HomeMy WebLinkAbout2000-P02478 - re-roof .� PERMIT
�ITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po24�s
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(612) 249-4600 Date Issued: s�is�oo
SITE ADDRESS: 941 North Arm Dr
MOUND,MN 55364
PID: o�-li�-23-ii-000i
DESCRIPTION:
Proposed Use:
Census Code 434
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: $ 111.25 Valuation: $ 4,800.00
State Surcharge Fee: $ 2.40
TOTAL FEE: $ 113.65
APPLICANT: RONALD CHRISTENSEN OWNER: R L&M A CHRISTENSEN
941 NORTH ARM DR 941 NORTH ARM DR
MOUND, MN 55364 MOUND MN 55364
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
PLICANT ERMI IG A RE D BY SIGNATURE �y ��
O
Copies: Ciry,Applicant,Assessor,Finance Page 1
� Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUII,DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) WNE OR CONTRACTOR
Jos srrE annxEss: 9�I N���-�� �-R w� �� z�:�..�.3� y
NAME OF OWNER: �o h/-} �� L- ��R�S��i�S�� PHONE: (home) ��'7�'3�
(work)
MAILING ADDRESS: �y� D�c���l� A�n, �2 ci�: D�P a Nn z�:�'s3 �
CONTRACTOR: PHONE:_
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAIVIE; REGISTRATION#
TYPE OF WORK: New 1� Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �o o� - �S,p�i� � f Sfi i n q�PS — _
f�PW,�u `r- ��/A C� Q
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $�,�60
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 Ciry 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; �i��' 2��
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sea 13.04 RIGHTS OF SUBJECTS OF DATA •
Subd. 1. Type of data. The righu of i�ividual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the pucpose ar�d intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identity of other persons or entiries authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesdgative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav�lace the notice reauired under this subdivision in the individual income taz or oronertv 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 confidenrial. Upon his further request,an individual who
is the subject of stored private or public data on i�ividuals shall be shown the data widiout 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 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 authoriry shall provide copies of die private or public dara upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authority 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 immediate compliance is not possible. If he cannot comply with
the request within that time,he shap so inform the individual,and may have an addiUonal 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 of public or
private data co�xeming himself. To exercise this right,an uidividual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authoriry shall withic►30 days either: (a)wrrect the data found to be inaccurate or i�omple[e and attempt to notify
past recipients of inaccurate or u�complete data,i�luding recipients named by the individual;or(b)notify the individual that 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.
The determinaaon 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 �ity of Orono or any of its departments may require you to furnish certain
private or confidential information. �
You aze notified that:
1. The information you fumish will he 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 certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is r uired to process this application or permit.
.
Fir Middle Last
A dress �7/�� �/ � ���� _ /
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City State Zip Phone /
I underst my rights as stated above.
Sig re
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