HomeMy WebLinkAbout1997-009165 - tree dam/roof repair PERMIT
�,CITY OF ORONO PERMIT TYPE:
' 2750 Kelley Parkway- P.O. Box 66 =;;'z_w�?:'���
Crystal Bay, Minnesota 55323 Permit Number: ;4;._i:.-�`; ;�.�-�
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(612� 473-7357 Date Issued: -
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: - ;�.:_::.::: �� _ .-.;-: _ _ :;� . �...�:� .OWNER:
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APPLICANTiP ITEE SIGNATURE ISSUED BY:SIGNATURE
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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 inforniation)
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�—
THE APPLICANT IS: (circle one) OWNER OR�CONTRACTOR
JOB SITE ADDRESS: ��'OD J'h a b u u�o o.r� 2.b Z�� S.S`3 q�
NAME OF OWNER: ,� u U�o l � PHONE: (home) �/7l O y 7�
(work)
MAILING ADDRESS: ��DD �'�►.a bU r�,oc�b CITY: �r r��vD ZIP: �f'J�q /
CONTRACTOR: � f}-C o �-�c, PHONE: `�4�� J�ba
CONTACT PERSON: J"'er,r U ?�w�wM4BIL T��G F Lo �!�-��0 5�
MAILING ADDRESS: /y.S/D y�Sy-k ✓�. CITY: /�a cx.�r,/ ZIP:�7��
STATE LICENSE: �# �/ �D
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�,i2 Land Alteration
PROPOSED WORK(describe in detain: T'y�Q.� d y 2 0 0-� �Da�Yz
���-e✓J' a— /�-�20 0-{�
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GARAGE STALLS: ATT. � DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /�O�� �
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: .r,��,r,.� DATE: 7— �— �7
NOTE! Parade of Homes events require separate permit approvaZ by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
�
Sec.13.04 RIGHTS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual on whom rhe data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and incended use of the requested data widiin the collecting siate agency,polidcal subdivision,or sratewide sysum;
(b)whether he may refuse oY is legally required to supply the requesud data;(c)any Irnown consequence arising from his supplying or refusing to supply
private or confidential dara;and(d)the idendry of other persons or entides authorized by state or federel law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve dara,pursuant ro secrion 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the norice rewired under this subdivision in the individual income tax or propem taz refund
inst�uctions 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 ic is classified as public,private or confidenaal. Upon his further request,an individua!who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to him and,'if he desires, shall be informed of the content
and meaning of that data. Afrer an individual has been shown the private data and informed of iu meaning,the data need not be disclosed w him for
six months thereafter unless a dispute or acuon pursuant to this secdon 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 acaal costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possibte,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 addirional five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accarate or complete. An individual may contest the accuracy or completeness of public or private
data conceming himself. To exercise this right,an individual shall noafy in wridng the responsible authoriry describing che naturo of the disagreement.
The responsible authoriry shall within 30 days ei[her: (a)correct the data found to be inaccurate or incomplece and attempt to nodfy past recipienu of
inaccurate or incomplete data,including recipien[s named by[he individual;or(b)notify the individual that he believes rhe data to be correct. Data
in dispute shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinadon of the responsi6te authoriry may be appealed pursuant to the provisions of the administraave 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 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 permit.
,��7� YYY�II.`� r r t/Nu i�
Fint � � M�ddle Last
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Addn,�s
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Ciry State Zip Phone
I understand my rights as stated above.
Signatu •
47i08 '97 13�22 I D�R1�1 R I 1rER UX'BER FAX=612�421-8131 PAGE �
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s16.b7a18D Pso�eC� De�iyn Loa�ds: Roof: t,ivl:� 40.00 p�#r DE�ad= 15.00 psf
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s16.b7He10.00II16D
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Maat R't� (lbs) 2�59 2259
Min R'n (�.be} 391 391
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Min Brq(inchy 3.75 �.75
Desiga Veln�e $p�u�� z Group Allo+r i.DF R�tia
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pan# s Group Allow LDF Ratio
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�if7.P tO rr�r����� �r
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or 1�ildilnq ot�iaial a�aid v�rify tbs iup�tt losds at�t
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r cowrrc�.al wes, a caaceatratea lo� ch�ak �� ba
e16.fi�'S p�rlor�d p�c t.be buildinq c�!!e.
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