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Home My WebLink About2001-P04704 - re-roof PERMIT �I�'Y OF ORONO Permit ►vumber: �750 Kelley Parkway - PO Box 66 P04704 Crystal Bay, Minnesota 55323 Permit Type: Minoratterat�ons (952) 249-4600 Date Issued: �2iioi2oot SITE ADDRESS: 1421 North Arm Drive Mound,MN 55364 PID: 07-117-23-44-0073 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Buildin Census Code O/S- Building Permit Class: g 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: $ 2,075.00 State Surcharge Fee: $ 1.05 TOTAL FEE: $ 84.30 APPLICANT: Western Cedar Supply OWNER: Thomas Norman 9700 13th Ave 1421 North Arm Drive Plymouth,MN 55441 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-�REAL IMPROVEIV�NTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �.-t� �--�.eli'�''�Ccf'C_ G' APPLICANT PERMITEE SIGNATURE ISSU BY SIGNATURE Copies: 1-File(Signitures Reauired), 1-Apolicant, 1-Monthlv Reoorts. 1-Assessine. 1-Finance Page 1 =Tota1 Fee: $ Date Received: - Entered By: Permit#: 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 CONTRACTO JOB SITE ADDRESS: ��o� l /Ud'��,,,��,'11�IP: �'S� � �/ �tJ�ri+-.�r� NAME OF O�VNER: �w�► �xor�: cnome� �� a y�$ (work) `t 38-33d� MAILING ADDRESS: �y�-n.,2 CITY: �.- ZIP: S�3�y CONTRACTOR: S r o� PAONE: �C' � �5%/ ^d 3d� CONTACT PERSON: /�,p�-�, MO /PAGER d'��-a8� 'Y��S MAILING ADDRESS: 9 7 0o i �•c�crrY: 1 Z�:�;5� STATE LICENSE: # ��/.SSS�� ARCHITECT/ENGINEER: PHONE: MAILII�'G ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New � Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: �C��/��s� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ a` i ��'S 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: �'I 5 DATE: �?—/6�'� _ NOTE! Parade of Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGHTS OF S[JBJECTS OF DaTA Subd. i. Type of data. 'Ihe rights of individual on whom the data is stored or co be stored shall be as set for[h in this secaon. Subd.2. Information req�rired to be given individual. An individual uked w supply privare or confidendal data conceiviag himself shall be informed of: (a)the purpose and inunded use of the cequested data within the collecang�tate agency,political subdivision,or statewide system; (b)whether he may refuse ot is tegally requusd to suppty the iequesud data;(c)any irnown coauquence arising from his supplying or refusing to supply priva[e or confidendal daa:and(d)ehe idenriry of other persons or enddes authorized by sta[e or federal law to receive the data. This requirement shail not apply when an individual is asked to supply invesagadve data,pursuant ro secdon 13.82,subdivision 5, to a law enforcement o�cer. 'It�e commissioner of revenue mav olace the nodce rewired under this subdivision in the individual income taz or propem taz refund insnvcaons inscead of on chose forms. Subd.3. Access to data by individuai. Upon request w a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whe�her it is class�ed as public,private or confidenrial. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and;if he desires, shall be informed of che content and meaning of chat data. Afur an individual has been shown the private data and infonned of its meaning,the data need not be disclosed m him for siz months thereafter unless a dispute or acdon pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of[he dara. The responsible au[hority may mquire the roquesring person to pay[he actual costs of making,certifying,and compiling the copies. The responsible authoriry shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of the date of�e request,excluding Saturdays,Sundays and legal 6olidays,if immediate compliance is not possible. If he cannot comply with the requesc within that time,he shail so inform the individual,and may have an addidonal five days within which to compiy with the request,excluding Saturdays, Sundays and legal holidays. , Subd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or compteceness of public or pri�•ate data concerning himself. To exercise rhis right,an individuai shall nodfy in wricing ehe tespoasible authoriry describing[he nacure of rhe disagreemenc. The responsible authoriry shall within 30 days either: (a)correct che data found m be inaccurate or incomple[e and attempt to noafy past recipienu of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual thac he believes the dara to be correct. Data in dispute shall be disclosed oniy if the individual's stacement of disagreement is included with the disclosed dara. The deurminaaon of the responsible au[horiry may be appealed puauanc w the provisions of the administrarive procedure act reladng w 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 aay of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you fumish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, buc refusal may require that the City deny the permit or license. 3. The information may be shared with o[her 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 required to process this application or permit. First Middle Last Address Ciry State Zip Phone I understand my rights as stated above. Signature