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Home My WebLink About2006-P09989 - re-roof PERMIT CITY �F ORONO 273� Kelley Parkway- PO Box 66 Permit Number: po9989 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterarions (952) 249-4600 Date Issued: 6/14/2006 SITE ADDRESS: 50 Landmark Dr unit# Long Lake,MN 55356 PID: OS-117-23-21-0019 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building 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: $ 265.25 Valuation: $ 15,840.00 State Surcharge Fee: $ 7.95 TOTAL FEE: $ 273.20 APPLICANT: Allstar Construction OWNER: Robert&Caroline Fullerton 8401 73rd Ave N-Suite 80 50 Landmark Dr Minneapolis,MN 55428 Long Lake,MN 55356 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 MINNES BUILDING CODE REQUIREMENTS. � ^ �,� �.__� dYvlc�� AP ANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 s-f t Total Fee: $ Date Received: Entered 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 TRA JOB SITE ADDRESS: �a LA�c�n�asr k �r" ZIP. Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes �-No If yes, a specia!event permit is reguired with Police Department and City Courrcil approval 60 days prior to the event. Shuttle bus service wdl!be required unless applicant demorrstrates suff cient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: ��v � lr� Fv�l(,�,,.}�,,� PHONE: (horne) (work) MAILING ADDRESS: �'� L��.r.rw�c a. CITY: O2 AN J ZIP: CONTRACTOR: Pl.t_�,h+� Co�C'��+�'�� PHONE:�.3��35'' L2Zf� CONTACT PERSON: �e LCon. MOBILE/PAGER: 'G/2 -�G v' G 3�1• MAILING ADDRESS: y/ ? '' � I�"� "1 CITY: �'��cLt� P�IP: 5 t'r/2 y' STATE LICENSE: # 3 a y 7 EXPIRATION DATE: 3 � n � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detain: T4+� - �f� r �—2�af STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED � ESTIMATED CONSTRUCTION VALUATION�exCludi�ig land): $ '�St �yv �� I hereby apply for a building permit and I acknowledge that the information above is complete a}�d.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 rt without a permit;and that the work will be in accordance with the approved . APPLICANT'S SI ATURE• �""'''�� DATE: �G�r�y U` 3t .� � Sec.]3.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. 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. Infonnation required to be given individual.An individual asked to supply private or confidential data conceming himselfshall be infonned of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he 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 confidential 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 when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision S,to a law enforcement o�cer. i ne commissioner of revenue may_place the notice required under this subdivision in the individual income tax or orooertv tax refund ��crrs�rions instead of on those forms. Subd.3. Access to data by individual. Upon requestto 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 confidential. 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 the content and meaning of that data. After an individual has been shown the private data a�d informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or actioa pursuant to this section is pending o�additional data on the individual has been collected or created. The responsible 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 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. [f he cannot corttply with the request within that time,he shall so inform the individual,and may have an additional 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 completeneas oPpublic or private data conceming himself. To exercise this right,an individual shal l notify in writing the responsible authority describing the nature of the disagreement.The responsible authoriry shall within 30 days either: (a)correct the dam found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including 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 determination of the responsible authority may be appealed�'ursuant fo�he pr3visions of the administrative procedure act relating to contested cases. � ,, DATA PRIVACY ADVISORY � ' �In accordance witli 1VI.S:T3.04;Subd.2,"Rights of subjeCts o�'data',we woutd Like to inform you that your request for a permit or iicen�e 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 qualification for the permit or license requested. 2. You may refuse to suppiy 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 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 ceetain 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. ��Gf�r �5�4�v'7��.. First Middle Last �� si y� �„ �l�s�-��.� s�- Address �4 PC�►r,.� /��v Ss ss-s City State Zip Phone 1 , y rights a ed above. gnature Reset Form ��