HomeMy WebLinkAbout1994 - roof raised CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ Date Received: 1 1//Y/�
Date Approved:
Entered By: •
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 CONTRACTOR
JOB SITE ADDRESS: J0 Uv°L'�>T L- S ZIP: .4-57;
(work)
(c,g.Lcp`/edec PHONE: (home) q 7�1G07
NAME OF OWNER:
MAILING ADDRESS: 3 8 ct We> I1f Si CITY: C)iOvo ZIP: 6-15'351
CONTRACTOR: NO i Y t C)W W L 72_ PHONE:
MAILING ADDRESS: ` 1 1 1 CITY( d 12C)w'0 ZIP: _ c C
STATE LICENSE: #
ARCHITECT/ENGINEER: `itQ GI is 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) : 12/1150) 121AF= ,C 4t/S74LltO A •(,t,/AJaY 3
STORIES: SQ. FEET OF EACH FLOOR: iitU0C 0141447" 14.00I
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 3°50 0 i
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
•nderstand 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.
�PLICANT'S SIGNATURE: f-H DATE:
/off 1/441(
.447
A
CITY of ORONO
CITY Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
OF
ORONO 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.
AwL,
Fi 4&14' Rcl" Middle Last
3e) cidt— LAtic�_Si
Address
o_ L_ 533S-C
City State Zip
415-1%1
Phone
I understand m rights as stated above.
Sign ur1111!!V
-
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING -
S13.p4 RIGHTS OF SUBJECTS OF DATA
Subdivision L Type of data. The rights of individuals 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. Anindividual asked to
•
supply private or confidential data concerning tames thin telf he collbe ecting informed
agency,
PP
purpose and intended use of the requested (b) whether he may refuse or is legally
political subdivision, or statewide system;
required to supply the requested data; (c) any known consequence arising from his
q private or confidential data; and (d) the identity of
other pe or refusing itoe supply P state or federal law to receive the data. This
other persons or entities authorized byto
requirement shall not apply when an indioviadua we asked foredmonsupplyoffinvestigative data,
r.
pursuant to section 13.82, subdivision 5,
The commissioner of revenue ma •lace the notice re•uired under this
subdivision in the individual income tax or •rooertV tax re and instructions instead o
on those orms. •
Subd. . Access
to data by individuaL Upon request to a responsible
authority,, an individual shall be informewhether hpr vatethe
orsubject
confidential•stored
Upon his
individuals, and whether it is classified public, ublic data on
to him and, ifo hep desires, shall
further request, an individual who is the subject of stored private or
individuals shall be shown the data withoutany charge. After an individual has been
Se informed of the content and meaning the data need not be disclosed to
shown the private data and informed of its meaning,
him for six months thereafter unless a dispute or action pursuant to this section is
pendingn
cted
or additional data on the individual
hasenr Pule c datorupre request by
ted. The
provide copies of theprivaterequire the
thehponsible authority subject shall The responsible authority a�a c ing the
individual of the ache tual.costs of making, certifying,
requesting person to pay
copies. if possible, with any request
The responsible authority shall comply immediately,
made pursuant to this subdivision, or withinfive days i of he datee of the request
u not
excluding Saturdays, Sundays and legal holidays,
possible. If he cannot comply with the request within that time, he shall so inforth the
within which to comply
individual, and may have an additional five
daysdays.
request, excludingSaturdays, Sundays
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of public orrwa ting ta o cconcerning
e himself.
To
o
exercise this right, an individual shall notify
in describing the nature of the disagreement. The responsibletauthorityompleand attempt to
shall within 30
days either: (a) correct the data found to be inadata, including recipients named by
notify past recipients of inaccurate or incomplete
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
to the
• included with the disclosed data. be appealed pursue
The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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