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Home My WebLink About1999-011139 - land alteration � � PERMIT CITY OF ORONO PERMIT TYPE: �....._... �. .;.._. „ 275� Kelley Parkway- P. . Box 66 �:;-1:' �_�-4- � ;w:-�:� Crystal Bay, Minnesota 55323 Permit Number: ;n,,�, ; ; :;;�; (612) 473-7357 Date Issued: --� ��-:-. { . .. . . ., _. SITE ADDRESS: i�- - - -"�� f�=�� .';'��. ,]S� . . _. . . . . . 1{..{�i .�. �_�LL�,"l1i_f,Y i DESCRIPTION: :r`•-:_-�� i—`N=1'ijf91_. ��VC+t�s �r�.!'`,.';1 F��E_ :1-,�`t'—;�ii_��`� REMARKS: FEE SUMMARY: _=�:� �,=��= �•��•i s'•)i`i —• • C _______ .�_.��. i`F''�.:�t� t";•�r' !�•�,,,� , :i:7 CONTRACTOR: OWNER: -- , :,:^ ,_ ;-.:;.;—;a; — ;_;=;i==�#: �.�,=�� E := _��_: -,��w`%�� :�,r°� q_ij��—ie..i,� i*i4 ��"� +�. . 3.L — : f; :1 _ .. � ._. _ _. ., � , — — ._ i 3��, �.�i�4��#�`_;I��€�i� �-lt.�:�.��Y r-+.�_'.��_��i�� '�i�I`�'`I�_}�� € 's�F :?t��.,_,_ f��.._ t,:.w;.-�__ _;Fs- �i��?r�f=.� s� r•_ -- - -.,, .. ._ _ � , �:�'rt.r�: r r- s 3.-��.f�7 �,�h�w� ��_� .�}'_` r��..�._ �,��_i�e��: �!. =:T�i i: ( � :F: , . �- 4,}s , r,4:.�_ t_. .ti . {�� _.. _ _. t ' .., _,_..T} �^ ,r^^ ' � f.s � i .. �.` i � C47� �g k .t...�i��1�3K r t T � � 9 u�. .� � l 3}"S S J.4!..� ..i '.3.I,t�!`�i(�s..':.... l"'tl�_ _F?:?_=�. P"' # !S.�V� ..:i 1 r� s..e�_t.E_,,,;,,,5 } �ff,-,� ,„�._f._._ '�.�S�?,� € €-t.._L.._ t M . ; ..._� � _. . � � e� � APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE r ? Total Fee: $ Date Received: � Entered By: Permit#: i CITY OF ORONO - BUII.,DING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. . (please print all information) THE APPLICAh'T IS: (circle one) WNER O CONTRACTOR JOB SITE ADDRE S: ��pt� ��l.�.�Z�/u� ZIP: �� / � r C��''-'/`-( '�J' " 1 `-- ��9�1� �C.�` NAME OF OWh�R: �J�j� C�C=—�� PHONE: (home) ��(o %�C� C� (work -�'jc3-�-f��D �fs/- 7b'UO MAII.ING ADDF�ESS: ��ro �� -� ��: � Z�:�� s�z 3�i� . . CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAII.Itii'G ADDRFSS: CITY: ZIP: STATE LICENSE: �# ARCHIT'ECT/El\TGINEER: PHO�TE: 1�IAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration� PROPOSED WORK(describe in detain: /O�L��_S / % �� /�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 1 din land : $ � �� . ESTII�i IAT'EI C�NSTRUCTI�N VALUATI�N(exc u g ) 1 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 and work is not to start without a permit; and that the work will be in a o dance with the approved plan. APPLICANT'S SIGNATLTRE: � DATE: � � 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. � � T . Sea 13.Q4 RIGHTS OF S[JBJECTS OF DAT.�► ' Subd. 1. Type of data. The righcs of individual on whom rhe dara is swced or ro be swced shall be u sec for[h ia this secrion. Subd.2. Informatioa required to be Yivm individual. An iadividual uked to supply privace or coafidendal dan concerning himte(f shall be info�uted of: (a)the purpose and iatended use of the requested dan withia the collecdng Stace agenry.political subdivision,or stacewide rystem: (b)whether he may tefuse ot is.legally cequiced to supply the ctquesud d,ata:(c)any Imown coauqueace arising ftom his supplying or refusing to supply private o�coafidendal data;and(d)the ideadry of o[het persoas or eaddes au[hocized by stace or federal(aw co Kceive the data. Zhis requitement shall noc apply when an individual is uked to supply invesdgadve daa,pursuant to secdon 13.82,subdivision S.oo a Iaw enfoccemeac officer. �� PI1TT�!l1f1RIr f1f rcvenu- mav Dlac- the nodc� rauired under this subdivision in the individual income taz or orovertv tax refund insnucdons inscexd of on ehose foims. Subd.3. Aceess to data by iadiridual. Upon request W a tesponsible aurhoriry,an iadividual shall