HomeMy WebLinkAbout1995-007418 - temp sign PER� IT
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CITY OF ORONO '' PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: - - ' ���
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(612)473-7357 ; :i:�t:1.�::;'`=;:�:
SITE ADDRESS: �
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: -- }-;�;�_:: : ; : ::;. -
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APPLICANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE
Total Fee: S ;Ci r �'Z� `
• � DateReceived:
�� Date Approved:
Entered B��: ,�,� Pe:mit,=`: l `�/`,�
CITY OF ORO�O - BUILDI�tG PER1tiIIT APPLICATION
AI.L I�i�'ORtiL�TION I�IL'ST BE SLBtiiI'I'TED IN F�ZL BEFORE PL��1 REV�tiV ti�L
BE ST�RTED
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THE �PPLIC:�:��'I' IS: (circ:e one) O��I�ER OR CONTR�CTOR
JOB SITE �DDRESS: ` `i'l' ' � ! � 1 � � t)+ f' ;:', ,. c ZIP: '� 'S 3 c� ;
N�1�IE OF O�VYER: � . � +�` ' � '� k
PHO�IE: (home) �l �� � C� `/�, � .
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l�1AII.��G�DDRESS• _� � � � :�, �. �; � CITY: ; �, �� ;��� ZIP: �� �c` �l
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CONTR�,CTOR: PHO�IE:
I�IOBILE PHO�IE/P:�GER:
1�IAILI�i 1G�DDRESS: CITY: Z��
ST:�TE LICENSE: �
�RCHITECT/ENG��EER: PHO\E:
1IAILL�TG�.DDRESS: CITY: ZIP:
���IE: REGISTR�TIO�i n
TYPE OF WOR�i: New Addition Accessory Structure
:�1ove RemodeL�Plterstion I.��nd Alteration
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PROPOSED`VORh(describeindeail): � - ; _
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: G�iR�,GE ST�I.LS: ATT. DET.
ESTL1iATED CONSTRUCTIO`�%:�-L'�,TION(excludin�land): 5
I hereby apply for a buildina permit and I acknowledae that the information above is complete
and accurate; that the work will he in conrormance with the ordinances and codes of the C:ty'
and with the State BuildinQ Code; that I understand this is not a pennit and woric is not to start
without a permit; and that the work wiil be in accordance �vith the approved plan.
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?,PPLIC�ti"'I"S SIGNATLIRE: � �_� /�� �,�����-�,� � �
�VOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non-permiited events wi11 not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS OF D�T�1
Subd. 1. Type of data. The rieh[s of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd. '_'. Iaformation required to be��en indicidual. �n individual asked co suop(y private or conndeaaal data conceming himself shall
be informed of: (a) [he purpose and intended use of[he requested dara wi[hin the collecting'state agency, polidcal subdivisioo, or stacewide system;
(b)whecher he may refuse or is le2ally required to suoply�he requested dara;(c)any�own consequence arising from his supplying or refusing ro supply
priva[e or confidendal dara;and(d)the identi[y of orher persons or enades authorized by state or fzderal law to receive the data. This requirement shall
not apply when an individual is asked ro supply invesdganve data, pursuant to secdon 13.82, subdivision�, ro a law en2orcement o�cer.
The comm ssioner of re�e ue mav eiace tne nodc r auired under this subdivision in the individual income tax or oropem t�_refund
ins[rucrions ins[ead oi on rhose iorms.
Subd. 3. Access to data by individual. L'pon request to a responsible auchority,an individual shall be inYormed whecher he is the subjec[
of stored data on individuals, and whe�her i[is classuied as public, pnva[e or contidenaal. lipon his further reques[, an individual who is the subject
of stored private or public data on individuals shall be shown[he da�a wiehou[any charge ro him and, if he desires, shall be informed of the content
and meaning of that data. Afrec an individual has been shown�he priva�e data and informed of its meaning, the data need not be disclosed to him for
six months thereatter unless a dispuce or acaon pursuanc to �his secaon is pending or addiao�al data on[he individual has been collected or crea�ed.
The responsible authoriry shall provide copizs of ehe pri�•ate or puolic data upon request by[he individual subject of the data. The responsible authoriry
may require the requesring person ro pay �he actual costs of making, cerrifyine, and compiling[he copies.
The responsible authoriry shall compiy immediacely, if possible, wich any request made pursuant to this subdivision, or wi[hin five days of
the date of the request,excluding 5a[urdays.3undays and leeal holidays, if immediate compliance is no[possible. If he cannot compty with the request
within that time, he shall so iniorm the individual,and may have an addidonal five days wichin which to comply with rhe request,excluding Sa[urdays,
Sundays and legal holidays.
Subd.d. Procedure when data is not accurate or complete. An individual may contest[he accuracy or compleceness of public or priva[e
data concerning himself. To exercise[his rieht,an individual shall no�ify in wricing[he responsible au�horicy describing the nature of the disagreement.
The responsible au[horiry shall within 30 days either. (a)correct the data found to be inaccurace or incomplete and attempt to nonfy past recipienes of
inaccurate or incomp(ete data, includine recipien[s named by [he individual; or(b) nodty the individual rha[he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's sta�emer.c of disaereement is included with the disclosed data.
The determination of the responsible aucnori[y may be appealed pursuan�ro �he prov�sions of the admuusaative procedure acc rela[ine to
conces[ed cases.
DAT:� PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. �', "Ri�hts of subjects of data", we wouid like to inform you that your request
for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential information.
`�'ou wz notiited tl,,at:
1. The information you fumish will be used to determine your qualification for the permit or license requested.
2 You may refuse ro supply dara, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, s[ate or federal aaencies 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 'vf.S. 13.04 (available uoon request) to review private data on yourself.
(. Your full name is required to process this application or permit.
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First ltiddle Last
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Address �
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Ciry State Zip Phone
I underst� my rights as sta�ed above.
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Signature