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Home My WebLink About1996-008199 - epdm re-roof ,^ PERMIT i CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Q1 j Lei j NG Crystal Bay, Minnesota 55323 Permit Number: i y; (612)473-7357 Date Issued: 07/2.5/196 SITE ADDRESS: 55i TONKAWA RD P.I . N. ; ().5-117-23-32-0004 DESCRIPTION: EPDM RE-ROOF Building Permit. Type SF-ADD/REMODEL � Building Work Type RE-ROOF Census Code 434 ALT . RESIDENTIAL i I REMARKS: j i FEE SUMMARY: VALUATION $1{7,985 Base Fee $174 . 75 Surcharge --------- Total Fee $180. 9-4 ii i CONTRACTOR: - Applicant - ST . LIC: OWNER: GAR'-OC:K FRECH ROOFING C O 17227129 1423 '=CARLON CURT I S � 09 SNELL I NG AVE 550 TONKAWA RD � MINNEAPOLIS MN 55404 ORONO MN 55356 (512) 722-7129 540-5442 THE LJNDERSI GNED HEREBY'"RE i*. TS PERM I SSI OW TO -MADE 9=E0FIED AND AGREES TO op,ALL l t. WOW,` It, : TFtl T C OW,L IA ORONO ORDINANCES A14D STATE ,OF MINNESOTA,, BUI'LC)ING L_` APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE - Total Fee: S DateReceived: Date Approved: Entered By: Permit - —� CITY OF ORONO - BUILDING PERI IIT APPLICATION ALL D, �FOR.NL•�TION'.fUST BE SUBMITTED IN FL LL BEFORE PLAN REVIEW NVILL BE STARTED ---------- -��kC7� THE APPLICArT IS: (circle one) OWNER OR O JOB SITE ADDRESS: SSD ork [Zoad ZIP: 5 I NA�1MIE OF ONV ER• 0 k)r+i 5 \ PHONE: (home) (work) MAILI G ADDRESS: �'.D• l�X 5�1�� CITY: M � s ZIP: CONTRACTOR: �ja,�' (� - n C4� PHONE: tiiOBILE PH !PAGER: 1�IAILIi`i G ADDRESS: 23� f)? :�k►n �ITY: ��1 ZIP: STATE LICENSE: G1�D( 23 ARCHTI-ECT/ENGINEER: PHONE: �IAILL�i G ADDRESS: CITY: ZIP: REGISTRATION AiNf E: TYPE OF WORK: New Addition Accessory Structure Move RemodeVAlteration 1/ Land Alteration PROPOSED WORK(describe indetail): n Y Dc> S a rb0 Qn h se— STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. L E STL1-IATED CONSTRUCTIO`V_-'iL.UATION(excluding land): $ 10, I hereby apply for a building pe,-=t 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: G ` DATE: --2 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. Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.'_. Information required to be given individual. An individual asked to supply private or confidential dace concerning himself shall be informed of: (a) the purpose and intended use of the requested data within the collecting§tate agency, political subdivision,or statewide system; (b)whether he may refuse or is legally required to supply the requested data:(c)any known consequence arising from his supplying or refusing to supply private or confidential data:and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data. pursuant to section 13.82, subdivision 3, to a law enforcement officer. The commissioner of revenue may ciace .he notice required under this subdivision in the individual income tax or nroyerry tax refund instructions 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 whether it is classified as public, private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without 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 action pursuant to this section 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 authority may require the requesring person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority 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 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete 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 disagreement is included with the disclosed data. The determination of the responsible authority 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 City of Orono or any of its departments may require you to furnish certain private or confidential information. You are r1odfied 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 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. 6. Your full name is required to process this application or permit. ill V, First Middle Int 2 �09 A V e . Address �/V S-S LID L r� S City_—r State Zip Phone I understand my rights as stated above. Signature