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Home My WebLink About2001-P04598 - re-roof� 1 CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Poas9a Crystal Bay, Minnesota 55323 Pet'mit Type: MinorAlterations (952) 249-4600 Date Issued: lli�i2ooi SITE ADDRESS: 3690 Lyric Ave WAYZATA,MN 55391 P I D: 17-117-23-34-0034 DESCRIPTION: UBC Occupancy R3 Proposed Use: ttesicientiai Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ g3•25 Valuation: $ 2,911.04 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 84.75 APPLICANT: Lake Wood Roofing&Siding OWNER: JOHN J LAGIESKI 610 13th Ave. 3690 LYRIC AVE 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. ' - > 1 ��s-��n��-�� z�� A I E I NA RE ' ISSUED BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 r . Total Fee: $ �y� �j Date Received: //— �—U% Entered By: �y'� Pemut#: , r' 2-� 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 ADDRES��`/�� ZIP: �_�� NA1�iE OF OWNER: � * PHONE: (home �+ �1�� GI (work) MAILING ADDRESS:�;�i (� .� ��pqa ��TY: ZIP:L=�e� 1 � CONTRACTOR. � ��PHO . — � c � � CONTACT PERS . BILE/PAGER: � MAILING ADDRESS: D Q� CITY. ZIP: STATE LICENSE: � � ARCHITECT/ENGINEER: PHONE: NIAILING ADDRESS: CITY: NAME: STRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: - � STORIES: � SQ. FEET OF EACH FLOOR: / � � . NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTTVi IATED CONSTRUCTION VALUATION (excluding land): � � �� U 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 pernut and work is not to start without a pernut; and that the work will be in accordance with the approved an APPLICANT'S SIGNATURE: I 1 I J l �� NOTE! Parade o Homes events require sepa e permit a roval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. ♦ � Sec.13.04 RIGIiTS OF SLJBJECTS OF DaTA Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be�vm individual. An individual asked ro supply private or confidendal data conceming himself shall be informed of: (a)the putpose and iateaded use of the requesred data wichin the�collecdng 3tate agency,polidcal subdivision,or statewide system; (b)whe[her he may refuse oY is legaqy required to supply che requesud data:(c)any lrnown consequence arising from his supplying or refusing tn supply privace or confidenrial data;and(d)the idendcy of o[her persoas or enades authorized by state or fedecal law to receive the data. This requirement shail not apply when an individual is asked to supply invesagadve data,pursuant to secdon 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the nodce reauircd under this subdivision in the individual income taz or nroaem taz refund instructions insuad of on those forms. � • Subd.3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whecher he is the subject of stored data on individuals,and whecher it is classified as public,private or confidendal. Upon his fu►ther nquest,aa individual who is the subjecc of stored private or public data on individuals shall be shown che data widsout any charge to him and;if he desires,shall be informed of the content and meaning of�hat data. After an individual has been shown che privau data and iaformed of its meaning,the data need not be disclosed to him for siz months theRafur unless a dispute or acuon pursuanc to this secdon is pending or addidonal data on the individual has been copected or crea[ed. The responsible authority shall provide copies of the privam or public dara upon request by the individual subject of the dara. The responsible au[hority may require the requesring person to pay the actual cosec of making,cerdfying,and compiling the copies. The responsible authority shall comply immediately,if possible,with aay 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 the requesc wirhin that time,he shall so inform the individual,and may have an addidonal five days wi[hin which to comply wich the request,excluding Saturdays, Sundays and legal holidays. . Subd.4. Procedure when data is not accurate or complete. An individual may conusc the accuracy or completeness of public or private dara concerning himself. To exenise this right,an individual shall noafy in wridng the responsible aurhoriry describing�he nature of the disagreemenc. The responsible authoriry shall within 30 days either: (a)correcc[he data found ro be inaccucate or incomplete and aaempc to nodfy past recipiencs of imdccurate or incomplete data, including recipiencs named by the individual;or(b)aodfy the individual that he believes[he daca to be correct. Dara in dispute shall be disclosed only if the individual's stacement of disagreement is included with the disclosed data. The decerminarion of the responsible authoriry may be appealed pursuant w the provisions of the adminisaadve procedure act reladag to contesced cases. DATA PRIVACY ADVISORY In accordance wich 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 Ciry 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 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 ceRain 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 , C�ty State Zip Phone I understand my rights as stated above. ' S;gnacure