HomeMy WebLinkAbout2004-P07945 - re-side a r ,4 �
PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po�9as
Crystal Bay, Minnesota 55323 Permit Type: M�or Atterarion�
(952) 249-4600 Date Issued: 9i2oi2ooa
SITE ADDRESS: 30 Myrtlewood Rd
Wayzata,NIN 55391
PID: 36-118-23-33-0011
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Pernut Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 391.25 Valuation• $ 24,390.00
State Surcharge Fee: $ 12.70
TOTAL FEE: $ 403.95
APPLICANT' Twin Ciries Siding Professionals OWNER: Bruce&Lori Paulson
� 664 Transfer Rd. 30 Myrtlewood Rd
Suite 22A Wayzata,MN 55391
St.Paul,MN 55114 �
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.
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RMI SIGNATURE ISSUED BY SIGNATCJRE
Covies: 1-File(SiQnitures Re4uired),1-Apvlicant 1-Monthlv Reports, 1-A�essin¢, 1-Finance Page 1
� 09114s'2q64 13:02 6516344129 TCSP PAGE 02
Tutal Fee: $ ?d3. 95 DateReceived: 9`�1��� 7
Ente�red Sy: � ,,�� __ Permit#• flh 7�
C[TY OF ORONO� B�ITIL.D�NG PERM�T APPL�CATION
All inforaa�tao�a�must be subuaitted in fal�before plan rev�ew will be s�arted.
(plea�se piant all infor�nution)
—l..-. —
THE,APJPLICAI�TT IS: (circle one) OWNER U CQNTRACTOR
JOB SITE ADURESS: '�,�I(Yl.T���.�►,�cx�`� , �: .�`� `� `� I,
Will tl�as be a Parade o�'Hames,Remodelers Showcase Hame or other D�s�lay Home?
❑Ye8 �.NO ,�f'yes,a special event permit is reguired with Police Deparrme�zt and City Cvuncil approvoC
60 day�prior b the ev�nl. 5'hultle buv.vervice wiJl be r,equired unless applicuntdemonstra�s
,a�cient on,site parkir�g is avuilable. ,Non-permitted evenriy wil!nor be allowecl
�1AME OF OWNER: �o r'►�a- �r��.� Pa._�A��o r, _PHQNE: (honae) �I 5a-N'T3- Oo���
MAI[.INC ADAItESS: �' � CI'�X: �c �.���IP: 5��i I
�'�.Q.�v t- _I e w o od �
CONTR�A.CTO�: T.�� C'_�.�.:� � :.,�-,, ��-n�-`e.ss'c o,c1�s P�ONE: l��1_�,�-,�5;'�I�H
CQNTACT PERSUN: A n� m n�� ��� �'IOBILE/PAGER:
MA�LING ADD�.tESS: r:r�� Tr��S��< <l� C�TY: �k��P�_�--1 ZIP: ��S�I+�E
ST,ATE LICENSE: #_��03� ��� EXPIRATIQN DA'�'E: ��3�,o�
ARC�TITECT/ENGINEER: PHONE:
MAIL��iG ADDRESS: CITY: ZIP:
�A�; REGISTRAT�ON: #
TXPE OF'WORK: New ,A.ddition Accessory Structure
Move Ham� Rezxaodel/Alteration ,.�
PROPOSED WORK(dese�lbe in detai�: (� �.��e a- re r,� �c� � ���=►nc�
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S'�.'ORIES: SQ.FEET OF F.A,Cki FLOOR:
1�T0.OF BEDROOMS: GARAGE STALLS: ,A,TTACHED DETACHED�
ESTIMATEY�CONS'�'RUCTION'VALU,A,T�ON(exctuding aa�d): $ ,.����� a`'
I hereby ap�ly for a buildin�pemnit an.d Z ackt�owledge that the in£oxmation above is co�p�ete and accurate;
that tlae woz�c wi11 be in confomaarzce wath the ordinances aaad codes of the City a►xd watk�tl�e State Building
Code;that�wnderstand this ia not a pezxnuit and work is not to stazt without a permit;and tlxat khe work will be
ita accordance wath tk�e appzoved plan.
