HomeMy WebLinkAbout1995-007601 - temp sign —�_—_ __. — _. �— T�—Z . . T. j . . _
PERMIT
��TY OF ORONO PERMIT TYPE:
� �5'b Kelley Parkway- P.O. Box 66 _ _ ��::=•a
Crystal Bay, Minnesota 55323 Permit Number: -::,.:,;
(612)473-7357 Date Issued: � -
1 ;?i;":r=;. :=``:
SITE ADDRESS:
: .- _ _. .��3:�:�=:��_;t::.� __. .
�t'_;
_.. ..� ! . f'�`_._+.ir'.�. ,
DESCRIPTION:
"_•`_.:�'t i"'i�_;i"i_F%�'1�{ �� i �'E�'v.i ♦
.. . ,_i�? . .. ..i 3} . . . ._ ? �:..�fi��i+�E�.�'�i�'l�f
' I E _f. ' '.t7'•
.,!� °_ . ..�..F��E�. . _ �-_- — F l'f�':y .
tr: '� _.
. �._...._."`"'!°::: .
i_.i i�#� — ��i�:- . . .. •
. .._`__._..'?Y ::i��i_(N:�i%if\y
REMARKS:
_ � _
.�w€ � ,. _, ; - - -
.__: : _ T _ _
: . � , •_ ; � .,T : ;_. - '(;1�.a i ' t � . - � -
: : :F,�
, ;
. ._ . , _. . . , , .
_ _ . . _. , . . : . �_� _ .�._
FEE SUMMARY:
____..______ _ ___
��._�::��. - _.__ . = _ . .:E:'r
CONTRACTOR: OWNER:
.._. . ._ ,_ � � _
;_:, . :: ; .: . . : ,_..._
, , , : . , :�: ; ;�G;,.��:;.;_,,
' .. . _. =�-;_��=�;�-'_r`':`� ...
- r:r.;
_. .":r�4�_t - �i_.,'}:.��.
. _ ..s_. f:' _. _. _ ..�..
.?�?.. . ..r•, :�. �i�. /��., �-" f ,.' {"' ri.y.1,+3 �i .� ' �L. 'x
.. ,. (�
i � ''" _;�..���.}��#J a3 �� . E° '$i�4.5l���°.r�'.. t.«,�'t.�'!,_ :_ . : _.3 . 'ty!v F`r�—i!._. . . � . ,.... . �9� . ..
� .'.';..., ` ,, f 3�..�����} 'FdC k � '�" : :�P� .�l�_.��'�L..; . '$�t���F l.F'�. ..., : ..`..�. i��.'? ,. ...�7 1�' , ._.!` .. . , .:{.. i �...5 F..r t A �kaa.^
.,.. i.» .__ ^�
_ . ._ . _. E�''
� �.:. �.:-� �,�.i��i�'�� `;�' � '=������ ��.� ��11���'-`s�_���?�� - _.. . . <`_:� ± a ��;�_ :;s3�i. .. , _ , :�t w � �
: . / �
/3 � r'
� �
r �,� -� --�
L �. ' ,
�'��Z-fi��'1 --��
ISSUED BY:SIGNATURE �
—�------ ___���•
. >•�Total Fee: � DateReceived: i�- �� � s�
" Date Approved:
Entered By: Permit#:
�1�Q/Go,,c� ,2_s—�,� (,�,,
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORNIATION��IJST BE SUB�iTTTED I�i 1 FULL BEFORE PLAN REVIEW WILL
BESTARTED
-- ----------------- )�c-�-�---�/
THE APPLIC��1T IS: (circle one VNE OR CONTRACTOR
-� - ` -.� �. �-_
�� � � � ZIP: � S � /
JOB SITE ADDRESS: �� � � ��Zk' �t .� .�_ � _ /
- � ��� � �} - �
. �_,
, ��. �
NAl'�1E OF OVVNER. ��L..:`� -'�� ��` C` v� � --- PHOi�1E: (home)
_. �, / /(work) (��0 � <{�� i i � `-17 3
-� �,�-��;_.c� � �� CITY: /�(cr 4`�� �_�_ ZIP:����..
N�AILING ADDRESS: �� ' f
CONTRACTOR: ' PH0�1E:
MOBILE PHONE/PAGER:
VIAILING ADDRESS: CITY' ZIP'
STATE LICENSE: #
ARCHTI'ECT/ENGINEER: PHONE:
I�IAII.ING ADDRESS: CITY: Z��
NAi�TE: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration Iand Alteration
� �) J; - i' �;-� _
�'����/� - �:1�; �` �_� .,� � �< ��t-
PROPOSEDWORK(describe indetail): ,/��-�
�� �c 1l - ��
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOi�'1S: G�iRAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excludingland): $
I hereby apply for a buildin� permit and I acknowledge that the information above is complete
and accurate; that the work will be in conformance with� flrdinances and codes of the City
and with the State Building Code; that� understand this not a permit and work is not to start
without a permit; and that the woz� wi�l: � ���ce with the approved plan. __
�-
/i / � j ,� ���--�ATE:/�" �
APPLICANT'S SIGNA�'IJ]K������� �
NOTE! Parade o Homes events require separa#�/ermif approval by Police Department and
City Council 60 days prior to the event. Non p rmitted events will not be allowed.
�#< ,
Sec.13.04 RIGHTS OF SLJBJECTS 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 section.
Subd.2. Information required to be givea individual. An individual asked to supply private or co�dential data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wi[hin the collecang'state agency, political subdivision,or statewide syseem;
(b)whether he may refuse or is legally required to supply the requested dare;(c)any lrnown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shail
not apply when an individual is asked to supply investigadve data,pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissionec of revenue mav place the norice required under this subdivision in the individual income tax or propertv tax cefund
instructions instead of on those fornts.
Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of srored data on individuals, and whether it is classified as public, private or confidenrial. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wi[hout 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 iu meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or acdon pursuant to this section is pending or addidonal data on the individual has been collected or created.
The responsible 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 requesting person to pay the actual coscs of making, cerrifying, and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made pursuant to this 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 that rime,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 compieteness 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 ro be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data
in dispute shal]be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative 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 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 pernut 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.
C c ��L� G L ��� �i� ��`� 3 z��� �� �
First� M ddle �t
� ��'� �'�-�--�—� � _ _
Ad ress � /
`���j,����� - �;,�'�: `� �' �� ��� //�, _�/J/����
°Ci�, State Zip Phone
7 i
I und my. ' ts as Stated ab
�, �/��, � ' _, - �.--��
� � C C / �1���s �-__�__—_---�._
� L L� ' -
S' nature