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Home My WebLink About1998-010408 (tearoff/re-roof) PERMIT f' �;ITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Crystal Bay, Minnesota 55323 Permit Number: ::;;f,�;_;x.�:�;� 612 473-7357 Date Issued: +t�i sr��_!:=� � ) t.t,f;'�.; � - SITE ADDRESS: �.��=' i=,'-��:_�i=s� i:I ii �:� DE�C 1 IOf�- � � —' � - - - -� I E�;F'_�� -t, , ��,��i-;€_�,_;. _�E.�I .L E1 L 2Z� �`�t'tiE 1 t• '�`t�,T _��—;=��t�','i+`.�f'(i��!'�L �,�#= 1 t.j,s2�� i;;z�i-::: �y�.�,� ;;�,—�i:�l:i�= i_�'!l`�� t�a�i��:= '1�� i-l�_Z . `:��_�i f..f�j��4 �F-1L REMARKS: FEE SUMMARY: Y`Ci; l�if} i i(�fl`� �� L�,,.�Z� �Ci CJ�"' I'"�':.� ��f'+_ J., . i� _.�L;S�i IYI Gi�1��',1 i�'.` f L. _^_._._.'� �s._a...:ri i��Ef.�f �_.s� T�i f.�, , t_7{t CONTRACTOR: OWNER: — ��i i c��:�t- — '_�T . ��'�: `��;"1 j ! }-� f;c.�F til_1t_i�— I �Jfi j,::.:i'f—�!_��:'_; _.�:t_1�_' :_��.�L:_.�TH f;r14,� ti:��C L p i`I�;s;i�i6�'siJ �;E_�t� _,L_ _ ;:;�'_;i:�i t�s� tr;_3i_lf,sL;,j ��(4 ;�C•�'!_.�J,. I—it;iW:�',l3�,E s'?�J �-�,=::—l;j {.`-��` t I�.;'• —C —�'� _ _. �_.__. . _��..._. ..,, � _ _ 'r:i't::. -- t�'"�f�c:�-- �{�-j!- �_�;`,i:ti-�� : (�,iftj=.�% {-t'.�+.`.��'�` �`i_t','t;_:�_� I :-. :��f-;;;_._,:_.�'i_F;;; I E_'# � �}—;��.,fY F =:iv 1-�'L_i-i!_ i� .i—`,,'._+r�.:":L,t;t� — — S_•�i �S�!! ;-��'�� i-zt�!'i+_..••`.:—� j t! {fl_{ ;--i�_{ :h�_�. .. . 1�� _ �;:,'i`•._.1 _:_f!`�t—'{ 1;-}.d_` �_ t�"� r-t�i.._ �_ i . . s:ja L f_>�1 I(' fi f i_IL.L� I �'�I'?; .I�� j�C;i J :; 1 i'�i� �. !_i;.' �''��.��3_..'��;��f�� ,�;1_, i�!1�#��v;i t. t!.?t: i 1z'�;E_}.�i'�`.�._.? .� — - � � . � APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE �'� . � � � Total Fee: $ Date Received: Entered By: Permit#: /G �/O 8 CITY OF ORONO - BU1I.DING PERNIIT APPLICATION A.11 information must be submitted in full before plan review will be started. (please print all information) ----------------------------- - ----------- ---�=��-z--------- --- -- THE APPLICANT IS: (circle one) Oti�NER O�ONTR.ACTO � JOB SITE ADDRESS:�� 5�� Z�: � NAME OF OWIVER: �� S�' / /S�H PHONE: (home) 3�� 'f+S��o G.n c�� (work) MAILPi tG ADDRESS:- CITY: ZIP: CO�TTRACTOR: V�� S�''' :�� nS �. PHOi�TE: �7� - � ��^-.� / CONT'ACT PERSON: � v�� MOBILE/PAGER �'E�7_3 i� 7 MATLI�i tG ADDRESS: CTTY: ZIP: STATE LICENSE: # �3=> �I AP CHIT'ECT/ENGINEER: PH0�1E: 1IAII,�tG ADDRESS: CITTY: ZIP: r,T�ME; REGISTR.A.TION# TYPE OF tiVORb': Ne�v Addition Accessory Structure Move � RemodellAlteration_� Land Alteration PROPOSED'�VORb'(des ribe in detain: I �ft'2 � �?�'� S�' e'S �� ,�Z-�t� � i �---5 /� �� F pr� n-> - STORIES: SQ. �EET OF EACH FLOOR: � NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET. ESTI�I2ATED CO\TSTRUCTION VALUATION (exclud.ing land): $ �, �`��-� I hereby apply for a buildinJ pernut 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 BuildinJ 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 accordanc with approved plan. APPLICANT'S SIGNAT'URE: �` DAT'E: 1� ' � �� - � � NOTE! Parade Q Flomes events require separate permit approval by Police Deparlment and � City Counci160 days prior to the event. Non permitted events wi11 not be allowed. � ,- , , Sac.13.0;RIGHTS OF SUB.TECTS OF DATa Subd. 1. Type of daca. The riehcs of individual on whom[he data is stord or to be scar.d shali be as set forth ia this secaon. � Sutd.2. Information reqirired to be given individual. An individual asked to supply priva[e or coafid�ndal dara concerning himsetf shall ba iaformed of: (a)the purpose and inc�nded use of the reques�dam wi�hin the collecdng Stace a�eacy,polidc:l subdivisioa,or sa!ewide rystem; (b)whecher he may refuse or is legally requir.d�o supply the requesud dac3;(c}any Irnown coasequence arisin3 froci