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Home My WebLink About1995-007524 - tearoff/reroof PERMIT w ��ITY OF ORONO PERMIT TYPE: 2750 Kel ley Parkway- P.O. Box 66 ...��;��u�= Crystal Bay, Minnesota 55323 Permit Number: _ _ . _ __ (612)473-7357 Date Issued: _ : SITE ADDRESS: "�-„-;;��; i t,,�= r•:=;° _.__ _ _ _. ..:,..�_�_ _. _. . . . . . .- . .. _ --7, 's,---_—_ ___:—E:.. %i DESCRIPTION: _.. .. . . .._. .- - _.. .. ._.: . . -.... �..:_ _.. t��[_;? t i'•-._ t'.� i't�`j'fii�.� ��}';=�� __r`,f":!''� i . I�..4iIYIfyF�: _ .ii !'li..i�Ji�i�(_.: :... ... "'._ L.� � 7�S: �i'�i�_ {•,i'!i'F' p _ "'.�:. . � _.. _, W... . . �i'-'L= ,.._ "�,i_�f_�:" REMARKS: FEE SUMMARY: r':-il_1_,!',...'T Slfn� . _ _:':_' !:•=:;`� •�: :"�'�r�.'� `.'� � . . .._._ _ .....'L.? .... �:��= ; ��.,5..... - ,�_' .�� _ t...:) _. . CONTRACTOR: _ .-..,;.,,i ; :� _.r-,;. _ ':.:_. : :;_ OWNER: ; :,. �:: -;�� - - - - ,_. . , .,,�._. , Y:,;is. s {.? ta . . _ `{_. -a.�rs! . . .... r�� • -- . ::, .` . .� i� t.. . :. : •_ _ .'. .:_: _ : ';_ .'�_ y t - - - � i:-. . _ _ ._ i''i .��a�' J:.'s.} -. �. _ _- _ � ._ . ��f�_ti'?!::.�_�1�+=: �i`'•. fa:_ _��.i�''�_'' T'= s .-�::t'_-. v_l�``_. E�4'u :'��:. 4 €—:# �:: i t:�:.:a_�..._,-�.:_��"�(:' ::��:�- . - � .. .. . �� . . . . , . ; � . �„ ..� �. � , c�� ,� ��. 'c_ Y .� - >j ,�.,� t `�"��"��_��..�� °...�`'��'�� «.� �'r.�'-.�'4.�' ,�i"�� t t,» .�s ":��.�� '�° . .,... _.,. . .. _ . ._» �� '" ��'�T�� r�C�#� �i�r��`, �'�� t,� �#��. ��.Jh�':>��f �'�"��`�` ��t��`�I��:E -��T�r��,��.�.. ��"`�' _�� .... _� ,.r��t��:.:�'� ��i��3 ':;�"�T� ��`.�� It}lt��:::fa=T�l ��t��.,��t'��',��;�:��:��:��T��W L � � � � ��- � n � �'Yl'1?- � APPLICANT/PERMITEE SIGNATURE — ISSUED BY:SIGNATURE �/�^'�� Total Fee: S�%�� %� ' DateReceived: DateApproved: Entered By: / Py`�t�' � � f -.1"�L CITY OF OROtiO - BU�D�G PER1vIIT APPLICATION AI.L�"F'ORtiI�TION I�iLST BE StiB1�iITI�ED IN FLZ-L BEFORE PL��1 REVIEtiV tii�TII.L BE ST:�RTED �___ -------------------=�,-------------------------- ---------------- �--- THE �PPLIC:�v'T IS: (c;rc.e one) O`VNER OR CONTRACTOR �, �__ - __. JOB SITE �iDDRESS: ��g � ��"C"�C-� � IY'�._�— ZIP: � �7C � NAi�IE OF O`Wi ER: �f y� K F; ��(1 ��— PH0�1E: (home) �7�, -C�S��"j��j aT—� C (wor�) I�IAILI��G�DDRESS: -��"n� CITY:� -� _ ZIP: � / CONTR�CTOR: �-► 1 tr^ � �r��-� Pxo�: S�r � �� IOBII.E PHO�IE/P�GER: I�IAII.Iti'G�DDRESS: '�,�,1 S /l1 � �� , I�__�CITY: I � ZIP: �� ST�TE LICE�'SE: # � :�.RCHTI'ECT/E�G��EER: PHONE: �IAILL�'G�.DDRESS: CITY: Z�: v�v1E: REGISTR-�TION n TYPE OF ti�ORh: New Addition Accessory S�ucture ivlove Re.-nodeL�Alterat:on � T_2n�1 Alteration PROPOSED�VORK(describeinde*�il): T�C�,C- C7�-� - {� r(� %� STORIES: SQ. FEET OF EACH FLOOR: v0. OF BEDR001�IS: G�R�GE ST.-�LLS: ATT. DET. ESTLtiiATEDCO�'STRLCTIO`v�,i.L'?�TION(escludin�la.nd): S�, 3pU `�G I hereby apply for a building permit and I acknowledae that the information above is comple�e and accurate; that the work will be in conrormance wich the ordinances and codes of the Ciry and with the State Buildino Code; r.hat 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. :�PPLIC��tT'S SIGNATLJRE: �'� ;� vu� l/(/.