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Home My WebLink About1997-009288 - tear off/re roof , PERMIT �' CITY OF ORONO 2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: _ : :�,.;_- : _Y�..� Crystal Bay, Minnesota 55323 Permit Number: '..��..``-��:�w��= (612) 473-7357 Date Issued: _ . . _ _ . . . SITE ADDRESS: _ � _ _ .__�:"� ``T �=:_ ; - DESCRIPTION: _..... � _ . ..._ - -- : ,�.._..; r . _. . . _ . . . .�°��-�. 't_�_f�- — ._. __ ;:�:� -°�s��Ci;i.' -r,Y•,=:,� =;F—i-i�.:�,':'1=�:��'''s,t��lJ��.�.. -�=i i ?�_;.i�' {�l ir�i'}:; ��r j.:+�._ �+E_.�1 t_�ie�� {�+ } 7' t_t_'.��.'.'.�,�'.� ..i�;if�]}%�_+, �-t�_'� C't?r� . �.��r•1�+'�E�1!.k fj"�i�.... REMARKS: FEE SUMMARY: __.j�� =;=.� `�'=.' . �'�_ , . —. . � '.-�ilS'i�"tr{t'��t+ --------.wix'..i:a�:u: y °-�}'=� �}=-' �1':� _ �:-` '...-.�, CQNTRACTQB � _�=. � '-� � �`. 01111L�1ER _ : � � _. : .� :: - -�';: _ . _ _. ._. . ._ _ . _ _ _ _ - - _ .. _ . . .. . _ _.. . :L;_:'i:�? � . . . _ . :=:i,i i.:W:i��_ ;+°:°_;i �''� `�'�j �; `t'�Ts`�.:'_; .'- �' ;;It.I%< �:t� �+:=,'r"::3 . ._�� ._ .. _ . _ _ _ . _. :__ - .��i.,�'.'� . . Ir-f „��'»{"�2 _ 4C 6 �: ; - ^` . . _ . ` � :s`.� _. ..._. ._. _y.k _. . .,. __. , . - '' .s m • i=_ °'� , .._. _ }_+ _��. _...�.... ., � .. .` r . ..."+..��,��,.,.L��Cll :�?'"EE��... � �e....[. ��,.. . ,.f«.+ .. 4i e � 1 � ..y .! . _ ».. �^r . �. „ ..� � - 5.•.: .. , _: � ...»__ t r _ ._ f._._ :4 _, . ... .'� 1�.�� _ ._ „ !,__'"�t. _...._ h _ . . . `i;._� _i^' i 1�' . � ;� _, � w . r.u;; _ .�. ? t �.,. _ . %"i�.E F. ..:x.� . . __ _��_ — �, _. t�L i'�`.�`.'t _.._..�._... , `�' '� i�t:- k:a � t +!- I �d . . _: ;., .,.- .,< . e .� , .� � . . . ._ __ . , . � .n.._.__ __ � / t � / l . APPL�CANT/PER EE SIGNATURE ISSUED BY:SIGNATURE ., . � S, Total Fee: $ �� DateReceived: DateApproved: Entered By: Permit#: '�� -;� , �, CITY OF ORONO - BUII�DI'�i tG PERMIT APPLICATION ALL INFORiI�IATION v1UST BE SLBi�1ITT'ED IN FULL BEFORE PLAN REVIEW WILL BE STARTED _-----------___------- ------- - ----------------- -- ,.. THE APPLIC��1'T IS: (circle one) OWNER OR ONTRACTOR` ; JOB SITE ADDRESS: � 3�S �s�i �'G'i�r R��. z�: SS�� l NAME OF OW�1ER: �d{� 1s��SU��1 J� PH0�1E: (home) y��~�-�;��; (work) MAII.INGADDRESS: ��'E�.$ ��S� ,�1J�'� ,�,� CITY: ��f`'i�'0 ZIP: SS� CONTRACTOR: ��L.�3 T_�/ Cd'�ST2ULi�G'��'' ---wC- PHOivE: �,_J'��.5�� NIOBILE PHON�E/PAGER: MAILINGADDRESS: �G�D� � � S�. S�. CITY:I-�(,"�/�./�J� ZIP: _.S'S:�`�� STATE LICENSE: # q�S6 . ARCHITECT/ENGINEER: PHONE: NiAILINGADDRESS: CITY: Z�� : REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move RemodeUAlteration Land Alteration PROPOSEDWORK(describeindetail):�,q/� �?/�F �� '!s'Or STORIES: SQ. FEET OF EAC'H FLOOR: NO. OF BEDROOv�S: GARAGE STALLS: ATT. DET. � ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �QS / �- 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. AP PLICANT'S SIGNATLTRE: � / � � � 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 RIGHTS OF SLJBJECTS 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 confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within rhe collecting�tate agency,polidcal subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entides authorized by state or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply investigadve data,pursuant w secdon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav alace the notice requirod under this subdivision in the individual income tax or provem tax refund insttuctions 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 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 wirhout 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 informed of iu meaning,the data need not be disclosed to hitn for six monrhs thereafter unless a dispute or acdon pursuant to this section is pending or addidonal data on the individual has been collected or created. 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 to pay the actual cosu 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. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal 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 compieteness of public or private data conceming himself. To ezercise th;s right,an individual shall nodfy in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurdte 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 shail be disclosed only if the individual's statement of disagmement is included with the disclosed data. The determination 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 fumish certain private or confidential information. You aze notified that: 1. The information you fumish 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 permit 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. 6. Your full name is required to process this application or pemut. �� G ,i�/��sa�/ First Middle �t I G�l �� / Addres ,�nN �� G�/ �,�iit/s '"' �� lry Stare Zip Phone I understand my ri e� above. s;gnacure