HomeMy WebLinkAbout1997-009823 - sign PERMIT
CITY �f�RONO
� PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 _
Crystal Bay, Minnesota 55323 Permit Number: , ,, _,._.,
(612)473-7357 Date Issued: _ -
SITE ADDRESS:
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DESCRIPTION:
REMARKS:
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FEE SUMMARY:
CONTRACTOR: OWNER: - -
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APPLICANT/PF, MITEE SIGNATURE ISSUED BY:SIGNATURE
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Tot�l Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT 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�i{�� S hcn.e,l ,�,nc� 1�- r (�c�u.,,-LZIP: 55 3�1 Z
NAME OF OWNER: ����j C�n: PHONE: (home) �� � - �,16�j
(work) �l-71 -�4��c�,
MAILING ADDRESS: PO �,�, �2.. CITY: N��c.,d� ZIP: S�3�i Z
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCffiTECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �T�c,r,���-5,�=�,,, 'P c r r�,} -�,�- f�;�i Le v�i��e�z�
►Z_ i � -�i� }�c,�� �z- Z�, -`�?
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED 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 conformance with the ordinances and codes of the City and with
the State Building Code; that 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.
APPLICANT'S SIGNATURE: 'A �._ �'C-�� DATE: i z' ��. � 7
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NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non pernzitted events will not be allowed.
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Sec.13.04 RIGH'TS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom�he data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. ?.n individual asked to supply private or confide�rial data concerning himseif shall
be informed of: (a)the purpose and intended use of the requested dan within the collecting"statE agency, polidcal subdivisiou,or sratewide system;
(b)whether he may refuse oY is legaily required to supply the reques[ed data;(c)any known consequence arising from his supplying or refusing to supply
• private or confidenrial data;and(d)the idenriry of other persoas or enaues auchorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrieaave dara, pursuant to section 13.82, subdivision 5, to a(aw enforcement officer.
The commissioner of re�enue mav place the notice required under this subdivision in the individual income tax or_propertv tax tefund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request 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 classified as public, private or confidenaal. Upon his further request,an individual who is the subjec[
of srored private or public data on individuals shall be shown the data wi�hout any charge to hirn and, if he desires, shall be informed of the concent
and meaning of that data. After an individual has been shown[he privace data and informed of its meaning,ihe data need not be disclosed[o hiin for
six months thereaTter unless a dispute or acrion pursuant to this secaon 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 individuai subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of makine, certifying, and compiling the copies.
The responsible authoriry shall comply immediate(y, if possible, wirh any request made pursuant to this subdivision, or within five days of
the date of the request,excluding Saturdays,Sundays and 1e2a1 holidays,if immediate compliance is not possible. If he cannot comply with the request
within thac time,he shall so inform the individual,and may.have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legai holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pm•a[e
data conceming himself. To exercise this right,an individua(shall notify in wridng the responsible authoriry describing the 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
inaccurate or incomplete data, including recipiencs named by the individual; or(b)notify the individual that he believes the data to be corcect. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsibfe authoriry may be appealed pursuant to the provisions of the administradve procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Ri;hts of subjects of data", we would like to inform you that your request
for a pernut or license from the Ciry of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified thar.
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 pemut 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.
(. Your full name is required to process this application or permit.
Le��1 Ke,ne e �-�'�' -
First vliddle Last
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Address
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t��v ��3�l 4��i -�����
���, Stare Z�p Phone
I understand my rights as stated above.
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Signature
/ D6� TV�T
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED /�Z -�t�i-97 �
PERMIT NO. ���� COMPLETED
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ADDRESS �
OWNER � CONTR��� ���e
TELEPHONE NO. `7` 7� " � 7(P �
� DESCRIPTION `fL� � ' ,t.�
� Ot FOOTINO 71 MECHANICAL RI 18 EXCAV/(iRADINO/FIWNO
y 02 FRAMINQ 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
ti� FINqL 14 SEWER HOOK-UP O6 PROGRESS
J 0 �SITE 27 SEPTIC MAINT. 21 COMPLAINT
W 07 DEM�FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP
= 09 PLUMBINO RI 23 SEP71C FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINd FlNAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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d WORK SATISFACTORY:PROCEED
W� _: PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,` pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next spection 24 hours in advance.473-7357
OwnedContra o n 't
Inspector.
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