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Home My WebLink About1999-012154 (re-roof) , � PERMIT � C�T'1( OF ORONO PERMIT TYPE: - 2750 Kelley Parkway - P.O. Box 66 Permit Number: i��`�� Crystal Bay, Minnesota 55323 � � �W = - (612) 249-4600 Date Issued: _ _ _ _ SITE ADDRESS: _ _ __ _ _ _ _. .. _ , _:._ _; ; � ; ; ;.� , : , � :.�.,. ., . . .� .: �-�;;�;�; ,_ .:. , . _ �, . _ .. - - - - -., , , . _ ,. , . :.. � :..... : , :_. . ., , , , . ,�,—:.a.-,-.:,4: DESCRIPTION: __.�__ ,_. . ,.._ _ _., ; �_:�� , �_ :.. �..�._.:. �; -...:�: � . . _. _ .. i-�1},�,a, i 3 j��i�� .�+�'�ii��. �'r�:}? _ ' , 's�}3 t:'-i.�V��:` ;{�3:�� , _;3 � __'i.i'-i i;':`�j'L ,•'G+�.:' t..�.`."'i ._I_i t•• � _,•�y"`•.={s+,•� _�,t��:_+ :.�.�r..fi 1-�E_� , f''•.;':_�' `'I.j'`'�;-�'._ REMARKS: FEE SUMMARY: . ._ . ._�_._ ._ _ '�'i-::...;::: : ; : ,. �: .,., . . ..:...., , _ _ _._..� . �-'?�� '��'L':�:�_ . ___ —:�;-� `E�r;s-.— - :� . ;. t _ . __________. : CONTRACTOR: OWNER: - ;��i:�:. ._. '.3 ,..= ��`ii .,� ; ,. ,-- '�' t i .$� . t t ;_� .• S : _ T, i ! � �` '�p[ ; _ � .. _ .,, r _ '..�... � I... �. . .�-. -. � ... ..F-.. � .j.' Y �x3 .? i t _.. _.._ _. .____.• . .. ._ . ._. .»' . '. . .... _. _ . . �...�_ . �. ..`. _#w ... . . ._ .. . _ .. . _ ... u; S, .. . ..._«.. _. _ . . .... .,4,� 4 3 '� .i� _: -t = ��'�! ; ° S _.. _, .` 1. .. .._ .. _. . � . _. .. .,_.. _ s.. t . .r . .. i. f *-, i� i.q � J W. I%��!%T/�i'��--� APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATUFE 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: ,J/�� Q��(`� �►v'�,I� ZIP: �� NAME OF OWNER: �DIC��/C� �7%yJ U/�/�,�.�i1.�� PHONE: (home) �/oZ"y�a.--%�� (work) �/�2��' - OD5 MAILING ADDRESS: (e�/�-� -�r�a'�a•� l��/s. cITY: ,Ca��.�,r�_ z�:�� . CONTRACTOR: ��j�-' ��l�P,��'�it/�� PHONE: CONTACT PERSON: � .+��,� QS nr L�D�-!�OBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: %✓�/� PHONE: MAILING ADDRESS: CITY: ZIP: rJAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: � ,�D�J�-� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �, G'G�� . — 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:��1i��/ '' 2 DATE: �/�v� -�QG��`' NOTE! Parade Qf 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 SUB.JECTS OF D�1TA Subd. 1. Type of data. The righrs of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency,political subdivision,or sratewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any laiown consequence arising from his supplying or refusing to supply privace or conndenrial data;and(d)the idenrity of other persoas or enddes au[horized by sta[e or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply invesrigadve dara, pursuan[to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of re`enue mav plac the norice reauired under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon requesc co a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her 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 shali be shown cfie data wichout any charge[o him and, if he desires, shall be informed of the content and meaning of[hat data. After an individual has been shown the private data and informed of iu meaning,[he data need not be disciosed to hicn for six monrhs thereafter unless a dispute or accion pursuanc to chis secnon is pending or addidonal 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 requesting person to pay the accual costs of making. certifying, and compiling the copies. The responsible authoriry shall comply immedia[ety, 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 chat time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, 5undays and leeal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or pri��ate data conceming himself. To exereise this rieht,an individual shall nodfy in wridng the responsible authority describing the narure of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccutate or incomplete and attempt to nodfy past recipients of inaccunte or incomplete data, including recipien[s named by the individual; or(b)notify the individual that he believes the data to be correc[. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the rzsponsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relaring to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Riahts of subjects of data", we would like to inform you that your request for a pernut or license from the City of Orono or any of its departmen[s may require you to furnish cenain private or confidential information. You are notified that: 1, The information you furnish will be used to determine your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that the City deny [he permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the pemut or license. 4. If your requested pernut or license requires Council action to approve, some informa[ion may become public. j. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this application or permit. First �'liddle Last Address State Zip Phone City I understand my rights as stated above. i v S�gnature