be informed whether he is che subject of stoted data on individuals,and whaher ic is ctass�ed u public,private or confidendal. Upon his ti�cther requesc,aa iadividual who is the subjecc o[stored private ar public dara on iudividuals shall be shown che dan wirhout any charge to hun and;if he desires,shall be infocmed of the contenc and maning of dtat daa. Afu�an individual h�been shown the private dan and iaformed ot ics meaning.the data need not be disclosed o�him for iu months thereafur unless a dispute or acaon pursuanc to this ucdon is pending or addiaonal data on the individual has been collecced or crea�ed. The cesponsible aurhoriry shall pcovide copies of the privace or public dara upon request by the individual subject of the daa. 'Ihe responsible authoriry may require rhe requesring person to Pay the accual coscs of rsukin$,cerdfying,and compiling ehe copies. The responsible auchoriry shall comply immediacaly,if possible,wich aay cequest made pursuant to�his subdivision,or wichin five days of the date of die requesc,excluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he canao[comply with the tequest within thac ame,he shall so infocm the individual,and may have an addidoaat five days wi[hin wtuch oo comply wi[h the reques�excluding Satucdays, Sundays utd legal holidays. Subd.4. Procedure when data is not aceurate or eomplete. An individual may contest che accuncy or completeness of public or private data eonceming himsdf. To execcise this right,an indiviCual shall norify in wridng d►e responsible aurhoriry describing the natuce of the disagreemenG 'l�e nsQoasible authoriry shall within 30 days eicher: (a)correct the dan found ro be inaccunte or incomplete and attempc to norify past recipientt of inaccunte or incomplete data,iacluding recipienrs named by ehe individual:or(b)nodfy the individual thac he believes[he data to be cocrect Data in dispute shall be disclosed oniy if the individual's stacement o(disagreement is included with[he disclosed dara. The deurminadon o[the rasponsible au[horiry may be appealed puauanc oo the provisions of[he adminisaadve pcocedure act relacing to contesad cases. • DATA PRTVACY ADYISORY In accordance with M.S. 13.04, Subd.2, "RiQhts 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 ics departments may require you to furnish certain private or coafidencial information. You aze notified that: 1. The informatioa 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 tho Ciry deny the permit or license. 3. The information may be shazed with ocher local, state or federal agencies to the excenc necessary to process the permit or license. 4. If your requested permit or license requires Council acdon 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. 4�i�i �— 5��„ �tiddle �� '�'D �� ` !� Addre��1� l /� �"�( !'l/ ��G�� / �U� � Snu Zip Pho� ��ry �'�� -s��O I unde�st d y ' as stated ab � � — �� ?� Sig ture r � ' � � _� 7 1 � v r�� V �� _ � � ' � � �� .�� , � � _ �� ` �� .. � � � � � ,� s �- ► �� g � �� - � �l r� � ,�� ► � �� w _ �� f� � � � � �� , � � � � � -. � � � � � � , � � � � � � � , � � � � � � , � � � � � � � � � �� r � � � '� / -� - . � � � ,,,� � � C\- � � "-' � I�� \ � �\\ �-�;`..'%.�_`�. �I � n . � �;� �: �.� � � ;� �� ' � `�` '��' � .� �fi � � � u� �. .r-_ 4_J � ,.,,,,. � o � � � �:�, , �� `� � �. a.-� � � Q.7 � \ � y 1 � .��'i (�i _� � � � � � o �� E_ �, � �"� � � t� "� � ,� '� �� ,' ,c �' � -� � �v � `� t0A `�1" J, � � � � � � � � � � � � � � . �- �` �� , �� X � � � � ?` � �- � � �� ' ` - �- r`- � � � � � � � x � � /�� L�tiC-�- , , � �: _ ► , � . � �� 1 � � C__---� � `/'� � � � � I I � � � � � , � I � , . � . � � � � � � �l � � �