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Home My WebLink About2004-P07891 - re-roof PERMIT CITY �F ORONO 2750 (�elley Parkway- PO Box 66 Permit Number: Po�s9i Crystal Bay, Minnesota 55323 Permit Type: Minoratterarion� (952) 249-4600 Date Issued: s�3o�2ooa SITE ADDRESS: 30 Myrtlewood Rd Wayzata,MN 55391 PID: 36-118-23-33-0011 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): B�lding-Re-Roof DETAILS: Approved per resolution#: Separate pernrits required: NOTICES/REMARKS: FEE SUMMARY: Pemut Fee: $ 167.25 Valuation• $ 8,058.00 State Surcharge Fee: $ 4.55 TOTAL FEE: $ 171.80 APPLICANT: Westum Cedar Supply,Inc. OWNER: Bruce&Lori Paulson DBA:Westurn Roofing Siding 30 Myrtlewood Rd 9700 13th Avenue N. Wayzata,MN 55391 Plymouth,MN 55441 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. !j%��v� C��'�'� � � APPLICANT PERMITE SIGNATURE IS D BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Apvlicant 1-Monthlv Reuorts, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: Eutered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER O CONTRACTO JOB SITE ADDRESS: .�� /'1y��w�� /�' ZIP: _,�� Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: � �,/ �So nl PHONE: (home)�sa- ¢�j-o��/ (work) MAILING ADDRESS: 30 ,iRj��/�v� CITY: �o�/o ZIP: �� CONTRACTOR: /c/C S�4,�- „J PHONE: 76�S9/D�� CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: oo v��✓ CITY: ,�/��.�Tl ZIP: sS��/ STATE LICENSE: #�c�o/S SS� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeVAlteration Land Alteration PROPOSED WORK(describe in detain: ��'�o� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � O,S8 00 I hereby apply for a building permit and I aclrnowledge 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 permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE::��;�� DATE: 1��% Sec.13.04 RIGHTS OF SUBJECTS OF DATA • Subd.l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. ' Subd.2. Information required to be given individual. An individual asked to supply private or con�dential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the coliecting state agency,political subdivision,or statewide system;(b) whether 6e may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or conFdential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply w6en an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice reauired under this subdivision in the indiv(dual income tax or uropertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or conf►dential. Upon his further request,an individual w6o is the subject of stored private or public data on individusls shall be shown t6e data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual6as been shown the private data and in[ormed of its meaning,the data need not be disclosed to him for si�r months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the prlvate 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 making,certifying,and compiling the copies. The responsible aut6ority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days oit6e date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the request within that time,he shall so inform the iudividual,and may have an additional five days wtthin 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 of public or private data coucerning himself. To exercise this right,an individual s6a11 notify in writing the responsible authority describing the nature otthe disagreemen� The responsible authority shall within 30 days either: (a)correct t6e data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or inrnmplete data,including recipients named by the individual;or(b)notity t6e individual t6at he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. T6e determination of the responsible authority may be appealed pursuant to the provisions of the administrative 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 furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualificadon 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 information may be shared with other local,state or federal agencies to the eztent 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 name is required to process this application or permit. ��9� First Middle Last Address City State Zip Phone I understand my rights as stated above. Sig re