HomeMy WebLinkAbout1999-011471 - replace siding PERMIT
CI�Y OF ORONO PERMIT TYPE:
� 2750 Kelley Parkway- P.O. Box 66 -:''-�';;`v=�`
Crystal Bay, Minnesota 55323 PermitNumber: ;_�_ �;�.;%;
(612)473-7357 Date Issued: �-i�,,:��;-;;'-��=;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: -- ���°�_� �F�L!�f. �`
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AP CANT PER SIGNATURE ISSUED BY:SIGNATURE
1bta1 Fee: $ Date Received:
Entered By: Permit#: //�/7�
CITY OF ORONO - BUII.DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started. .
. (please print all information)_ M - ----r
THE APPLICAA'T IS: ' (circle one) OWNER OR CONTRACTOR
JOB SIT'E ADDRESS: a��s S��ywoac( � ZIP: �S3q Z
NA1�fE OF OYPI\'ER: �r5f I1,��aI ��o�' � ��f PHONE: (home)
(work) tL� �71-0(1 r
NIAII..ING ADD�'•ESS: �`��S Sl��yw��( /�o( CTT'Y: ,l,��a•-�-� ZIP:_,�,'S.�qZ
CONTRACTOR: C�F�� H�N1'o� PHONE: `-�?a� I��`7�
CONTACT PERSON: MOBILE/PAGER:
MAII�Itii'G ADDRFSS: �790 C�ia�a Ln. CITY: Mvvw►p ZIP:�
STATE LICEI�TSE: �# �
A.RCHITECT/Ei\TGINEER: PH0�1E: �
i1�tA.II�ING ADDRESS: CTTY: ZIP:
NAME: REGISTRATION#
TYPE OF`VORK: New Addition Accessory Structure
Move Remodel/Alteration�C_ Land Alteration
PROPOSED`�'ORK(describe in detai�: -�-c,[�e., ob� Sidi�S �' �-�e .�� ��
Q �L2. I,�i'� n e W +G�.rv�
STORIES: SQ.FEET OF EACH FLOOR: _
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �
FSTII�i IATED CONSTRUCTION VALUATION(excludi.ng land): $ � ��,� �
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 Buildi.n� Code; that I understand this is not a permit and work is not to start without a
permit; and th�t the work will be in accordance with the approved plan.
A.PPLICANT'S SIGNATURE:
\ DATE: �
NOTE! Parade of Homes evenis require separate permit approval by Police Department and
� City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGFiTS OF SLTB.IEGTS OF DATA '
Subd. 1. Type o[data. ?he righcs of individual oc whom the daa is stoced or m be scnced shall be u sec[occh in this secaon.
Subd.2. Iaformaaon reqirired to be pven indi,ddual. An iadividual uYed w suppty pcivate or confidendal dard concerning himself shall
be iatormed of: (a)�he purpose and in�ended use of the rcquesied dara wichia the colIecdng Stace agecry,polidcai subdivision,or smmwide rysum;
(b)whe�er he mzy reEuse oY is.legally requir.d ro supply the cequesud data:(cj any larown coasequeaee uising ftom his supplyiug or refusing to supply
ptivac:or conndeneal data;and(d)the ideadry of ocher persons or earides auchorized by st�ce or federal law to rnceive the dara. This requicemenc shall
noc app[y when an individuaI is uked to supply invesdgadve daa,pucsuant ro secdoa 13.82,subdivision S,oo a law enfoccemeat officer. .
'Iha eecamissioner of rcvenue mav otac- che nodc� r�uired und-r this subdivision in the individua! income taz or orooem tax tefund
insnucaans insuad of on those forms.
Subd.3. Aceas to data by Individual. Upon requesc to a responsible authocity,an iadividual shall be infocraed whethec he is che subjecc
of stor:d dac�on individuals,aad whecher it is c[assified u public,privace or confidendal. Upoa his fucther cequesc,aa individual who is che subjecc
of scoced privace or pubtic daa on individuals shall be showa�he da�a wirhout any charge�him and;if he desires,shall be informed of the contenc
and meaning of that dara. Afte�an individual has been showa the private dan and infaraud of ics meaaing,the daa need not be disclosed to him for
siz moadss theceafter unleu a dispute o�acaon pursuanc w �his secdon is pending oc addidoeal da�a on the individual has beea colleued or created.
Ihe responsibte auchoriry shall provide eopies of�he privare or pubtic daa upon request by rhe iadividual subject of che dara. The tesponsible auchoriry
may require che cequesdng person to pay the accual coscs of makiag,cercifying,and compiling the copia.
The cesponsible authoriry shaI(comply immediatety,if possible,wich aay requac made purntant w this subdivision,or wichin five days of
the dace of che requesc,ezcluding Saturdays,Sandays and legal hotidays,if imenediace comptiaace is noc possible. If he cannot comply wi�h the requesc
wichin that dme,he shall so inform the individual,and may have an addidonal five days wi@iin which m comply with the«quest,ezcluding Saturdays,
Sandays and legal holidays. •
Subd.4. Procedure whea data ts not aecurate or eomplete. An iadividual may concest the accuracy or completeness of public oc private
dan conceming himself. To ezercise chis right,an individuaI shal!aoafy ia wridng die respoasible aufioriry descn'bing�he natuce of che disagreemeac
The nspoeuible auehoriry shall within 30 days either. (a)cocnct[he da�a found co be inaccucate or incomplece aad atumpc to nodfy past recipiencs of
iaaceunce or incomp[ece data.inciuding recipiencs named by the individual;or(b)nodfy the individual thac he believes the data m be correcc Data
ia dispute shall be disclosed only il the individual's stacemenc of disagreement is included wirh the d'uclosed daa.
The determination of the responsibte auchoriry may be appealed pucsuant to the provisions of the adminiscarive procedure act relaang to
concemd 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 ia depactments may require you to furnish certain private or
confidencial information.
You aze notified that:
1. The information you furnish will be used to decermine your qualificadon 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 wich ocher local�sta[e or federal agencies to the extent necessary to process
the permit or license. �
4. If your requested permit or license requires Couacil action to approve, some information may become
public.
5. You have certai.n rights under M.S. 13.04 (availabie upon request) to review private data on.yourself.
6. Your full name is required to process this application or permi[.
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I unde�stand my rights as stated above.
Signaare