-Q�1�_�J ' DATE: I � /��;�'=� � � . NOTE.' Parade o Homes events require separate permit approval by Police Department and Citv Council 60 days prior to the event. ��on-permirted events will not be allowed. . � Sec.13.04 RIGHTS OF SLBJECTS OF Da,T� Subd. 1. Type of data. The rieh[s of individual on whom che data is scored or to be scored shall be as set fonh in this secaon. Subd._'. Information required to be��en indi�-idual. An individual asked to supply private or conndennal dara concerning himself shall be informed of: (a) the purpose and intendzd use of the requested da[a wi[hin the coilecdng"state agency, political subdivision,or sta[ewide sysrem; (b)whether he may refuse or is legally required to supply the requesced dara;(c)any known consequence arising from his supplying or refusing to supply priva[e or confidendal data;and(d)che idenocy of ocher persons or endaes au[horized by state or fedezal law to receive the data. This requirement shall not apply when an individual is asked [o suppiy invesrigadve da[a, pursuan[to section 13.82, subdivision�, to a law eniorcement o�cer. The commissioner of rever.ue mav olace ��e nodce reauired under this subdivision in the individual income rax or oro�ertv [as refund inscruc�ions inscead of on those forms. Subd. 3. .-�ecess to data by individual. L'oon requesc to a responsible authoriry,an individual shall be informed whe[her he is the subject of stored data on individuals, and whe�her it is cfassuied as public, pnvate or confidennal. lipon his funher request, an individual who is the subject of stored private or public data on individuals shall be sbown the daca wi[hou[any charge to him and, if he desires, shal] be informed oL the content and meaning of that data. .�her an individual has be�n shown rhe priva[e data and iiuormed of ics meaning, the data need not be disclosed co him for six months thereai[er unless a dispute or action pur�ane co chis secdon is pending or addidooal data on[he individual has been collected or creaced. The responsibie authoriry shall provide copies of the pm•ace or puolic daca upon request by the individual subject or'the data. 'Ihe responsible authorirv may require the requesane person to pay the actual cosu of making, cerafyine, and compiling the copies. The responsible authority shall comply immediately, if possible, with any reauest made pursuant to this subdivision, or wi�hin five days of [he date ot the request,excluding Saturdays,Sundays and legal holidays, if immediate comptiance is not possible. If he cannot comply with the request within tha[time,he shall so iniorm the individual,and may have an addidonal five days wichin which to comply wi[h the request,excluding Sa[urdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compleceness of public or private data conceming himself. To exercise this neht,an individual shall notiry in wncing[he responsible authoriry describing the na[ure of the disagreement. The responsible auchori[y shall within 30 days ei[her: (a)correct the data found ro be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplete data, includine recipienrs named by the individuaf: or(b) nodfy the individual tha[he believes the data to be correct. Data in dispute shall be disclosed only if the individual's sra�emenc of disaereemen[is included with the disclosed data. The determination o[[he responsible auchori[y may be appealed pursuan[ro the provisions ot the adaunistradve procedure act relacing to contested cases. DAT�, PRIVACY �DVISORY 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 i�s departments may require you to furnish certain private or confidential iniormation. You are rotified [har. 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, bu[ refusal may require that the Ciry deny the permit or license. 3. The information may be shared with o[her local, state or federal a�encies 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 ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this aoplication or permit. �,n�n F� �� ' I(�t 1��<� �C>c`�th — First titiddle Las[ �� ' Address c� I� /`�ii-� , �, � _ �.� �� Ciry Stare Zip Phone I understand my rights as stated above. f s�v-�,,w �2�.L��t�� Signature