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Home My WebLink About1998-010333 - land alteration PERMIT ` CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 �-��_'�� '`��'� ��'�=��-' Permit Number: ;_=j��;_;_; Crystal Bay, Minnesota 55323 _ ._ _ (612) 473-7357 Date Issued: �f`;:;��;_,;_; SITE ADDRESS: ��=� =,;�i ��4�� t�l t:: � ��uT iri =`i—i i �_-- --1:'—{�tl;,�� DESCRIPTION: f �;C�[3 �;i T��;T i��k :{�;,�x� �'��r��i�� YF�� .�;i�ii� N�_T�i�'�i I�=i�� - , ,�--� � .�`-� REMARKS: :,.11F-:_T�t. { i I_� ;.t_E!`yi 1� ( �:_IE.[`.�� I_�� L,;Y`S"'`il_I`t'j-�:_ i_EF 1i�'._�t i�� I ��_:�.� �:�.i 1��, , }r��s�v+�+�.�t��r`°�� i�+I ji ;�i��l' ��I i�t� �`�`=;r�;t il"i f�+i� . FEE SUMMARY: i�;��_ �� -------- �.'m..,_isi;�i f �'��s �'� °�'- i bt i S r.,:F.C•;,� -!'r •.. • - - CONTRACTOR: — �a��;� ic:��-�t. — OWNER: �,:i:��:;� �:�_��°�,�F�t ii�i T�:i�� :��?=:�,_;�:=t }-`s.i�t�t,�;t,�% ;;°s=;ri_r�;- -t!t 1 � � i'E i-i i�`�I i`�:ri�� 4;:.;:t; F=....'_� �;�� E �.._��„�_��. ��._n 3_iF;4_t. ...{ ;�� ..-.�^,tY� �'�„E E L �`1_r-1�i�{_ �1i4 ��i_,t 7� ( �`Yi_ . . _. _ _ _ t,{�,I:,,_'.i �;f'- - :{:�� •}'�, i � -2 �%,.i�` _' �{`':'r?L.. i tii-'k:ii:;3aia::=.i'1'"'- i"�r l_l;v.i?�..�'�_�:t;[�a#�:# !-`.sF i;�.:=;`,� �i �i:1 si-'_, , _ =��`;€'�i`� � __-,�',i :�. t,�„•.,c-. i t-:i�: _--• _ . _.. .__.�� - -- " {' N �;:,� �: i,� ra��:.� (i� i +1_i f-31_k� ��# t'-� � ^L+ '��I I t s S_,S S.f_j ;-, [ � r `•��i'r� >'�t�t_ _�� f�'Y =_t�- -.��3�_� • � !"•, i!� _ .._ . L !�s-:- i! i_s�;['s :��'i;ui.i-`_. I•' — E_1;' �'�j€Js;ii=_:_�:!{r't L't_l�!�i T�:;;, �I �a•� h.__�.a'i 7�}:'�-.;�iF{�I `� , � � �Z APPLICA T/P ITEE SIGN TURE ISSUED BY:SIGNATURE !� �- � - .T i : Total Fee: $ Date Received: Entered By: Permit#: �/p��3 � CITY OF ORONO - BUII�DING PERMIT APPLICATION A11 information must be svbmitted in full before plan review will be started. (please print all information) . TAE APPLICANT IS: (circle one) OWNER OR CONTRACTOR � JOB SITE ADDRESS: �o�� S��x�i �1�P , /V- ZIP: � ' � NAME OF OWNER: �� -�e.��t- J.�l I� 1^Ia NN�r � PHONE: (home) _�n (work) MAII.,ING ADDRESS: �I aa-O S i�c?�► � CITY: ��o�-0 ZIP: I t � , CONTRACTOR: ��SS.P �ON�.�T'�c��tr� PHOivE: �7-3 'C937_3 i CONTACT PERSON: �.�-`��+�-LL t— MOBILE/PAGER: ��I-G��`� ' �,nvGannxEss: �3oo � (�ile PI�i�...f crrY: P�f JP1C�� z�: ��ol� STATE LICENSE: # ' � ARCHITECT/ENGINEER: PHOI�TE: MAILING ADDRESS: CITY: ZIP: ' N�: REGISTRATION# � i TYPE OF WORK: New Addition Accessory Structure Move � Remodel/Alteration Land Alteration �'� PROPOSED WORK(describe in detai �d � �'Ul � � �: �u� v�-- U-� � x�° �S �,�-� -�r-� �� °� � STORIES: SQ.FEET OF EACH FLOOR: � NO. OF BEDROOMS: GAR,AGE STALLS: ATT. DET. , ESTI�VIATED 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 Buildin� Code; that I understand this is not a permit d work is not to start without a permit; and that the work will be in accord e with p ved plan. APPLICANT'S SIGNAT'URE: DATE: —3� NOTE! P,�rade of Homes events require sepa ate rmit approval by Police Department and � City Counci160 days prior to the event. Non pe uted events will not be atlowed. � .. Sec.13.0:RIGHTS OF SUBJECTS OF DaTA Subd. 1. Type of daea. The rieh�s of individual on whom[h�data is stored or to be swred shalI be u set fo�ch in this secdon. Subd.2. Informatien reqirireci to be givea individval. An individual asked to supply private or confideoaal dara concerning himseif shall be informed of: (a)the purpose and inrended use of the requested dara within the collecang 3tac�agency, polidcal subdivisioo,or statewide sysum; (b)whether he may refuse or is legally cequired co supply tbe