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Home My WebLink About1997-009197 - tearoff/reroof PERMIT CITY OF ORONO PERMIT TYPE: � �"`�° ; ;t=,.�:�: 2750 Kelley Parkway- P.O. Box 66 Permit Number: �-�`�'�-�`'�`=�•' Crystal Bay, Minnesota 55323 - . - - -- (612) 473-7357 Date Issued: �_-T`j��_:'��';':-'�' SITE ADDRESS: i _ - - �I DESCRIPTION: _. .. „_ ' __ 'fs:s'�• I+�'�' _. : :_1], i f'{��i��i ;i i_3�'}:; f `,+''C+�,? . ..__'__. . . _. _. , . ,� -' ''- � x— ; -{- � —r: - t , . — .. . iT� t i REMARKS: FEE SUMMARY: vr �._.. ��+�'F�.✓''.�. . �N ��±� , . � , a �� ~' �7 s�.�~�-3�.'` � '...^:. �.��. �. . �..M`..�..�� .... j i i i_.%i�, }"e�F� ��'.� . .. .. � \__ CONTRACTOR: -��-��-�.� ;�_�.,-:` ,_,�. _ ,. T- _� �. � . ._. � - -.;:M>:�-:�:� OWNER: _ _ ___._ _.. _.. . _.. .. ._ _�'� ��. ...- - - - _. _ . . _ . . . _.. . : � ,,, , y __ '(' _( r. =r- ,...� � _ ._ _ . . `. � . . . _' _ :: !i rr? ;�1 t 5�..:!'f _rl..l_;;_� .�..,,�� ....'.��'..�_. .... ."';t`:��? }y ....._ .. �L�: �X.C.��:l._•�;Tl�t=;` : . . _ _ .- - - F '_ _ _ - - _ � , :�_� : .:.; : ,: : - - - - � ._ - ---- rv.�....,.., i.JAeE. ? L'.� _:"� .� p ,. '�f i'� '�r'��..s-� :} '��r:F � ,,, ', i''-<�,.acus��;., .__. .:..... s ._._,_� ,r�' f� _ _. _ ri . . .�__ . ._. ..... _. . .., . __. .�... . . _ : v .._ '-, i `-. ° _ � , : r- , ,. T �. �l� ; <-�: — Ti�l �"Si—f •� }' �' �';�i: .� '. _- a��:. ._ .. �''.' �Ji « -� '� , — � � _�,: r�. _a `" , _ .,.._.r _�, _.f . . :,. . �_�. � . _'�� ,. s; i� L i��"I s 6 _#" . , � � _ ' ;.�, ,� � •. 'C' 6r' ' • � ' a � _.. �� " '.,.. ! �_.+t"?.: .%__ _.�.L.?�..�P'Iili#._.__ < .. •._=i ?"1!�". i._�i ! �_. .. ..,.�� »: ?'i .., .,t 1!��)! J,if.:fi � ,„�� "'�_:+SE_ ?. _ _. . � . _, , , , L _.__� � - P ICANT/PER TEE SIG A U E ISSUED BY:SIGNATURE C�lZ_ � Total Fee: $ ��,�'" Date Received: 7 f��,,.�7� Entered By: ��^� Permit#: �/�� CITY OF ORONO - BUII.DING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: Z � u.r�P' � ZIP: �v�ow0 NAME OF OWNER: y�t G h1Gt�� rt fi�j G►' PHONE: (home) l 7�I�`�` (work) •�� ,� MAILING ADDItESSs �Gc� CITY: ZIP. 3� _ CONTRACTOR: �L �� "�'�" �� S PHONE: � �0 6S CONTACT PERSON: w V � �VIO�ILE/PAGER: [ -Z MAII.,ING ADDRESS: ��G ��t l�'CrrY: �x S��►- z�: .�S3.�1 STATE LICENSE: # t ARCHITECT/ENGINEER: PHONE: MAILING ADD1tESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ /�'(>CJ� _ 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 under d this is not a permit and work is not to start without a permit; and that the work will be ' a cordance with th a roved plan. APPLICANT'S SIGNATiJRE: DATE: NOTE! Parade o�Homes eve t require separate rmit approval by Police Department and � City Council 60 days prior to e event. Non permitted events will not be allowed. � Sec.13.04 RIGFTTS OF S[JBdECTS OF DATA Subd. 1. Type of data. The rights of individua!on whom the data is stoced or to be stored shall be as set fordi in diis section. Subd.2. Information reqirired to be givm individual. An individual asked W supply private or confidential data conceming himself shall be informed of: (a)the purpose and inteaded use of the requesced data within ihe collecting Etau agency,polidcal subdivision,or statewide system; (b)whether he may refuse oti is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidenaal data;and(d)the idenary of other persons or enaries authorized by stau or federal law w receive the data. This requirement shall not apply when an individual is asked to supply invesdgadve data,punuant to secdon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the noace rewired under this subdivision in the individual income tax or nronem tax refund instiuctions instead of on those fo�ms. 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 wherher it is class�ed 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 w him and,-if he desires,shall be informed of the content and meaning of th�t data. Afur an individual has been shown[he private data and informed of its meaning,the data need not be disclosed to him for siz months thereafter unless a dispuu or action pursuant to this section is pending or addidonal data on the individual has been collected or created. The responsibie authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the roquesting person to pay the actual cosu of making,certifying.and compiling the copies. The responsible authoriry 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 immediau compliance is not possible. If he cannot comply with the request within that rime,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 i�ividual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shail noafy in writing the msponsible suthoriry describing the nature of the disagreement. The responsibte authoriry shall within 30 days either: (a)correct the data found oo be inaccurate or incomplete and aaempt to nodfy past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes rhe data w be correct. Data in dispute shall be disclosed only if the individual's sratement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provuions of the adminisuaave procedure act relating to conusud 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 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. � �Cu�� Jr• ��' '�r First t �ddle �t 2[0�� , Addross �� 'J✓J / �( ��"'� �Xc.�(s�`o� City State Zip Phone I un rst d rights as tate above. < 1 $ig I11[C . � .