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Home My WebLink About2002-P05019 - re-roof PERMIT CI��Y'C�F ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Poso19 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 4i9i2oo2 SITE ADDRESS: 4365 North Shore Dr Mound,MN 55364 P�D: 07-117-23-43-0031 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Permit Class: Building Census Code O/S-Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 251.25 Valuation: $ 14,900.00 State Surcharge Fee: $ 7.45 TOTAL FEE: $ 258.70 APPLICANT: Western Cedar Supply OWNER: William&Laura Stoddard 9700 13th Ave 4365 North Shore Dr Plymouth,MN 55441 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. �� '�h-��-� /'%J�� APPLICANT PERMITEE SIGNATURE ISSU Y SIGNATURE �,, Cooies: 1-File(SiQnitures Reouired). 1-Apnlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 +t 'Total Fee: $ Date Received: �0 5 ��J Entered By: Pernut#: �l-�- �/ CITY OF ORONO - BUII,DING PERIVIIT APPLICATIOleT All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------- , ----�___------------------------ THE APPLICANT IS: (circle one) OWNER R CONTRACTOR ��. _J JOB SITE ADDRESS: y�� , ��c�'C' ��;��'- ^ZIP:---- NAME OF OWNER: ,��'G�r� ��5�� PHONE: (home) (work) �-��- y��-_�..?�� MAILING ADDRESS: CITY: ZIP: � CONTRACTOR: �,k�S7�ti�-n C�� Sc�,G��y PHONE: �' � �-�Yl"o,��% CONTACT PERSON:�I�_. MOBILE/PAGER: l�/��i l��y�S�� MAILING ADDRESS: 1 -7c�^`� l3�`�z� �t,J CITY: �r. ZIP: �y� STATE LICENSE: # � ARCHITECT/ENGINEER: PHONE: MAILING ADDRES5: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New� Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: jr��i-aFf�i�A-c� � STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� f�� 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: ``� ' DATE: �" �-�:1 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. � ' � 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 secdon. Subd.2. Information reqtrired to be given individual. An individual asked to supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requesred data within the collecting'state agency,polidcal subdivision,or sratewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any 1�own consequence arising fmm tus supplying or refusing to supply private or confidenrial data;and(d)the idenary of ocher persons or enriaes authorized by state or fedecal law to receive the data. This requirement shall not apply when an individuai is asked to supply invesrieadve dara, punuant ro secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav piace the nodce reauired under this subdivision in the individual income tax or�ropertv 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 class�ed as public, private or confidendal. Upon his fucther request,an individual who is the subject of stored private or pubiic 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 rhat data. After an individual has been shown the private data and informed of i[s meaning,the data need not be disciosed to him for six months thereafrer uriless a dispute or action punuan[to chis secaon is pending or addidonal data on the individuai has been collected or creaced. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual cosu of making, certifying, and compiling the copies. The responsible authoriry shall comply immediacely, if possible, with any request made pursuant to this subdivision,or within five days of the da[e 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 inform the individual,and may have an addirional five days within which to comply with the request,excluding Sarurdays, 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 pri�•ate dara concerning himself. To exercise chis righ[,an individual shall nodfy in wricing the responsible authoriry describing�he nature of the disagreement. The responsible authoriry shail within 30 days ei[her. (a)correct the data found ro be inaccurate or incomplete and attemp[to nodfy past recipienCs of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreemen[is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuan[[o the provisions of the administra[ive procedure act relating to contes[ed 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 fumish certain private or confidential information. You are notified that: 1, The information you furnish will be used to determine your qualification for the pemut 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 pernut 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. (, Your full name is required to process this application or permit. First Middle Last Address C�ty State Zip Phone. I understand my rights as stated above. ` -r�7�--� Signature