HomeMy WebLinkAbout2003-P06627 - temp sign PERMIT
C ITY O F O RO N O Permit Number:
275��.Kelley Parkway- PO Box 66 P06627
,�Crystal Bay, Minnesota 55323 Permit Type: si�Per,�t
(952) 249-4600 Date Issued: 8/6/2003
SITE ADDRESS: 3440 Shoreline Dr
Wayzata,MN 55391
P I D: 17-117-23-43-0142
DESCRIPTION:
Proposed Use: Commercial-Busines
Perxnit Class: General
Pernvt Type: Sign Pernrit Pemut Sub-type(s): Sign-Temporary
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 35.00
Valuation: $ 0.00
Misc.Fee:
TOTAL FEE: $ 35.00
APPLICANT: DAVID OSMONSON OWNER: David Osmonson
3440 SHORELINE Dr 3440 Shoreline Dr
WAYZATA,MN 55391 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
/ ��
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Avplicant 1-Monthlv Renorts,1-Assessin�, 1-Finance Page 1
Total Fee: $ Date Received:
� Entered By: Permit#:
.
CITY OF ORONO - B G PERNIIT APPLICATION � ( �
�
All information must be submitted in full before plan review will be started.
(please print al ' tion)
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
�
JOB SITE ADDRESS: y (� � ZIP: _�S,� �
NAME OF OWNER: �/��� �s�iv►�j/�<g b�n PHONE: (home)
(work) - O�
MAILING ADDRESS: ��1ij � CITY: rZIP:__i"c' , L�Q
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRES5: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
� � �
PROPOSED W RK(describe in detai : .e J /
'7� f � ��
h4s � 6e o�..f �' ����t�' �'w�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $
I hereby apply for a building pemut 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 understan this is not a permit and work is not to start without a
permit; and that the work will be in acc ance ith e pproved plan.
APPLICANT'S SIGNATLTRE: DATE: S��d �
.
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF S[JBJECTS OF DATA •
Subd. 1. Type of data. 'Ihe rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqtrired to be given individual. An individual asked ro supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requesced data within the collecting State agency,political subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refitsing to supply
private or confidential data;and(d)the idenriry of o[her persoas or endties authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigadve data,pursuant to section 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of re�enue mav place the nodce required under this subdivision in the individua! income tax or oroaertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by iadividual. Upon requesc to a responsible authoriry,an individual shall be info�rned whether he is the subject
of swred data on individuals,and whe[her it is class�ed as public,private or confidenaal. Upon his further request,aa individual who is the subject
of stored private or public data on individuals shall be shown the dara without 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
six months thereafter unless a dispute or action punuant to this secdon is pending or addiaonal 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 requesdng person w pay the acwal costs of making,certifying,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 immediau compliance is not possible. If he cannot comply with the request
within that time,he shall w inform the individual,and may have an addiaonal 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 conust the accuracy or completeness of public or private
data conceming himself. To exercise this right,an individual shall noafy in writing the rosponsible authoriry describing�he nature of die disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomptete data,including recipients named by the individual;or(b)nodfy the individual that he believes the dara to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The deurmination of the responsible authoriry may be appealed pursuant to the provisions of the admuristrarive procedure act relating to
contesud 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 fumish certain private or
confidential information.
You aze 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 perm.it 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.
First Middle Last
Address .
C��, Srdte Zip Phone
I underst my rig as stat a e.
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S' ture