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Home My WebLink About1997-009512 - re-roof/tear-off � �- PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 - _' �,''`' ` Permit Number: -��"'-�'��'- Crystal Bay, Minnesota 55323 �"==i"� (612) 473-7357 Date Issued: - SITE ADDRESS: :. - _l �:-°i ';; . ... . � �.4'i-i.,�;�._:'7 S "'7 .� .._��__ e{-; DESCRIPTION: ,.. :. ,, . . �--. �. . .. . T-- .-. r �:.:,�,_ '. _ -:- — — . _ ._ ._ ... � . ..?. .il .. . � � .� _'i....._�'=��i� E��x_. ...°..:i��.._ .. _._ 3 �.f i. ,;:��il'.'. . j�`i: I"�.%.—j-i: ;i_s'f �:k'1;�� ' 1"� "t '— _ .. .__... _:'3=.^ri ,'L.�,si. r�!_1 . i'tis..:_,E;�1V1`;rr,;l__ REMARKS: FEE SUMMARY: - �-��:�:F-, — :-:.-: _ _s} =. ._.�_.}� ________��____ CONTRACTOR: OWNER: - ; :,�.:;�::: -: �.: .�:;-�; — . _ _. ��i.�� _ _ . _ ...;'ir--�; i n {"�'_..'.'I;� .. . ..._ �~� °eiF�i __��:.i .., ..;.� ...�;.. �.: �_ �•-: :7� .�; ;,,, . {� C —' ' :e f;. .�j e Sy V .. .� 9 4.�.. ,�,.' �£i�s.,. *rz'�ta.,a_.s..w��.•.,f'�a:...�. 1"t.,.s`t>...s..�'T` �i��.z��r��w . __ . _�_�. ., _ _�.-' _ �! �� .. _,_ , t r._ _ .� �._:��; ... _.�� `=��'�.C��'I E�� tt��.i °�t,��r�,;�. �'�"� �ir� ��...� �:�s_+��.: _� F � � . w � . . EJ, . ' �_ .. .':� � s.. .��"�_„ �� , , �B��5��1�t�� ,.�..��l�..t't3'�t8�•�.�! �i�� $�x��t�. �� -l�'�t�3t1�?r..-:'_f�� .�r,.. _�.t 3,..._ 7. �.`.i _ _ _{•,:.� .. .._'P� ._!��;� . .., ;' -.. . . � � � � � � � � � ,�- ��' �� APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE v � �� Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �� <,�vC�G��; ��v,/� ZIP: �-, ��.J�� NANIE OF OWNER: ��' �^�� PHONE: (home) �I�� _ �lliisl7 ,��t�> (wark) MAILING ADDRESS: ��,�5(/''• �'fa(��i�� CITY: .v-� /�(.t ZIP: 'C r` /'� CONTRACTOR: r � � � �' �' � �� PHONE:�f ) S- ��` CONTACT PERSON: ��;J �- MOBILE/PAGER: MAILINGADDRESS:�'3o2�i��. ,f/�,j�<<� cl,:�/' CITY: %.�� '<,' ZIP:C r�,'-:, STATE LICENSE: # � 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�: ��/`J! �r,��li�' ��, ,��,�•� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ r,�'��%�� =�� 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 �h ,,,a�pproved plan. � � i y (, -, APPLICANT'S SIGNATURE�;;�''��-�'i/ DATE:i�/� T � NOTE! Parade of Homes events require separate pernzit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 ,� .s Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rig6ts of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An i�ividual asked to supply private or confidendal data concerning himself shall be informed of: (a)the pucpose and intended use of the requested data within the collecting state agency,politicai subdivision,or statewide � system;(b)whether he may refuse or is legally required to supply ihe requested data;(c)any lmown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or enrities authorized by state or federai law to receive the dara. This requirement shall not appiy when an irndividual is asked to supply invesdgative data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or orocertv tax refund instrucrions instead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or co�dendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data widiout 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 acuon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authociry shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authoriry may require the requesUng person to pay the actual costs of making,certifying,ac�compiling the copies. The responsible authoriry 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 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 additional five days within which to comply with the request, excluding Saturdays,Sundays attid 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 himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or i�omplete and attempt to notify past recipients of inaccurate 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 shall be disclosed only if the individual's statement of disagroement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating 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 furnish 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 permit or license. 3. The information may be shazed 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. .N // � First Middle ast �7 �� -�,/zr��.� , � 1�.�� .� �.,� �d�� e � �� -a � 4�" Ciry State Zip Phone I understand my rights as stated above. i� Signawre 6