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Home My WebLink About1996-008022 (Addition/Remodel) -- - -r^ � - -- - - - z- v ' �- - - , - - PERMIT , ; CIT;Y OF ORONO � ,; 2750 Kelley Parkway-P.O. Box 66 PERMIT TYPE: �,�,�� Crystal Bay, Minnesota 55323 � Permit Number: �_�`_y;;�.�iY (612)473-7357 Date Issued: �y�l�,�yl,��, � SITE ADDRESS: ;�.�;-;c� A�I i�GQ�:�i� WAV .T�� '.�I .�I. : �y::-117—�:—:�_.—i_�a'��h DESCRIPTION: �'EF�AIfi �'�=iTT�D l�ALL:; E.ua l��in�� F'��rre�t TyF�� r3F—�DDlREh1+�DEL E.ui T�i�� 1��r4:: T�F�� f E�li�VATE�/F,Et�#r eM3EL �:�ns�as C�� 4.1�. ALT. FcE'��Ei�i T AL I � i � REMARKS: � FEE SUMMARY: �J�L�1ATIe��! ��at� �'.�5e Fe� ��1+. .t:eCa ' :��1 1��L9 1 �� .w..ib`N.`iit� � ' T��t•�1 Fee --------��1 .�,t� I CONTRACTOFi: — A��1 a c.�n t — ::�T. L I C: OWNER: � c;�t i�L I T`� Hi�h1E t:E�'V I�:EL: 1�.7�1'�� ;�t I(y:e''1�� C:N�t�'LT��hl .ii iH�l '3�'� •"_,AiVTt� VEF�A G� �::"�c' AE T MGD��iV WAY � C:NA�iHA:::��Ei� �'ii� �!�:_,17 i:i�,�'Ef��e �� 5:,:��. B;h�.�8 ��+�—�.'�'�� - �. THE t��C�E�=:T�;i��C� NE�'E�Y fi1�g�E�E�:�':: F`E�`t�I:=::=tT��.� �� :� T�� F�ER� I f�F`�i�=��'E�iEt�i;= . , i =�F°EC:�F��D t�IVC� A�G�iEE'� Ti1 !3t i ALL. t,�:I�}h 1�3 :�T�Z��' �:��f'°9�L I F�i�C� �!�TN ALL. ��'�' j��= � L �.E�,�i�i i �_i�,�t T#�A�I�:Ev: Ai�E� =:;Tt�?E �.�� F�I I i�#��..�.iT�t E:t a�LC�I[��; �:��DE �`��a��T�'��EtriT:::. J - -- --- -- -- I t � � APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE ,� �� otal Fee: � DateReceived: , Date Approved: Entered Bv: Permit�: CITY OF ORONO - BUILDING PERMIT APPLICATION �iLL liYFORMATION I�IUST BE SUBMITI'ED IN FULL BEFORE PLAi�T REVIEW WII.L BESTARTED --------------------------- THE �PPLIC�,:�!'T IS: (circle one) OWNER OR CONTRACTOR JOB SITE �DDRESS: �� B�y�,�b'��/� z�: 5535� �t�ti1E OF OWNER: .�oNiJ �pE�t.c..'tb� _ PHONE: (home) (work) I�iAILING�iDDRESS: CITY: p,�in!0 ZIP: CONTR�iCTOR: QvPti-�Tl �� HP� �pAGER: 4S�"o� Z NIOBILE �IAILING ADDRESS: �S� 5��+� �Q CITY: _ZIP: s�'3 r1 STATE LICENSE: # 2 00 Z t S�4 ARCHITECT/ENGINEER: PA��' I�IAILTi�1G ADDRESS: CITY: Z�: N��: REGIST72ATION # TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSEDWORK(describeindetail): �G��'��- G?�.S��y�i ��'"��--� �'�GLS .4 � /�-��GU/��.5 r' �.ey�!�.� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROONIS: GARAGE STALLS: ATT. DET. � EST11-faTED CONSTRUCTIONVAI.UATION(escludingland): $� I hereby apply for a building permit and I acknowled;e 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 wichout a permit; and that the work w' 1 be in accordance with the approved plan. :�PPLIC?��1T'S SIGi�IATURE: ATE'' � 3� � NOTE! Parade of Homes events require separate perinit approval by Podice Department and City Council 60 days prior to the event. Non permitted events will not be allowed. �� " `'',�„- =� Sec.13.04 RIGHTS OF SIJBJECTS OF DATA = Subd. 1. Type of data. The righrs of individuai on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individnal. ?`°individual asked ro supPiY Private or confidenaal data concerning himself shaI1 be informed of: (a)the purpose and intended use of the requesced data wichin the collecdng rstate agency,poliacal subdivision,or statewide sysoem: (b)whether he may refuse or is legally requited co saQply the cequested data;(c)any l�awn consequence arising from his supplying or refusing to svpP�Y privace or confidendal data:and(d)the idenury of other persoas or endties au[horized by stace or federal law w ceceive the dara. This requuement shall noc apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer. 'Ihe commissioner of revenue mav lace [he nodce re uired under this subdivision in the individual income tax or ro em raz refund instrucdoru inscead of on those forms. 5ubd.3. Access to data by individual. Upon request to a responsibte authority,an individuai shall be informed whether he is the subject of scored data on individuals,and whe[her it is classified as public,priva[e or confidendai. Upon his furrher reques�an individual who is the subject of stored priva[e or public dara on individuals shall be shown the data wirhout any charge to him and;if he desires, shall be informed of the content and meaning of chat data. After an individual has been shown�he private data and infocmed of ics meaning,the data need not be disclosed to him for six manths chereafter uniess a dispute or acrion pursuanc to this secdon is pending or additional data on[he individual has been collected or creared. The responsible authoriry shall provide copies of the privare or pubiic data upon request by the individuai subjec[of the data. The responsible aurhoriry may require the requesting penon to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall comply imtnediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saardays,Sundays and legal holidays,if immediate compliance is noc possible. If he cannot comply with the request within[hat time,he shall so infocm the individual,and may have an addirional five days withia which to comply wirh the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accucate or complete. An individual may contest the accuracy or completeness of public or private data concerning himseif. To ezercise rhis righ4 an individual shall nadfy in writing the responsible authority describing the namre of the disagreemenc. The responsible authoriry shall within 30 days either: (a)correct rhe data found to be inaccurate or incompiete and aaempt to nodfy past racipienu of inaccura[e or incomplete data,including recipienrs named by the individual;or(b)notify the individual chat he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemenc of disagreemeat is included with the disclosed data. The determinadon of the responsible authority may be apPealed pursuanc to[he provisions of the ad �n»uve procedure act relating to contesced 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 aze notified that: 1. The information you furnish will be used to dete�mine 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. g, 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. V t/L-�ci.l,L � �l7'�� First :biiddle � �t 1/� .��l4- Addres �/�hj�i� / �J / T �S � i Clty Sryte Zip Phone I unde tand my rights as stated above. r V`�-' Signaatre t_. ��