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Home My WebLink About1997-008908 - re-roof PERMIT CITY OF ORONO PERMIT TYPE: 2750 Ke�ey Parkway- P.O. Box 66 Permit Number: " - - - Crystal Bay, Minnesota 55323 W `� ` Date issued: '-"-�'='��j`-`�=' (612) 473-7357 -- SITE ADDRESS: _ ..�- .:;7:;-�`; _ _ _ . .. � _.. _ ,�;,:_.. . : :-- �°- - --t; , ,_. ,.: .;:_:.: ;... ,., , , : : .::... � ._�._: .� �_:.�..�. DESCRIPTION: �;�L ;� - :-;; �-:-, . ._... .'._ _ . . r�:F 1, :;-��;-,�,,�� --._ _ .__, _t'fi'=._ _ 'r`= � _. —r'_. . . . :�_��1�_=.. 'W�{�: �.:_!1 : ia;�.'i'}'. , , .. {'i`_'ii�_y_. i.�=:il'=!.�'_ !.. =�=.:3r.—.� n�.:'••�':— fi�--� • i';`��I�!`�; .�!f-i1_. REMARKS: FEE SUMMARY: . . ..._:F�;? �ii;�_ - - ; t.. - ._:•:�.��:_ ?=_._ . _.,_ . ___ :��_t� W��ir.:