HomeMy WebLinkAbout1999-011313 - replace windows � PERMIT
CITY OF ORONO PERMIT TYPE: - -� ��
� 2750 Kelley Parkway- P.O. Box 66 - - ~' ��'`"'=
Crystal Bay, Minnesota 55323 Permit Number: _ _. _ _ -
(612) 473-7357 Date Issued: - - _ .:��_=;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT PERMITEE SIGNATURE ISSUED BY:SIGNATURE �-�'�- l�,
�=� ���TY OF ORONO � 6124730510 09/24/9b 14:00 � :02/03 N0:522
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' To�ta1 Fee: $ Date Received: '�. _ _
Entered Hy: .�r� Permit�+: /'/�/ ''� �'+� :a .�9�
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CYTY UF ORONO - BUILDING PERMIT APPLICATYC)rt ' � '`
Ap ir�forn�atlon must be submitted in �ull before plan review will be started.
� , (please print all informatlon)
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TH� APPI:ICANT IS: (circle one) OV�NER OR NTRACT�
JOB SITE ADDRESS: ag�� ���'-� �D� ��-� ZIP: 5�3 91 ,
� NAME OF OWNER: �-�a'U'l�k S�-�.-� PHONE: (home) y�1 �v7a
� (w4rk)
r+tati,nvG a�a�ss: �g��► Cr<.oCu P�-. n d. crrY:,�.;,� zrr:s s3��
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G�CONTRACT4R: .��� �" Qx2 P�#ONE: �a--�l�?�y
��,9. . CONTAGT PERSON: 1�0(,C.�. �sZl�-as�-/ 1VIOBILE/PAGER:
� � 11riATLIlYGADBRESS: 35��i3`�C�e •7��i C1TY: ZIP: s�-!3a
Q � � ^n� ��AT� LIGENSE: a aoo�{o c�3d
�\�k �����„ ��
v O/ �
��,U" �' . ARCHITF.CT/ENGINEER: n�`� PHONE:
�\�� MAII.ING ADbRESS: C�TY: ZIP:
_7 ��� NAME: REGISTRATIUN�
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'> •TYP� O�' WORK: New Add'uion Accessory Saucture
��a,� Move Remodel/Alteratian ✓ Land Alceration
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- PROPOS�A�VVURK(describe in detai�: ��� �,�p ��f y��lr�c,,4,r rl,, _ _____
i,�)ibl�.���,f- .n� � .
STORIES: SQ.FEET OF EACA FLOO�2:
NU. OF BEDR0014IS: GARAGE STALLS: ATT. DET.
ES"i'IMA7'ED CONSTRUCTION VALUAI'ION (excluding lan�: $ `�1
I h�reby appty for a building pettnit and I acknowledge that the informetion above is complete and
accurate; that the work will be in confornnance with the ordinances and �odes of the Ciry and with
, ' the State Building Code; that I understand this is not a permit and work is not ta start without a
permit; and that the work will be in accordance wfth the Qpproved plan.
APPLICANT'S SIGNATURE: DATE: 3/3v�99
NOTE! ,p,����.qf,�[Q�p� events requfre aeparnte perm approval by Pol�ice Depat�tment and
G�ily Cor�ncll 84 days prdor to the event. Non perniitted eveRts w�ll not be allowed.
Rer.pivad Timn Cen �A 1 �d�A?If Ari �� T�...� C�� �� 1 . d�D1�I
TY OF ORONO � 6124730510 09/24/96 14:00 � :03/03 N0:522
Sec.13.04 ItIG1�TS OF SUBJEC'fS OF DAT.�
Suhd. 1. Type of dats. 'Ttte c1�h1s of indlvidud o11 whom tha d�C1 i9 srored or to be stored shall be as set fonh In this�ection.
Subd.�. inloneatloe r�qtdr�d to ba�Iren iodi�►iduxl. M ladividual as�ed ro supply privsa or eonfideeuel d�a concerntng 6itnaelf Fhall
be infe�med of; (t)tha purpose�nd inunded use ot the Tequested d�a within rhe cotleedna snu agenay,polldcal aubdi�ision,or snre,vide rys�em:
(b)wfiether he may rePuse ot'i9 legally tequired w supply�he roquesud dvu;(c)any knoan coauque�u:e arising from his supplyln�or relUsing to supply
privs�e or coaflden�i�l daa;and(d)fie idoncih of odur person�or endoes aud�orized by sum or tederal I�►w sn rec�ive rhe da�a. Th�requlreme�e Shull
not apply wheo sn individuei ie nskeJ�o�upply lnvesrig�dve dam, pursuani�o ceedon 13.62, subdivision S,to�I�w enforcement otPicer.
