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Home My WebLink About1992-004661 - next to driveway =- PERMIT CITY OF ORONO PERMIT TYPE: E4 �DEFINED 1335 Brown Rd. South P.O. Box 66 Permit Number: Crystal Bay, Minnesota 55323 Date Issued: 09/24192 (612) 473-7357 SITE ADDRESS: :3965 WATERTOWN RD CH P. I .N. ; 32-118-23-32-0003 DESCRIPTION: , NExT, TO I 4 AY User Permit TY ^;"i I-AND ALTERATION X s r _ k CITY OF X � FINAKE OFFICE REMARKS: 0i GEN 50.44 cHEcK Ti 50.00 RECEIPT-TAW Y011 FEE SUMMARY: #253690 C001 R01 //yy •//�� 091, Ti kWM k . Base Fee -------- � �. �? Total Fee $SO.00 CONTRACTOR: QR' Applicant DAVID 3965 WATERTOWN RD ORONO MN 55355 APPLICANT/PERMITEE SIGN TU E ISSUED BY:SIGNATURE �� a CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ Date Received: Date Approved: Entered By: ' ,�'dv Permit: ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) -------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER or CONT�R/A�CTOR� JOB SITE ADDRESS: ., ZIP: (work) NAME OF OWNER: A.,ey PHONE: (home) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: PHONE: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) :'lec d CCA - STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED 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 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: DATE: a-= CITY of ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices • • - On the North Shore of Lake Minnetonka 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 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 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 to review private data on yourself. 6. Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. r Signature BUILDING&ZONING—47 3-7 35 7 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS—473-7359 ASSESSING 51.3.04 IUGH75 OF SUBJECTS OF DATA Subdivision L Type of data. The rights of in 'viduals on whom the data is stored or to be stored shall be as set forth in this sectio to be given indi 'duaL An.individual asked to Subd. 2. Information required . (a) the supply private or confidential data concerning himself shall c informed a ency, purpose and intended use of the requested data wit the collefuse cting or is legally Political subdivision, or statewide system; (b) whetherhe may required to supply the requested data; (c) any know 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 feder law to receive the data. This. requirement shall not apply when an individual is aske to supply investigative data,pursuant to section 13.82, subdivision 59 to a law enforcment officer. iuired der is tice r The commissioner of revenue ma cert th re and instructionsuinsteadhof subdivision in the individual income tax or ro on those orms. - -- - - . Subd. 3. Access to data by individuaL UP n request to a respdata on onsible authority, an individual shall be informed whether h the or confidential.e Upon his individuals; and whether it is classified as public, p publicor data on further request, an individual who is the subject of st roe him ande if hdesires, shall individuals shall be shown the data without an t ddaatgae After an individual has been Se informed of the content and meaning t data need not be disclosed to shown the private data and informed of its meaning, pursuant to this section is him for six months thereafter unless a dispute or actin p ending or additional data on the individual has be r public datacollecteduponrequest by ed. The P require the responsible authority shall provide copies The responsib authoritymay the individual subject of the data. Yl gcertif 'n � and compiling the requesting person to pay the actual costs of making, copies. 1 immediat y, if possible, with any request The responsible authority shell comp y made pursuant to this subdivision, or within li five da f immediatof the e ompliance request, not he excluding Saturdays, Sundays and legal holidays, possible. If he cannot comply with the request within that time, he shall so info the P have an additional five days wi 'n which to comply individual, and may and legal holidays, request, excluding Saturdays, Sundays g when data is not accurate complete. An individual may Subd 4. Procedurepublic or priva a data concerning himself. To contest the accuracy or completer shats-of p the responsible authority exercise this right, an individual shall notify in •ible authority shall'within 30 describing the nature of the disagreement. The respo to days either: (a) correct the data found to be late data includingcura or recipients named by notify past recipients of inaccurate or incomp the individual; or (b) notify the individual that he 'eves the data to beement s Data in dispute shall be disclosed only if the individuale c statement of disagreement included with the disclosed data. be appealed pursuant to the The determination of the responsible authority o contested cases. provisions of the administrative procedure act relating