HomeMy WebLinkAbout1995-007380 - reroof/reside garage PERMIT
% ��Y OF ORONO PERMIT TYPE:
! 2750 Kelley Parkway- P.O. Box 66 - -_ ' "- '
Crystal Bay, Minnesota 55323 Permit Number: ^��=�=��;'=;��.'-`"='
(612)473-7357 Date Issued: ^ ^
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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CONTRACTOR: QWj����^ Y � i-�u:�.:�, !,l�,�:_!1;. —�
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE , �°.� ,
E � * Total Fee: � ?. - DateReceived:
�i: �5 I
' DateApproved:
Entered By: �'� Permit#: ���Z'
CITY OF ORONO - BUILDI'iVG PERII�IIT APPLICATION
AI.L INFORi�IATION I�iUST BE SLB�IITTED P�FULL BEFORE PL�'�t REVIEW WILL
BE STARTED
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THE APPLIC��tT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��D v S��� �y w��� � ��✓ z�: SS �3 c
NAIVIE OF O�VNER: /,.J�' � �0'� � ����'��Sv� PHONE: (home) `( � � �`I � � �
(work)
i�1AILINGADDRESS: Z I D� S������ w�s, � 1�� CITY: � �-, �� ZIP: S� 9 /
CONTRACTOR: - ' PHONE:
NIOBILE PHOiVE/PAGER:
v1AILING ADDRESS: CITY: Z��
STATE LICENSE: #
ARCHITECT/ENG�tEER: PHOi�tE:
�IAII.INGADDRESS: CITY: Z��
��y�: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration Land Alterarion
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P OPOSED WORK(describe indetail): �' � j `` � �' �i' � (' �-�
�'�� �„) s !� � rv t�L�'� , � �J �� c> -�,
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STORIES: ___�___ SQ. FEET OF EACH FLOOR:
NO. OF BEDROO�IS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ �/ ���
I hereby apply for a buildina permit and I acknowled�e 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 wor ill be in accordance with the approved plan.
�iPPLICANT'S SIGNA • �/�----`� DATE: C� �� GS
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
Ci1y Council 60 days prior to the event. Non permitted events will not be allowed.
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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 secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data wi[hin the collecting'state agency, political subdivision, or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidencial data;and(d)the identiry of ochec persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individua( is asked to supply investieadve data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propem tax refund
instructions 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 without any charge to him and, if he desires, shall be informed of the content
and meaning of that data. Afrer an individual has bee�shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this section is pending or addirional 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 cequesring person to pay the actual cosu of making, cerrifying, 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[ime,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 completeness of public or private
data concerning himseif. 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 incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipienu named by the individual; or(b)nodfy the individual that he believes the data to be correct. Data
in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the admuustrarive 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 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 pemut 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.
6. Your fuli name is required to process this application or permit.
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First ?viiddle Last
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Address �n/7� G �S� / �"7 / �j � � 0'
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City Stare Zip Phone
I understar}d- y ights as stated above.
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