HomeMy WebLinkAbout1997-009803 - balloon snowman . PERMIT
� �,�TY OF ORONO PERMIT TYPE: � Y, ^
27�0 Kelley Parkway- P.O. Box 66
Crystal Bay, Minnesota 55323 P e r m i t N u m b e r:
(612) 473-7357 Date Issued:
SITE ADDRESS:
DESCRIPTION:
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FEE SUMMARY:
CONTRACTOR: OWNER: . , - �
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APPLICANT/PERMITEE SIGNATURE � ISSUED BY:SIGNATURE �
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� Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BiTII..DING PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ,3.j,�� _� ZIP; -s�S�3 / �
NAME OF OWNER: J r G �I?�4'Y� U/S PHONE: (home�Io?����'Z-2.�-1
��1� �/�/ (work) d/2--�f7/ - �S/7�
MAILING ADDRESS: � Z� CITY•^' �rs� ZIP:s`S'3
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CI1'Y: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
OP D W RK(describe in etai�: �'�� ��� ��T%�'r.� i�%�`�
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ST RIES: SQ. ET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding 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 confo ce with the ordinances and codes of the City and with
the State Building Code; that I unde� � d this is not a permit and work is not to start without a
permit; and that the work will be ' ordance w' h the ap roved plan.
APPLICANT'S SIGNA ----- �A�: ���
NOTE! Parade of Homes e nts require separ e permit approval by Police Department and
City Council 60 days prior o the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[JBJECTS 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 reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requesred data wi[hin the collecting§tate agency,polidcal subdivision,or statewide sysum;
(b)whether he may refuse oY is legally required to supply the requestr.d data;(c)any laiown coasequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idendry of other persons or endries authorized by state or federal!aw to receive the data. This requiremenc shall
not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav alace the noace required under this subdivision in the individual income tax or propertv taz refund
instmctions inscead 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 data on individuals,and whe[her it is classified as public,private or confidendal. Upon his further request,aa individuai who is the subjecc
of stored private or public dara on individuals shall be shown the•data wichout any charge to him and,-if he desires,shall be informed of the content
and meaning of fiat daca. Afur an individual has been shown[he private data and informed of i[s meaniag,the data need not be disclosed to him for
six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addidonal da[a on the individual has been collected or created.
The responsible authority shail provide copies of the private or pubtic data upon request by the individual subject of the dara. The responsible authority
may require the requesring person to pay the actual costs of making,certifying,and compiling the copies.
The rosponsible authoriry shall compiy immediately,if possible, with any requesc made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the requesc
within that time,he shall so inform[he 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 compleceness of public or private
data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing[he 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 nodfy past recipienu of
inaccunte or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correcc. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authority may be appealed pursuant to the ptovisions of the administrative procedure act relating co
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 pemut 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 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.
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