HomeMy WebLinkAbout2000-P02630 - re-roof � ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po263o
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations
(612) 249-4600 Date Issued: �i6ioo
SITE ADDRESS: 3250 North Shore Dr
WAYZATA,MN 55391
P ID: 08-117-23-41-0006
DESCRIPTION:
Proposed Use:
Buildin Census Code 328
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: $ 32.65 Valuation: $ 750.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $33.15
APPLICANT: �CHARD ANDERSON OWNER: NORTH SHORE MARINA INC
3222 NORTH SHORE DRIVE 3224 NORTH SHORE DR
WAYZATA,MN 55391 WAYZATA MN 55391
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE W1TH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII.,DING CODE REQUIREMENTS.
�
I T ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
. . j �b
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BITII�DLtiTG PERNIIT APPLICATION
All information must be submitted in full before plan re�iew will be started.
(please print all infornuztion)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �JZjC� �`� � ���C �� � ZIP: J j
PHONE: ome
NAME OF OWNER: I ���Q� �Q��_ (h )
� (work)
�taa.�'G ADDRESS: �3�zz l9-� .S� .- Del crrY: z�:_.��I
C0�1TR�.CTOR: ��',,_�,� PH0�1E: ��1 �ZI���'
C0�1'TACT PERSON:(j,q,,,���° NiOBILE/PAGER: Z'�p -- 3� n .
lYiAILING ADDRESS: � , CITY: ZIP: � .
STATE LICENSE: #
r��CHITECT/ENGINEER: PA���
` ;�II.,Ti�'G ADDRESS: CITY: ZIP:
��ti�: REGISTRATION#
T��PE OF `VORK: New Addition Accessory Structure
Move RemodeUAlteration � Land Alteration
PROPOSED WORK(describe in detai
�: ��2 2�x.�1� �
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROO�IS: GAR�GE STALLS: ATT. DET.
ESTII,i SATED CONSTRUCTION VALUATION (excluding lan�: $ �S��
I hereby apply for a buildin�permit and I ac�owled�e that the information above is complete and
accurate; �hat the work will be in conformance with the ordinances and codes of the City and with
� the State Buildin� Code; that I understand this is not a permit and work is not to start without a
gemut; and that the work will be in acc rdanc with roved plan.
APPLICANT'S SIGNATURE: DATE: % 4O
1�'OTE! P�rade of Homes ev ts require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
Sec.13.0�i RIGEiTS OF SUBJECTS OF DaT�
Subd. 1. Type of daca. Ihe righcs ar i�dividual on whom the data is sco;-d or ro be storcd shall be as set forrh in diis secaon.
Subd.?. Informaaan reqirired to be�ven iadividual. �n individual asY:d to supply private or confrdendal dara concczning himself sfialI
be iaformed of: (a)che purpose and in[:nded use of the requested dam wichin che collecdng's�r:agenry,polidcal subdivision,or sacewide rystem;
�b)whe;her he may rfuse or is(e3atIy required m svpply�he requesud dan;(c)any lcown coasrr,ueace arisin3 from his supplvi:.;or re[using ro supply
priva�or conf:dendal dara;and(d)[he idcnary of oe�er persoas or endaes auchoriz�by sram or fed�ral law ro rec_ive�he dae. This:equir.menc shall
noc apply wFen an individual is bsked to sspply in��esriearive daa,pursuant ro sec_oa 13.82, subdivision 5, co a law enforce�.ac ofricer.
The eomr,ussioner of r:•enuo mav ols:e che nodr_ r_�uir-d under�his subdivision in che ir.dividua! ir.come tax or orovem taz refur.d
ins�rucdons ins,e_d of on chose forms.
Subd. 3. ?,ecess to data b�indiYidual. lipon request to a responsible auc.horiry,an individual shall be infocmed whed:er he is ehe subjecc
of scDr_d daea on individuals,and wh:�er it is clsssif:ed as public, privato or con:.d_adal. L'poa his fur,her request,an individual who is the subjea
of s�oc`d privace or public daa on indi�•iduals shall be shown che daci wi�hout aay c:ar3e ta hi�a and,-if he desires,shall be iaiomed of[he concer.c
ar:d meaning oi�isat dac�. After an individual has�een shown the privatr,data ar.d ic:ormed o[iu meaning,the daci nrd not be disclosed m hirn for
six mon�s cheraiuc unless a d'upute or acrion pu:suanc co chis secdon is pendi:.g o:addidoa�l daa on che individual has beea collecmd or creaced.
'Ine responsibia auehoriry shall provide copies of�he privace or pubiic data upon requ:sc by the individu3l subja�of rt:e daci. Tne responsible auchoriry
may r.quire�he requesring person ro pay the acnui coscs of making,cerafying,i.d:ompiling the copies.
The responsibla au[horiry shall comply imn:ediate(y, if possible, wich�:.y r.quest s3Ca pursuant to chis subdivis�on, or within five dsys of
the dace of the request,excluding 5amrdays,Sur.days and legsl holidays,if immedu:e compliacce is no[possible. If he canaoc comply wi[h[he requesc
wic,`sin thac ame,he shall so inform che individuai,znd may have an addidoaal five days wichia which to comply wita the requesc, cxctuding Sacurdays,
5undays and legsl holidays.
Subd.4. Procedure when data is not accurate or complete. An ir.diviZual may concest[ha accurdcy or complateaess of public or pri�•ac: '
data cor.cerning himsetf. To exer.ise chis righ�an ir.dividual shall nodfy in wridcg�`.e r_spoesiote aurhoriry dascribing rhe nan::e oi che disagreemeac. .
The responsiblo auchoriry shsll within 30 days ei�`.er. (a)corrrcc[he data found ro te inaccu�m or incomplae and aaempt to nnd:y pasc rtcipients of
inaccurs:e or incomplece dan, inctuding recipieaa named by che individual:or(b)codfy cl:e individua!thac he believes[he dara to be correct Dara
in dispuce shs1I be disc!osed only if the individual's sncement of disagreemenc is ir:luded wi�4 the disclosed data.
The dete:minadon of the rzsponsibi�auehoriry may be appealed purs.:�-.ro the p;nvisions of the administr3rive pro:eduro act relacing to
contesced cases.
DAT� PRIVACY :�D`ZSORY
In accordance with�I.S. 13.04, Subd.2, "Righcs of subjecu oi data", ��e would like to inform you that your reauesc
for a permic or license from che City of Orono or any of its depz:ments nay require you to fumis� certain private or
confidencial information.
You are notified that:
1, The information you fi:mish will be used to determi�=your qL�lification for che perm.it or license requested.
'� You may refuse to supply data, buc refusal may reeuire that the City deny the permic or license.
;, The information may be shared wich ocher local, sca!�or federal agencies co the extene necessary to process
the permit or license.
.}. If your requested perm.i[ or license requires Council accion co approve, some infocmacion may become
public.
�. You have cercain riQhts under �1.5. 13.04 (availabl� upon request) to review private data on yourself.
(, Your full name is required to process chis applica�:ea or pe:m.it.
First �tiddIt Last
Addcess
Ciry Sa` Zip PF.oce
I under and m 'ghts �s s ated a' .
�
Si antre