A.PPLICANT'S SIG�iATUItE: � DA,TE: �1 �^
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5oa13.p4 ,�[GFfC9 OF BUBJECT$OF DA1'A
Subd 1. 7"ypc of da4. 7�c righes of mdividcwl om whona tbe dam is stmsd or w br ataaed�1ra11 bc as sec�m this sxdan.
Subd.Z.Infornasciam ivq�wod to 6e�iveo iadividual Att ioadividaa!askod to sapPkY�x arc�dendal dats oonccniyg�sdisLaII be
iufaonod oE (a)ttic p�apo9e+►ad ial�aded use a�'the requcatal dam wi'+hna the oollectiag stace aB�Y�Politicsl sobd�visi
whatherhemsyrefnseo�'isleCallYra9ucedrosupplYtherequsstadda c o�t.arstatcwidciY�;�b�
pa�ive0c or corifidaatid deta;aad(d)the idcnti ofatbar �;()�0.rlmawn co�eqneax anisimg from 1►is aaPP�Y�B arrc£asmg w supP�j'
�y pasaas oz eatities anrhotiaed by smm arfederal law to recdve tb,e da�a.This ruq�marart shsl(
not appty when no ivdividoal is aslsd to 9upply mvenigadve dam,pyrs�,�ut to secGoa 13.62,subdivision 5,to a!aw e�afaa�emwc o�Zt.
fllaca t6e n�'nce ica,�.,e.d.,,,a ��.• •. • ' ,S�lg4II7o�1W
Subd.3.Acass w d3ta by iadirvi�ual.Upaa�eq�pt W a nspomsibls euzhozitY,a�iadividual ahall be oafaotaudwhedtczhe is Uu subJcu of
stored deta am iodlviduxls.8qd WI76t}16!lt AS CIi99lf 0d ii pOb1lC,p�ivate or oo�SidentiaL Upon his furth�rxeqae9t,an nadividual who u t6e subjcct of
swrod pxirvaoe or publfic data om 6adiridaals sh+ll be�isoana the data wptl�oat aaY°�ro bim atnd.if he d�sites,aha11 be i�u,Eom►ed of the contept apd
mezaing of�hat deta.�4a im mdivldae!Las bada ahawa tb,o privaee dats and inf�ed of its rpa4oia��,tLe data Aeed mc bo discloeed w hi.m for su
maut6s th�imlcas a disputa oractiosa pazsuant W khia sectioz�is pead'a�g ox addido�sa diva on the ix�dividael has baa colleeted or crcaced.The
re9paosible uuthorEty sheJl provilde copies cf tLe putvaoe or Pablic da�a upon reqaest by tde iadivldaad Snbjat of thm data. The mpvosible autbodry
�Y���6 xtl4��8 D�a to PeY the aconal coeta of noakipg�xnifY�nffi,��+�mB rbe copies.
The responta'ble autttotiry abe�i comp(y i�p�ax1Y�i�pos�ibte,wich anY requestmida parsaa�pt bo rhia subdivisioa,oarwithm 5ve days of
the datcoftlu z�4 ex�luding SatoxdaY9,Suadxys aad IeealholidaYs,l�Y6ruuedisteComptiance�s�motpossibk.ifheea�uoecompty wpth tberoguosc
aithinYs � egal ho d a�oaxa tbe iadihidual,and tlo�ay have ari additiaaal gvo days witfti�►which�o cpytop�y xrjth t6ciequest,eXcl�iding SatWrd�tys�
Saada w�d I y
SabJ.4.Procer!'arewloaadafaisaoeao�maceorepcp�lete.AniufdividualQpsyc�xstthaaa�acyn►'wmple�ofpablicoxpQivatcdata
concammg hirns�lf.To exarcise rhis xi�ltR en iadividal FhaD aoti�r m xriring the�+ospar�'bk�thoiitYd�nbing 8yonanae o£the disa�ropn�e�c Ths
ifla�civau or iulom�lete dtt�,���e�x: (a)�ct tLe data�ound w be imeicaaate ar imco�mPlaee amd atoerppt�o nodfY P��pis.au of
Ais�►ucc s}pll be djgeiosac( ��i�aamed by the mdividuel;oz(b)poHfY the iadividwl thschebelieves�he data to be wisecc Da�a ia
�Y��t�IC�A�'1d119�'9 91iic�Cal Of(�jgi�DWpCQit 181GC�17d6d W!�tbC dASC�DfEd d8fi
contested���adioA of du rrspaoaible auehoriry may ba appealad pmwaae eo the p�ovri�iaaa of�e adm�isns4iv�proeedwe ace mlaWog to
Zn�co�danee with M.5.13.04,Subd.2,��Rig�ts of subjocts vf date",we wvuld liace to iafo�m you that yourrequest
for a pennic oc license from t(�e City of Orono ot any olats depart�esrts may require you to�iunis6 cetlsin private ar
confidenUiel infot�oaation.
