The URL can be used to link to this page

Home My WebLink About2001-P04255 - re-roof PERMIT C I TY �J F O RO N O Permit Number: 275Q Kelley Parkway- PO Box 66 Po42ss Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: s�29�2001 SITE ADDRESS: 3645 Lyric Avenue Wayzata,MN 55391 P I D: 17-117-23-34-0043 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Buildin Census Code O/S-Building Permit Class: g Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 139.25 Valuation: $ 6,750.00 State Surcharge Fee: $ 3.40 TOTAL FEE: $ 142.65 APPLICANT: �'illiams Contracting OWNER: Tom Penn 5501 Bass Lake Road 3645 Lyric Avenue Crystal,MN 55428 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. � �� APPLICANTPERMIT SIGNATURE IS DBYSIGNATURE Copies: 1-File BiQnitures Reauired), 1-Apnlicant, 1-Monthlv Renorts, 1-Assessin¢. 1-Finance Page 1 Total Fee: $ Date Received: Ent�red By: Permit#: . � CITY OF ORONO - BUILDING PERNIIT APPLICATION � 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: � � � S L- J�C ZIP: � � NAME OF OWNER: � o n, �f/v � PHONE: (home) � S -� �- �/�s„� _S� (work) � � MAILING ADDRESS: s�`�'ri P CITY: dR o�o Zg': � 7 �3 -- S 3.��'i ,�� CONTRACTOR: �� , C�.N�r�� E� � PHONE: � G CONTACT PERSON:,��,�+.� �M ILE/PAGER:�;/a- S'S�^o� o � MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # o � � � 7 y �" ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe in detain: %p�� --a�f � .e nd� F STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ (� , �7 5�� I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; th�t 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 permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: (�C..,� � r DATE: � / � � NOTE! Parade of Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. a r Sec.13.04 RIGHTS OF SLIB.TECTS OF DaTA Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be givea individual. An individuai asked to supply private or confidenual data concerning himself shall be informed of: (a)the purpose and inunded use of che requesred data within the collecdng�fare agency,polidcal subdivision,or statewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown coasequence arising from his supplying or refusing to supply privace or confidenaal data;and(d)the idendry of o[her persons or enrides au[horized by state or fedeeal law to receive the data. This requirement shall no[apply when an individual is asked to supply invesrigaave data, pursuanc to secdon 13.82,subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nodce required under this subdivision in the individuai income rax or pmpem rax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of scored data on individuals,and whe[her it is classified as public, priva[e or confidential. Upon his further request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data wichout any charge to him and,-if he desires, shall be informed of the content and meaning of rhat data. After an individual has been shown[he privace dara and informed of its meaning,the data need not be disclosed to him for six months[hereafter unless a dispute or action pursuanc to[his secdon is pending or additional data on[he individuai has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible authoriry may require the requesting person to pay[he acrual costs of making,certifying,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 legal holidays,if immediace compliance is not possible. If he cannot comply with rhe requesc within that time,he shall so inform the individual,and may have an additional five days within which 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 conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing�he nature of the disagreement. The responsibie 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, inctuding recipients named by the individual;or(b)nodfy the individual thac he believes[he data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administradve procedure act relating to contested cases. DATA PRIVACY 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 fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to detemune 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 shared with 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 nazne is required to process this application or permit. V�� pi�� Middle L.ast Address Ci�, State Zip Phone I understand my rights as state�ve. � Signamre f