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Home My WebLink About1998-010124 - tear-off/re-roof PERMIT CIT�Y�O�' ORONO 2750 Kelle Parkwa P.O. Box 66 PERMIT TYPE: ;-;t_! i #��Yi j t�wi; y Y� t_+1 s.t I,:.�+ Cr stal Ba , Minnesota 55323 Permit Number: y y Date Issued: t-7��`�`#%�`��-� (612)473-7357 SITE ADDRESS: ;�°#��i�� °_�#-�r=�i,j'i`�?i�rl_t�� `.� .T�� ' . � . E�. . �-7_'i 1 ?'_s'`:_:--?�.—�i�ii}.�:�� DESCRIPTION: ��j,��`—�iF F i�f�—�i=!�_�F ��1i]. �.3.,1 l.t�� si''�F'._1`fil l 4.. ! �i�==:-:t �—��"','r�!1'�'f t't��13_!�i'..'—._E �;:.�i I��i�-�_� t��r�: T i t=� �;E-F��_'��=3� �=��n�:�l.�� i=F_EE:�� .�.�� ;�i . F:�`��C��tvTl€�� REMARKS: FEE SUMMARY: �,I�;�t ir;T 1T,t:;?',� �:�, �:�t 3 ��•z'T� t'H;_ �`�`� . .7C ��L�11'=�'l=q1':=:�=� ______._. ��.��: i:t�T.:�� ►-�;r�? ��+.f{'3;�:. i�i t �j� £��'i='i 1 3�•�1"! : ' �� . � i: �,, C�� 4t.+!' ��ll 1{— ��,lt_ � 1�.i��_f��;-�`� �,�t 1'wi ��h4`�� i_!�—j�`„ �{+`='7� �'+`��-"-'�` ��L`}�� ``�_= =��r=ti�,`��1�fi�l�t �v { F i�.,��:.��,,,� �f{�q i..L_i%.L�, {.ii l%S�`I{_,� 4ji�i7 ��i_is}i 'E.�'1.i,1 L�.�L"_F_�L_i�"3 �.�.�—�.t{_}�+`� -j— E — L .T �,;, —— _ L+L ,;' _ ; L,;-- —._ ,_. __ _ _ i'_iC:` — , .� . _ .•—._; . __ ��Vi� .. � ��: — ..__ . r•� a#�t _e .�.��i:=� s i��J�i 7 �t�#iz_E}�Y 6:;�(��f;3:.�� _. . �...�16' 1 `._ _:��:_':�'°Y '�€_1 ;'�F;�+.�. � i .t� ;i�,t..�€_ _��tt-'i-t;:„I:;�P-,•.�,,,,�`•:i`_ —y't—;.��1��,� i��y ��.��'ti=�_. {�[_I f�#! i-}i.,}_, 't.t}E_tit;�,. s i� _ . . .i'•_� t_t_!I`!;�'t �'r#�4�_�. �E ;�� '.�� _ �;y ;';i:.Y _�f.� } t d� '{_{t`,� 1 I�S 1 i T 3 :f.i �'°'" �r,`i;l:1 "T'h` I = S fi" "; i47'�I�.—,{ ! ��` T',i: ,,, — �i i__ t—'.i�-�'"'f t �;,f-.'+.'!.-.��.3 1` . #�. .t4_ _�"i_�t��ft'+t�_ . .. _ : � __. _.. �t_. _ _ � i�� , _._ .%�#�._.. �' � �,' A LICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE .� 1�ota1 Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUII.,DING PERMIT APPLICATION All information must be svbmitted in full before plan review will be started. (please print all information) • -------------------------------------------------_��_------------r----------------------------------- THE APPLICANT IS: (circle one) OWNE CONTR.ACTOR JOB SITE ADDRESS: Z�: r— NAME OF OWNER: � o� �C I (,A-�v�D PHONE: �nome� 7( - o� �� (work MAILING ADDRESS: �4 h �D ��W�o l��CITY: ZIP: ��. c CONTRACTOR:�%U ��, �`m 1 �� O 1'uS�. PHONE: CONTACTPERSON: ]"�l )y� MOBILE/PAGER: _f��.��.io . MAILING ADDRESS: ��j -7 S' C.YN w Qv t� ��=�Ovrvl�_ZIP: �S� STATE LICENSE: # S�c�c ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteratio��_ Land Alteration � ) PROPOSED WORK(describe in detain: `��2. G� �� '� ��(�/� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: A'TT. DET. � a� ESTIMATED CONSTRUCTION VALUATION (excluding land): $_�� _ I hereby apply for a building permit and I acl�owledge 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 ermit and work is not to start without a permit; and that the work will be in accordan with approved plan. APPLICANT'S SIGNATLTRE: DATE: ~ � � �� NOTE! Parade qf Homes events require separate permit approval by Police Deparlment and City Counci160 days prior to the event. Non permitted events will not be allowed. � Sec.13.04 RIGH'TS OF SUBJECTS OF DATA Subd. 1. Type of data. Ihe righrs of individua(on whom the data is stored or to be stored shall be as set for[h in this secdon. Subd.2. Information reqirired to be givea individual. An individual asked w supply private or confidendal dara conceming himself shall be informed of: (a)the purpose and inteaded use of che requesud data within the collecting State agency,political subdivision,or sratewide rystem; (b)whe[fier he may refuse oY is legally required to supply the cequesud dara:(c)any imown consequence arising from his supplying or refusing to supply • privace or confidendal data;and(d)the idenriry of other persons or enriaes au[harized by state or fedecai law to receive the data. This requirement shall not apply when an individual is asked to suppty invesdgadve data,pursuant to secaon 13.82,subdivision 5, to a law enforcement o�cer. - The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or provem taz cefund insm►cdons inscead of on rhose forms. ' Subd. 3. Access to data by individual. Upon request to a responsible au[hority,an individual shall be informed whether he is the subject of stored data on individuals,and whe�her it is class�ed as public,private or confidenaal. Upon his furthec request,an individual who is the subjecc of scor�d private or public dara on individuais shall be shown[he data wichout 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[he private data and iaformed of iu meaning,the data need not be disclosed ro trim for six months thereafter unless a dispute or acaon pursuanc to [his secaon is pznding or addiaonal data on rhe individual has been cotlected or created. The responsibie authoriry shall provide copies of[he private or public data upon request by rhe individuai subject of the dara. The responsible authoricy may require the requesring person to pay the actual costs of making,certifying,and compiling the copies. The responsible aurhoriry shall compiy immediately,if possible,with any request made pursuant to this subdivision,or wirhin five days of the date of the request,exciuding Saturdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he cannot comply with the request within[hat time,he shall so inform che individual,and may have an addiaonal five days within which W comply with the request,exciuding Saaudays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may conust the accuracy or completeness of public or private data concerning himself. To exercise[his righG an individuai shall noafy in writing the responsible authority describing the nacuro 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 incomplete dan, ineiuding recipienrs named by[he individual; or(b)nodfy the individual thac he believes the dara to be correcc. Data in dispute shall be disclosed only if the individual's statement of disagreement u included with rhe disclosed data. The determinaaon of the responsible authority may be appealed pursuanc to�e provisions of[he adminisaarive procedure act reladng to conusud cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Riehts of subjects of data", we would like to inform you that your request for a pemut or license from the Ciry 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 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 shazed 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 permic. � `�� m�� First Middie Last ��7� �:'/Vw6n� 'QLv� Address �YlC7 c�rv/� U1�1'�. S�S'��G� L-�7� — `�"-�� City State Z�p Phone I derstand my ri,gh as st e above. Signature