within that time,he shall so inform the individual,and may have an addioonal five days within wtuch to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authoriry describing the nacure 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 inaccunte or incompiete data, including recipients named by the individual;,or(b)noufy the individual that he believes the data to be correct. Data in dispuce shali be disclosed only if the individual's statemenc of disagreement is inciuded with the disclosed dara. The decerminarion of rhe responsible authoriry may be appealed pursuant to the provisions of the adminisaarive procedure act reladng to con[ested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri;hts of subjects of data", we would like to inform you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or confideatial information. You are notified that: 1. The information you furnish will be used to deternune your qualification for the pemut 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 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 ri;hts under N1.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. , � � � ) � � { � .. ��)��;f J�l �C.��' ��c:y`-� First Middie Last '=; �`�'�� -v�"�� ✓� � ' Add;ess } � , �� /�19(��/2i l� �l l�� '� �a �� 7�'�L� � I�' ��:' �' Ci� State Z�p Phone I understan �rz�( �i ts as_st � d above. -�i�l�-� Signature