� cuml�sionci�ii i"c.@OUC iI1Gv place rhe nory',ce r� i d under�his subdiyision�� indtviduel income rax or aroosm ��e�nd
lilE4FS1�i�.'l�l ad u�on rho:c[or�na
SuDd. 3. A�cets to data by indlridual• Upon rcques�to a rcspnnsible autho�iry.�n incli�idual:hail be informed wberher 6e le the s��bjeee
o[�tated dau on individuals,r�nd whechar ie is el�ssified as public,privi�e or canPldenrial. Upon 6is fUrther rcquea[,an individual who i�rhe subjtct
of swred pri���e or public dpw nn Individuals shall be sho�+rn e1+e dara withouc any chzr�e to hun and:iF he deelres,shep be infortned of rhe wnron[
aM mAeu�ing of diAt dara. Aher an individutl hi�been shown ihe p�i���a d4ra tnd ia(ortr�ed of it�meaning.the daa need not be diaelostd to him for
tix ewnd►a thereafur utiled� a dispute or�cdon punuan�m �his seeeion is pendin�or addiRonsl darm on the indiviaual ha�been co!lecred�+r erea�ed.
Tha respc►neible�uthpriry th�ll pro�ide copies�f rhe pri�are or public dera upon requesc Dy�he individual subjecc of d�e dara, 'R�e rcsponsible au�ho�iry
may requite thd requeatinO pmnen�o pay die aetuel cosu nf making,ceitityino.u+d compiltng d�e eopi�a.
'il�e xsponsible authoriry shall comply immadiately, if possible,with any request mede pursuant m d�is subdivision,or withln fi�e days of
�he date of d�e Teques�.excludinQ 9amrdays.Sundays ond legd holldays,iF immedlaee compliance is not po9sihle. If�he cartno�comply wid��he roques�
wi�in cha[etme,he aha11 eo it►form cha individual,and m�y ha�e en addirional five days wid�in which w comply wi�h she request,exeluding Saa�rdays,
Sund�ye and leyal holldays.
Subd.4, Roeedure�rh�n dn�a►s net oecurata or eomplete. An individual m�y con�es��he accuracy or compluenox�of public or priv�re
d�a eoncernln�himself. To exercise rhis right.�n indi'viduel shsll noafy in Mridn�tho respunsible suehurity deacribin�d�e nemro of the df�egreemenc.
The teepenel6le 4uihoriry dtell wid�in 30 days ei�her: (a)correc�thc data found�o be inaecurate or inc�mplea And sceempt to nodfy p�ue reeipfencs ef
inaetunte or incomplete dpn, Includin��ecipienu named by the individual;or(b)eodf�che individual thet he belleves the dotn co be oorrec� Da�a
(���purc ahsll be discloaed only if the indlvidusl's sneemenc of disa4reemnnr is includad wirh�he disclosed da�a.
'i'he detemunation of�he rrspansible.u�lioriry may be appealed pursuani eo th�pm�isionc of rhe adminiseiarive procerlure ect rel�4ns w
con�ested eaees. .
• pATA PRTV�CY ADVISOF�
!n aocordaace with M.S. 13.04, Subd.2, "Kighcs of subJects of data", we would like to inform ynu that your request
for a permic or 1[cense from che City of Orono or any of its d�par[ments may require you to furnish certain private or
confidentlal information.
You ue notified that;
1. The informetion you furnish wlll be used t�decermine your qualifica[ion for the permit orlicense requested.
2. You may rcfuse to suppiy da�a, buc tefusal may require that ahe City deny ;he pctmit or licen9e.
3. The information mey be shared wich othCr loesl, s[ate or federal agencies ta the excent necessnry to process
the permic or licensa
� 4. . Yf yout requested permit or license tequires Council action [o approve, some infprmatton may becomc
' public.
5. You have cenain righcs under M.S. 13,04 (available upon roqu�st) to review private data on yourself.
6. Your full name is required to process this application or permic.
, � Firci Middle Lu�.
AAdr�s . ,
Clcy Sn�e Zip Phon.
' 1•understand my d te s ed above.
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� '�i� ST'ATE OF MINNESOTA c � � �
� ,_,�N��9�'�� DEPAF2TMENT OF COl49MERCE :� �
� : h 133 Ea�t.9ev�th�t.
� � ,� f�t.P,auul,MN SS l01 :
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��t,r".�� (65I)296-6319
''..-..''.'' BUILDD�7G CONTRACf OR �
ID#20130q83 .
. BCTILDER
' CORPORATION
. Ezpire�: 03/31!?.000 . .
.. BRUCE IQLANDER .
�Hrs Q ciue by 3/3 l/7A00 -
. RENEWAL ANDERSEN INC � .� •
350�3RD AVE NE /:TUITE S
� FKIDLEY MN 55432-0000
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