You a�e notified that:
1. The is�octnatia,n you fu�noish wil►be used tio dete�ine yout quali£teation for the petmit or lieense
1°equesCed.
Z. You may refuse to suPP1Y�,but refusat may require that the CitY de�uy the pe�n,it ar uicense.
3. Tlae infuronation aaay ba sbared w�ith oth�r local, skatc or f�ederal age�ucies w khe exte�tt necessary to
process the pematoit or]icense,
4. public.�uested pe�nmit or lioeage teq�res Co�mcil action to approve,some iu�famation may become
5. You have cextain rigb,ts uader M.S.13.04(ava�ilabia upaait request)to review privau data o�a yourse�f.
b- Yous full natne is req�red to process this applicatiobl ar pertt�ik
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��tst SG�.P1 Il� �rW' i ^ �'�i�.S �c�i i �`R� rCrot�S S��lll�
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r u�deta d roy rights a8 etated above.
Signsin,t
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Q9/14/2�4 13:02 6516344129 TCSP PAGE 01
Twin Cities Siding Professiona�s
664 Transfer Road, Suite#22A
St. Paul, MN 55114
(651) Z55-2844 telcphoue
(6S 1) 634-4129 fax
vvvvw.tcsid�ngpcofessionals.com
emai]: info(a�tcsidingprofessionals.com
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Fa�- °'(�o�-��'-�`���(�l ����`� ir cluditxg coverl
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Phone- Date� ql, ti'�,.I,n�{
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❑ Urgern Q For Revi�w 0 Please Repiy
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2750 Kelley Parkway
P.O. Box 66
Crystal Bay, MN 55323
(952) 249-4600
Fax: (952) 249-4616
FAX TRANSMISSION COVER SHEET
Date: 9"�T"0?
To: �'/71'1
F'ax: (0 5/��O 3 S/-�l 2- `�
Re: �__ �� �
Sender: q��['��2-rv
YOUSHOULD RECEIVE � PAGE(S), INCLUDING THIS COVER SHEET.
IF YOU DO NOT RECEIVE ALL THE PAGES,
PLEASE CALL (952) 249-4600.
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review wiU be started.
(pleaseprirrt aJl information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: �CLY�Tr-���'-'-,�',�,�( � . ZIP: �� � � I
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑Yes �.NO Ifyes,a special event permit is required with Police Department and City Council approval
60 day.c prior to the event. Shuttle bus service will be reguired unless applicant demonstrates
s�cieni on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: j_o r`�a- � A� P � �,o r, PHONE: (home) q Sa-N�3-Oo�a.1
i.�0.yzcz��'O�)
MAILING ADDRESS: ,�O l�.v r��e.u�o od {�� CITY: _�c b�o ZIP: 5�5?�1 1
CONTRACTOR: S���L' �-�;es �,�:r.a P�o-�es�,o�,�� PHONE: �� �-���-,.�.s;-y 4
CONTACT PERSON: A h n M p c 1 .��� MOBILE/PAGER:
MAILING ADDRESS: ,�Q(o�I T�-.�,s�'e� '�. CTTY: 5-�,Po�wl ZIP• 55 b I�{
STATE LICENSE: # BC-�031 11 o S� EXPIItATION DATE: ���,�10�
ARCHITECT/ENGINEER: pHpNE•
MAILING ADDRES5: CTTY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home RemodeUAlteration �
PROPOSED WORK(describe in detail): R�nti�,�� e�— C'P_O��:CA— � t�'�nn
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION Fexcluding land): $�yT,�,9 p, °°
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
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: �1
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Sec.13.04 RIGHT9 OF SUBdECTS OF DATA
Subd.1. Type of data. The rights of individual aa whom the data is strned or to be storod shall be as set forth in this secdan.
