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Home My WebLink About1995-007533 - re-roof � PERMIT . . F ��T'Y OF ORONO PERMIT TYPE: _ 2750 Kelley Parkway- P.O. Box 66 ` � ' ` '` � ' `�- � Permit Number: �� `�"'"��'_��"` Crystal Bay, Minnesota 55323 � �� ' _ ` (612)473-7357 Date Issued: _ +�:s.. SITE ADDRESS: _ _ .- . �.:��;:.:� ��=°�� . .�>> ��r �.. ,. �: . ;.- � _ - - . �.: : ,..; : :_.. ; : ��__�� - _,;;;� DESCRIPTION: _ __. _ _. _ _ __ . :..�: _..., .:�� _ ;�_�. . . :: , :__: ::: ._.. . : : .,._ . . . . ��3I �.+:31s1'�� I'3?i'f'1'•_ C• �Y�''� ��i'�i-�'-�i�l:;,±_�rj i}.,��_.. _�i :i �,s�17 F.•� �ffy�`=:; i �.h,�,; �;��::_��.-f_i": REMARKS: FEE SUMMARY: � .... _. . .-.. ... . �� ...._ - .-�._t:��' � F�F' . � , . _�� -�;(1"��F�(�i_-. ..�._..._...�.....��. •� _ " tY..�`i_•=.� . "�' �•y- . ... � ' CONTRACTOR: �' `�;'`_'''- �=:��. . � . -- - -:� OWNER: �_. _ _.:. - - ,. , ,: i L.� :; '.=.i_I�U'.F, �:Vi, ,"s,�'i.`�i - � }- , • ; -.-- . ._ . __ . _ . _ _ .... _ . _ _.. _._,: . :,,� , ,: : ;; _ _ � ._ ..-��;� .'!-t�"•.�-•. .._.-. . . � . . !'�;..� ��'" ._. . _ . . �. .. - _. _ _. . ,`r''._ ._. . _. _. _. . 'F�T�"�si: �`F'��':, �I� � 1i�.:� . t�nti ��:�=;t'�1�. •:,Fr�i��:,� '1 I f.._��:+:�`;��' . _ ...... . ,.. . � 9 g7� ��3+±1.,!'�T��*�E74 �3 _..!" .. .. T l__�.,•�..°_ r .�: .�k.:.�3 .� _ . ? .' tr. .. ... . ._ . . ..'t.... ... . .... . j . . _ � . Cf�t �^ hL�^�. ik t� y� t 1-! _,,.. .__ . ?��'..G1�.•L�d��..�3`�1(»*" 3^#��iJ ��:# LI�_+ �:�Lf� °:.� .. �': ..�, ��.. . ..�,.��_.- , l,f_.'t . .i__i i+5,a.:� �fil L . , . ,..___ t_ �-.. . 3{�„ : . �: Ff. - ,� -�� -.r. �-� ' _ q �� , ;. .. .. _ : , : ,. , ; �. ' �.,t..�� • ,� �.. _ �.�.�� .��x._f�� . , ` . ` ; �� ;r' ;� ��- _ _ . _ _ , , , � � c (/-� � ,d/� APPLIC T'PERMITEE SIGNATURE ISSUED BY:SIGNATURE 1 L � Total Fee: $ `��Y '` � DateReceived: DateApproved: Entered Bv: Permit n: � � � CITY OF ORONO - BUILDI'�i tG PERMIT APPLICATION ALL INFORiv1ATION�ITJST BE SLB�IITTED Pt FiJLL BEFORE PLAN REVLEW`�II.L BESTARTED ----------- ----------------- ------- THE APPLIC��1T IS: (circle one) O`VNER OR CONTRACTOR ;� � , JOB SITE ADDRESS: ��J� � \�� ZIP:�'�� v NAME OF O�VNER: r �{ � �R� ��,--�, PHONE: (home)�� o t (work) NIAILINGADDRESS: �� .��\ ��_CITY: ZIP: � 5 "3 C.G `'� CONTRACTOR: �1 e�c� � c:..� .;� PHOiVE:��\ "��1 `�� NIpB PHONE/PAGER: ;�1AILINGADDRESS: ��. � � CITY: � , � � S`�C. ZIP: `_-��`6`� STATE LICENSE: # c:�� -7� 3 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: Z�: ��,�: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move RemodeUAlteration� Land Alterarion PROPOSEDWORK(describeindetail): \ � �� G�'�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDR001�IS: GARAGE STALLS: ATT. DET. d � ESTIlVIATED CONSTRUCTION VALUATION(escludingland): $ ��c.`,�.—S� _ I hereby apply for a buildin� 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: F DATE: ��—�2�� s 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. � r ' , Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidendal data conceming himself shall be informed of: (a)the purpose and inunded use of the requested data within the collecting§tate agency,political subdivision,or statewide system; (b)whether 6e 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 confidendal data;and(d)the idendry of other persons or endries authorized by state or fedecal law to receive the data. T1us requirement shall not apply when an individual is asked to supply investigadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav alace the norice required under this subdivision in the individual income taz or pmpertv taz refund instructions instead of on those for►ns. 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 shatl be shown the data wi[hout any charge to him and, if he desires, shall be informed of the content and meaning of ihat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafter 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 of the priva[e or public data upon request by the individual subject of the data. The responsible authoriry may require the requesdng person to pay the actual costs of making,cectifying,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,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shail so inform the individual,and may have an addiUonal 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 completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to norify 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 shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detemvnation of the responsible authority may be appealed pursuant to the provisions of the administradve 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 aze 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 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 permit. �,c c� o.Q� �'V�,�(15�\� F' stC� � {^ / ` � D�� W \\ 1-�.q"�3Zddle st Address S � ( � fl � `�c�S� 'M� �.��3 "� ��`1\ �°1� e1 City� State Zip Phone I understand my rights as stated above. Signature