HomeMy WebLinkAbout1996-007873 - tree removal .� � PERMIT
� ���i� �� �RONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �°��_'�� �}����'���T
Crystal Bay, Minnesota 55323 4}"�'-�;_
(612) 473-7357 Date Issued: ����.�,:_,�_��-
SITE ADDRESS:
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FEE SUMMARY:
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PPLICANT%PERMITEE SIGN TURE ISSUED BY:SIGNATURE ��
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Total Fee: $ `��.�Z.` DateReceived:
� DateApproved:
Entered By: /��, _ Permit#: �� �`'
CITY OF ORONO - BLT�DI'iVG PERNIIT APPLICATION
ALL INFORiv1ATION vNST BE SUB�iITT'ED IN FULL BEFORE PLAN REVIEW WII-L
BESTARTED
----- ----------------- -------
THE APPLIC��1T LS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: `-l `�l I �/Z,f��L����-�� ��- z�: `'�-�� 1
NAME OF OWNER: ��t'�% C-� � �� ��iL��� �`' PHO�IE: (home) 5�_ �6�•
(work)
MAILINGADDRESS: `�.��'�I �D j�j�yj �CITY: rl��� ZIP: 5��S/.�
CONTRACTOR: ,'�tic/C�- �'DkC`l�'N �/ PHO��TE: �f`7 .� ��
NIOBILE PHONE/PAGER:
iVIAILING ADDRESS: CITY: Z��
STATE LICENSE: #
ARCHITECT/ENGliYEER: PHONE:
MAII.ING ADDRESS: CITY� Z�'
N��: REGISTRATION #
TYPE OF WORK: New Addition Accessory S�ucture
Move RemodeUAlteration 1� Land Alteration
PROPOSEDWORK(describeindetail): % �ifa7 ��� � 5, ����������� `"�
�`I-'�"���;�1 l l= %/�'E�� �R'���?�u c�C`— �E�1� 'i�E'��S -
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROO��S: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excludingland): $
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�-t �''� DATE: �2.3 ��
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NOTE! Parade of Aome_s events 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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1
Sec.13.04 RIGATS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The righu 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 givea individual. An individual asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and intended use of the requesud data within the collecting Stau 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 refitsing to suppiy
private or confidendal data;and(d)the identiry of other persons or entiaes authorized by state or fede�al law w receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursvant to section 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 taz or propertv rnx refund
instrucdons 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 dara on individuals,and whether it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject
of swcnd private or public data on individuals shall be shown the data withouc any charge to him and, if he desires,shall be informed of the content
and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
siz months thereafter ualess a dispuu or acrion pursuant to this section is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shail provide copies of the private or public data upon request by the individual subject of the data. T6e responsible authority
may require the requesting person to pay the acmal cosu of making,cerdfying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to tlus 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 d�at time,he shall so inform the individual,and may have an additional 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 himself. 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 norify past recipients of
inaccurete or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Dara
in dispute shall be disclosed oniy if the individual's sratement of disagreement is inciuded with the disclosed data.
The determination of the responsible authority may be appealed pursuanc to the provisions of the administradve 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 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 eztent 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.
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First Middie ��
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Address
I'�177�� • /1'1 � 5��o s _3�L6 �b�'
Ciry State Zip Phone
I understand my rights as stated above.
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