Subd.2.Information requiied to be given individnaL An mdividnal asked to suPP13'P�'ri'ate or coafidential data conceming himself shall be
infarmed of: (a)tho piupose aad intended use of the requested dam withm the coliectiug state agency,Political subdivision,a�r statewide system;(b)
whether he may refuse or is legally requ'ved to supply the requested data;(c)any]mown conseqirence arising from his supplyiag or n�usiag to supply
private or conSdential data;and(d)ffie idendty ofother persons or entities anthoriad by state or fede►al law to xeceive the data This requiremeat shalt
not apply when an indfvidual is acked to yupply,investigaflve data,p�asuant to section 13.82,subdivision 5,to a law enforcement officer.
The cwnmissi�er of reveneP„���!�P the notice reg�tired under this subdivision in the individual'nrAme tax a2 W�A�Y tax refimd
inctn.rtio�ut�9a of on i1+os.f
Subd.3.Access to data by iadividuaL Upon�quest to a responsible authariry,an individual shall be mformed�yhetha he is die subject of
starod data on individuals,aad whether it is classified as pubGc,private or confidentiaL Upon his fiuiherreyuest,an individual who is the subject of
stared privau or public data on iadividvals shell be shown the data without any charge to hvn aad,if he desiros,shall be informed of the content and
meaning of that data After an individual has been shown the private data aad informed of its meaning,the data nad not be disclosed to him for six
months thereafter unless a dispute or action puisuaat to this secdon is pending or additional data on the individual hac becn wllected or cieated.The
responsible authority shall pmvide copies of the private or public data upon request by the individual subjcct of the data. The nsponsible authority
may require the requesting peison to pay the acWal costs af maldng,certifying,and 1' the ies.
�� �P
1'he iesponsible authority shall comply i�ediately,ifpossble,with any request mado pmsuant ta this subdivisian,or within Sve days of
the date of the iequest,excluding Saturdays,Sundays a�legal holidays,if immediate compGan¢o is not possible.ffhe caffiot comply with�e request
within tt�at time,he shall so inform the mdividual,and may 1�ave an additional frve days within which to co�ty with the roquest,exchiding Sahuxiays,
Sundays and legal hotidays.
Subd.4.Procedine when data is not aa,wate or co�lete.An individval may contest the acc�nacy as comq�leteaess of�ublic orprivate data
concerning himse(f.To exccise this right,an individual shall notify m writing flx nespon�ble authority descn'bing the napme of tbe disagtecnent.The
ne�onsible authority shall within 30 days either: (a)correct the data found W be inaccmate or incompkte end attempt W notify past recipieats of
inaccmate or inco�kte data,mcluding recipients nemed by the individual;or(b)notify the individuel that he believes the data to be cornecG Ihta m
dispute shall be disclosed onty if the individual's statement of disegreement is included with the disclosed data.
'The determiaadon of the r�spoasible authority mey be appealed pursueat to the provisions of the admiaistrative procedure ect relaring to
conbested cases.
DATA PR�VACY�DVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subj�ts of data",we would like to inform you that your request
for a pernut or license from the City of Orono or any of its deparirnents may require you to fumish certain private or
confidenrial informarion.
You are notified d�at:
1. The information you furnish will be used to detennine your quaiificatian far the permit or license
requested.
Z• 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 extex►t necessary to
process the permit or license.
4. If your requested permit or license requires Council action to appmve,some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)tfl review private data on yourself.
6. Your full name is required to process this application ar pennit.
t�l Y1n I I l �c-�� �l o r�, r.�
�'LS�rI'}1 Y1 qS `-T-i.� � r� ��QS � t :vt� r 2S S��
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Addresa
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Clty 3tate ZiP Phone
I understand my rights as stated above.
Siguatun
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