his supplying or refusing to supply private or eonndendal data;ar.d(d)the idandry of orher parsoas or enddes au�horized by sc�ta or federal law to rceive the daca. This requiremeoe shall not appiy when an individual is asked to supply invesdgadve dan,pursuan�to sec6on 13.82,subdivision 5, to a law enfor�ement ofrccer. - Thz commissioner of revenue mav place u�z noace r_ouired und:r this subdivision in the individual ir:cone �x or vrooecN taz refuad insavcrions inscead of on chose focros. Subd.3. Access to data by indi�idual. lipon requesc co a responsible auchoriry,an individual shall be inforraed whecher he is the subject � of scord data on individuals,and wh�[her it is ciass�ed az public,privat�or confidenaal. Upon his furcher requesc, an individual who is the subjecc of stored private or public dara on individuals shall be shown the daci wi�hout any charge to him and;if he d�sires, shall be infocmed of[he content and meaning of[hat da�a. Aher an individuai has been shown che privac.-.data and informed oE its meaning, th�dat�need not be disclosed to him for six mon�hs[hereaiur unless a dispute or acaon pursuant to chis secaon is pending or addidonal daca oa the ir.dividual has beea collzcced or creaced. 'Ihe resQonsibte authoriry shall provid�copies of the private or public data upon request by the individua!subjecc of[he data. Tne responsible authoriry may requir the requesring person to pay che acaial cos�of m3lcing,cerrifying,and compiling the copies. The responsible au[horiry shall compiy immediately,if possible, wi[h any requesc made pursuant to t�4is subdivision,or wichin five days of the dace of[he requcst,exciuding Saturdays,Sundays and legal hotidays,if immediate compliance is not possible. If he canaot comply with the reques[ wi:hin that ame,he shali so inform[he individual,and may have an addiaonal fivz days wi[hin which to comply wi[h the requesc,exc[uding 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 orprivate dan conceming himself. To exercise this ri¢ht,an individual shall noa"ry in wricing che responsible auchoriry d�s:ribing the nacure of the disagreemeac. The responsibie authoriry sh�li wichin 30 days ei[her: (a)correcc[he data found to be inaccurate or incomplece and aaempt to noafy past tecipienes of inaccumte or incomplece data, including recipienrs named by the individual; or(b)noaFy[he individual thae he believes che data to be correct. Data in dispute shail be disciosed only if the individual's s�tement of disagreemenc is included wich the disclosed dac�. 'Ihe decerminarion of the responsib(e au[horiry may be appzated pursuant to thc provisions of the 2dmirusaarive procedu�e act relaan� to concesced cases. DATA PRIVACY ADVISORY In accordance wich M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request for a pernuc or license from the Ciry of Orono or any of ics departments may require you to fumish certain private or confidential information. You are notified that: � 1. The information you furnish will be used to determine your qualification fo;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 ocher local, state or federal a�encies to thz ex�ent necessary to process ' the permit or license. 4. If your requested permit or license requires Council ac[ion to approve, some informa[ion may become public. �. You have certai.n riehts under M.S. 13.04 (available upon request) to review private data on�ourself. 6. Your full name is required to process this application or perm.i[. ��il-'1�2,�2/j�'�� -� 2�� Firsc tiliddla � Last � 7 � � `I'�N(.t/c'3Z3� �_� �- V�'-� Address �� v ,�,�1� r�-� �/ > ; 51 `� �-� �,�--_�S--� � . Ci�y Sate Zip Phoae I understand my rip ts as tate above. l�� . �.� Signature :