The URL can be used to link to this page

Home My WebLink About2001-P04431 - re-roof .� PERMIT C�YY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po4431 Crystal Bay, Minnesota 55323 Per'mit Type: Minor Alterations (952) 249-4600 Date Issued: loisi2oot SITE ADDRESS: 3399 Crystal Bay Rd Wayzata,MN 55391 P I D: 17-117-23-44-0021 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: $ 139.25 Valuation: $ 7,000.00 State Surcharge Fee: $ 3.50 TOTAL FEE: $ 142.75 APPLICANT: Gates Roofing OWNER: steve Sobieniak& McKinney 4640 Ximines Lane N 3399 Crystal Bay Rd Plymouth, MN 55442 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK [N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. , _ '��' �d�-- .--�— APPLICANT PERMITEE SIGNATURE ISSUEDBYS[GNATURE Covies: 1-File(SiQnitures Reauired), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 . '�'o'tal Fee: $ Date Received: Entered By: Pernut#: 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 OR CONTRACTOR JOB SITE ADDRESS: -� ' �� 75i-"'-' ✓� ��7 ZIP: NAME OF OWNER: �;�� f s" ; �� .v'� � pHONE• (home) (work) MAILING ADDRESS: �'3 f ' 47'.'}� v��s CITY: ZIP: CONTRACTOR: ��,:t << s r«�•�.. ;� ..� y ��,�� PHONE: ��3 .r 5 s�:� -�-,�%.�3 CONTACT PERSON: �3 i-u�E e.-�r e s MOBILE/PAGER: MAILING ADDRESS: �1G �v ��•��.�� - F- CITY: �'/z�� -%� ZIP: c�4�� Z- STATE LICENSE: # �;�1 l 3 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� -��- �'=� �`�� ` '� � ''��, � STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� `�`'� ` " � � 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 SIGNATURI'� r-2---�� DATE: ��`� �'< '- � i 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 RIGHT'S 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 secaon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency,polidcal subdivision,or sratewide system; (b)whether he may refuse oY is legally required to supply che requested data;(c)any imown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenciry of ocher persons or enddes auchorized by state or federal law to receive the data. '1'his requirement shall not apply when an individual is asked to supply invesrieaave dara, pursuant to secaon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data bv individual. Upon requesc to a responsible authoriry,an individual shail be informed wherher he is the subject of stored data on individuals,and whecher it is classified as public, privace or confidenaal. Upon his further request,an individual who is the subject of s[ored priva[e or public data on individuals shall be shown che data wi�hout any charge to him and, if he desires, shall be informed of[he content and meaning of[hat data. Afrzr an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months thereaher unless a dispute or acdon pursuan�to [his secrion is pending or addidonal data on the individuai 6as been collected or crea[ed. 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 requesting person ro pay the actual coscs of making,certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, wi[h 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 inform the individual,and may have an addirional five days within which[o 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 data concerning himself. To exercise[his right,an individual shall norify in wriang the responsible authority describing�he narure of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomptete data, including recipients named by the individuai; or(b)notify the individual that he believes rhe data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disciosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DAT� PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your reauest 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 determine 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 pernut 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. (, Your full name is required to process this application or permit. First Middle Last `�.•r—r-z � Address Ciry Sta[e Zip Phone I understand my ri�hts as stated above. /� �'; �t-______ C_-� a Signature