r.quested dac�;(c)any Imown coasequeace arising from his supplyiag or refusing to supply priva�e or conFidendal dara;ar.d(d)the idendry of other persoas or endaes auchorized by sc�te or federal law to receive the data. This requirement shall no[apply whan an individual is as4;ed to supply invesrigadve dam, pursuanc to secdon 13.82,subdivision 5, �o a law enforcemenc ofricer. - "[he commissioner of revenue mav place che noace rouired under this subdivision in the individual ir.come tax or orooem taz refund inscrucdons inscezd of on�hose forms. Subd. 3. Access to data by indiridual. lipon requcsc to a responsible auchoriry,an individual shall be informed whecher he is the subject of s�ored data on individuais,and whechzr ic is classified as public,private or confedendal. Upon his further request, an individual who is the subjecc of scored private oc public data on individuals shall be shown[he daca wi�hout any charge to}iim and;if he dzsires, shall be informed of the content and meaning of chac data. Aher an individual has been shown che priva�e data and informed of ics meaning, the data need not be disclosed to him for siz monehs thzreaiter unless a dispute or acdon pucsuan�to [his secaon is pznding or addidonal data on the individual has been collece�d or creaced. The responsible authoriry shall provide copies of the privace or public data upon r�ques�by[he individual subjecc of�he data. The responsible aurhoriry may require[he requesring person co pay the accual costs of making,cerafying,and compiling the copies. The responsible auchoriry shall comply immediacety,if possible, wi�h any request made pursuant to chis subdivision, or wichin five days of the dace of the requesc,exciuding Sacurdays,Sundays and legal holidays,if immzdiate compliance is not possible. If he cannot comply with the reques� wichin cha�time,he shall so inform[he individual,and may have an addiaonal five days wichin which to comply wi[h the request,exduding Satucdays, Sundays and legal hotidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri�•ate data conceming himselF. To ezercise chis ri¢hc,an individual shall noa"ry in wriang�he responsible authoriry describing che nacure of che disagreemenc. The responsible authoriry shall within 30 days either: (a)corr.cc[he data found to be inaccurate or incomplece and attempc to nodfy past recipients of inaccurate or incomplece data, including re.ipiencs named by �he individual; or(b)aodfy the individuai thac he believes rhz data to be coaecG Data in dispuce shall be discloscd only if the individual's stacemenc of disagreement is includzd with the disclosed data. The decerminarion of the responsible authoriry may be appzalzd pursuanc to the provisions of thz admirustrarive procedure acc relarin� 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 permit or license from the Ciry of Orono or any of its departments may require you to fumish cercain private or confidential information. You are notified that: � 1. The information you furnish will be used to determine your qualification for the perm.it or license requested. 2. You may refuse to supply data, bu[ refusal may require tha[ the City deny the permit or license. 3. The information may be shared wich ocher local, state or federal agencies to the excent necessary to process the permi[ or license. 4. If your requested permit or license requ'tres Council action to approve, some informa[ion 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 applicatioa or permi[. Firsc �tiddle Lasc Address . Ciry Statz Zip Phone I understand my ri�hts as stated above. Signacure