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Home My WebLink About2003-P06684 - re-roof � � PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po66sa Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 8/22�zoo3 SITE ADDRESS: 25 Myrtlewood Rd Wayzata,MN 55391 PID: 36-118-23-33-0014 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: T_"___C____". ___'_�".__ a�v�vv.v.va v�a�va�a�� FEE SUMMARY: Pernut Fee: $ 83.25 Valuation: $ 3,000.00 State Surcharge Fee: $ 2.00 TOTAL FEE: $ 85.25 APPLICANT: Plymouth Roofing&Insulation OWNER: Scott&Sarah Luse 17525 Cty Road 24 25 Myrtlewood Rd Plymouth,MN 55447 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 REQUI EN S. �� i l � . _� �, ;� a �� o � � , � � �� APPLICA �ERMIT IGNATURE � IS UED BY SIGNATURE Covies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 � - Total Fee: $ Date Received: Entered By: Pernut#: 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 OR CONTRACTOR �_-- -- - JOB SITE ADDRESS: ��(l��f�( �.� (,L�,(� (�C� ZIP: `� S .�� NAME OF OWNER: �J�"1��,-� �.�,(.�� PHONE: (home) �15:�-o��`j-.�� (work) MAILING ADDRESS: ��J f YI�Z`c.l,c.:�C;/� y�1 CITY: ZIP: S�'3 i l CONTRACTOR: i1 �-��wU �VL� PHONE: 7��-�7� "-.3.3( �7 CONTACT PERSON: � L MOBILE/PAGER: ��a-7/�—� �S/ MAILING ADDRESS: � ?.S�S �,-(-�-i 1�l. ��{ CITY: 1��-41'►'I.E ZIP: 3 S��/ 7 STATE LICENSE: # ,�3.�� ARCHITECT/ENGINEER: PHONE: MAILIIVG ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: ��rCU 1� O Ut?(' �((S j 11U Ql�E �c"�, ,Vr�) !c,��+"�, 30 ��r2�h �t��r'� ��- l �'�r , - STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �� ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $_ �, 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 permit; and that the work will be ' accordance with th,�'ap�i�ved plan. �, � � ,�� c1 . ,� � APPLICANT'S SIGNATURE: � '� �� '" � DATE: ��' � 3 •. NOTE! Parade o�Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be alloweil. • � Sec.13.04 RIGH'TS OF SUB,TECTS OF D�TA Subd. 1. Type of data. The righrs 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 given individual. An individuai asked to supply private or confidential dara conceming himself shall be informed of: (a)the purpose and intended use of the requested dara within the collecang'state agency,poliacal subdivision,or sratewide system; (b)whether he may refuse oY is legally required to suppiy the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidendal data;and(d)the idenriry of other persons or endries authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigadve dara, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�•enue mav place the nodce reauired under this subdivision in the individual income tax or propem tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shail be informed whether he is the subject of stored data on individuals,and whe[her it is classified as public, private or confidenual. Upon his further request,an individual who is the subject 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 that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereaftec unless a dispute or acrion pursuant to this secrion is pending or addiaonal data on the individuai has been collected or created. The r�sponsibte authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of makine, certifying,and compiling the copies. The responsible authority shall comply immediately, if possible, with any request made pucsuant to this subdivision,or within five days of the date of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is no[possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal 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. An individual may contest the accuracy or completeness bf public or pm�ate data concerning himself. To exercise this right,an individual shall notify in wridng the responsible authority 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, including recipients named by the individual;or(b)noafy the individual that he believes the data to be correct. Data in dispute shall be disc(osed 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 administrarive procedure act reladng 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 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 City deny the permit or license. 3. The infarmation may be shared with other local, state or federal agencies to the extent necessary to process the pemut 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 name is required to process this application or permit. I�� ( ��.r`-�v1��_�--� C� S L�-.� �L��v First Middle Last � �.5 a-� ��l.v�,.�� 1�� - Ada�ss�� 1't�.f��-� �'��.�—' �..� �� '—� /S��'�� 7'��-= - Ciry �— State Zip Phone 1 I erstand my right as stated above./ � � � �' . .� 1 r� . Signature