HomeMy WebLinkAbout1996-008217 - permanent sign _ _ _ _
PERMIT '
'�ITY OF ORONO PERMIT TYPE:
4
2750 Kelley Parkway- P.O. Box 66 - .
Crystal Bay, Minnesota 55323 Permit Number: `_ `;,
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(612)473-7357 Date Issued: i}:M:�tyS_:::,,^:_
SITE ADDRESS: s��� � ����' �''"r�' -
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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� ' , Total Fee: $ Date Received: 7�3i�q�
Entered By: Permit#: �2,��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) WNER R CONTRACTOR
JOB SITE ADDRESS: -��D Z ��m�c�ivC y�r u LF ZIP: �����
NAME OF OWNER 9 PHONE: (home) f�rZ—�v S`���
� (work) �7/—7 /
MAII.ING ADDRESS: �. 'lJ�7� � 7 CITY: /Vdu�2/� ZIP: —
CONTRACTOR: � � �— PHONE: �7! -- S�,�o�
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: ',�Z.. �{s,R�Iiv�,L�. CITY: NAuA��c ZIP:��
STATE LICENSE: #
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ARCHITECT/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�: ��� I�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��/1�.�
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 ihe ordinances and codes of the City and with
� . the State Suilding Code; that I understand,this is not a pernut and work is not to start without a
permit; and that the work will be�n-a approved plan. .
/
APPLICANT'S SIGNAT �: � � �
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
A�
Sea 13.04 RIGHTS OF S[JBJECTS OF DATA
Subd. 1. Type of data. The righrs of individual on whom[he data is stored or to be stored shall be as set forch in rhis section.
Subd.2. Information reqirired to be given individual. An individua!asked to supply private or confidenaal data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecdng�tate agency,political subdivision,or statewide system;
(b)whether he may refuse oY is legally required to supply[he requested data:(c)any faiown consequence arising from his supplying or refusing W supply
private or confidential data;and(d)the idenriry of other persons or endaes autharized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve dara,pursuant to secaon 13.82, subdivision 5, to a law enforcemenc ofFicer.
The commissioner of revenue mav p(ace the nodce required under this subdivision in the individual income tax or vropertv tax refund
instmcdons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whecher it is classified as public, private or confidendal. Upon his further request,an individual who is the subjecc
of stored private or public data on individuals shail be shown the data wichout any charge to him and,-if he des'ues,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
siz mont!►s thereafter unless a dispute or acdon pursuanc to [his secaon is pending or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesring person ro pay the'actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately, if possibte,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 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 legal holidays.'
Subd.4. Procedure when data is not accurate or complete. An indiVidual may contest the accuracy or completeness of public or private
data conceming himsetf. To exeicise this right,an individual shall nodty in wridng the responsible authority describing the nature of ihe disagreement.
The responsible auchoriry shall within 30 days eithe�: (a)correct the data found to be inaccurate or incomplece and aaempt to nodfy past recipients of
inaccunte 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 shail 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 provisions of the administradve procedure act relating to
contesred 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 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 permit or license.
3. 1fie 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.
g, 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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