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Home My WebLink About2005-P09398 - re-side � �` t PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Po9398 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 11/8/2005 SITE ADDRESS: 3645 North Shore Dr Unit# Wayzata,MN 55391 P�� 08-117-23-34-0007 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Pernut Type: Minor Alterations Pernut Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 209.25 valuation: $ 11,600.00 State Surcharge Fee: $ 5.80 TOTAL FEE: $ 215.05 APPLICANT: Twin City Exteriors Inc. OWNER: Brad Olson 9060 Zachary Ln N 3645 North Shore Dr Maple Grove,MN 55369 Wayzata,MN 55391 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. . \ l�� / l.-C� "`�. .. � APPLICANT PE E GNATURE SSUED BY SIGNATURE Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 2-16-1995 1 :07PM FROM P_ 1 . �`~ �11Y uc� uftuNU '� �1C4(SUS'lU U4/�4/�/t4 Uti=�y (� :U'1/U� NU:.S�ri �, Total Fec: S �.� ��' ��S Dat�R,cccivcd: �� G �� tttr�d Hy: `�,Z� . Fermit�: _ �� -�' � . ��1��j CZT`Y O� �RONO - BUILDING PERMIT APPLICATIOI� All iniormation musi be submlricd In full before plan �eview will be started. . (pleas�print a1l l�farmation) Z'fi� AFPLICA11i'� IS: (circic onc} OWNE�t O CONTRACTOR 10B SiTE ADDRE�S: ,��f-�1�� ZTF: NA1K� OF OWNER: ��-�.:f�L.�J PI�ONE: (homc) ?y�-.��`��7�'1� � (work) h�11T.ING ADDRESS: �� CITY: ZIP: COtYTRACTOR: TIJIN CITY EK7ERIORS C0. , INC. PHOIVE: � 763) 425-4737 COI�ITTACTPERSON: CLAUDIA 1VIOBTLE/PAGER: N/A Ml�'�L�GADDRFSS: 9060 ZACHARY �ANE N. ��108Cr'i'Y; MAPLE CROVE ZTP:55369 STA'�'E LICENSE; A� 2 53 5 � "' v _� />> � � �, ��TEG"TIE1�I�INEER; PH4NE: 11�AI.LYNG ADD�.SS: � CITY: zIP• NAI'�iE: REG�ISTRATIOI�I# TYPE OF 1�VpRK: Ncw Additian Acccssory Stn►cturc l�iovc RcmodeilAlccration,� Laud Ellteracion I'ROi'OSED WD�K(dtscribe in detai�:�SfQ !�t'TN �'�.4�19��C _ L�•.J �T4ft�S: SQ.FEET OF EACH FLOOR: INO. OF BEDR001115: GARACE STALLS: ATT'. DE7. F.�'�'�IATED CQNSTRUC'Y'YON YALUATION(c�rcludln8 land): $__�T�,�� I�tc�by apply for a building permit and I acla1owlcdge that thc informat[on abovc is complct�and ' accura�c; that thc work wiJI bc in confoccna�acc with thc ordinanccs ar�d codcs of thc Ciry and with thc S�xtc Buifding Cadc; that Y undcrscand �hls is not a gcrmit and work is not to btArt without a permit; and that thc work will bc in accordance with ihc a provcd p1un. APP'I.�ICANT'S SIGIVAT'LTRE: DATE: ��- '7',�� 1VOT1:! Pnmda nfffvnses tvrrsts requlra aeparotQ permit approvaf by Pottce IJeparh�enl and C�y Caurtcll ff0 days pri'or lo the even�. Non permilted eveials rs�ill nat bc allorved. � '• 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 OR CONTRACTOR JOB SITE ADDRESS: ZIP: Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO If yes, a specia!event permit is reqzrired with Police Department and Crty Council approva! 60 days prior to the event. Shuttle bus service tivill be required unless applicant demonsh�ates sz�cient on-site parking is available. Non permitted events wi/l not be allowed. NAME OF OWNER: PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration PROPOSED WORK(describe in detain: STORIES: SQ.FEET OF EACH FLOOlt: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTII�IATED CONSTRUCTION VALUATION(excluding land): $ I hereby apply for a building pennit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes ofthe 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 tlie app►•oved plan. APPLICANT'S SIGNATURE: DATE: 31 . ' . Sec.13.04 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. Information required to be given individual. An individual asked to supply private or conftdential data concerning himseif�hall be informed of: (a)the purpose and intended use of the requested data within the coilecting 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 identiry of other persons or entities authorized by state or federal law to receive the data.This requirement shall not apply when an individ�al is asked to supply investigative data,pursuant to section I3.82,subdivision 5,to a law enforcement officer. ThP commissioner of revenue may,ylace the notice required under this subdivision in the individual income tax or property t�refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,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 and infonned of its meaning,the data need not be disclosed to him for six months thereaRer unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies oti the private or public data upon request by the individual subject ofthe data. The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling tlte copies. The responsible aud�ority shal I 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 shall so infortn the individual,and may have an additional five days widiin 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The responsible authority shall within 30 days either. (a)correct the data 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 sliall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The dete�mination of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 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 deterniine your qualification for the permit or license requested. 2. 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 extent necessary to process the permit or license. 4. If your requested permit or license requires Cou��cil 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 Lest Address CiR� State Zip Phonc I understand my rights as stated above. � c Signature .i?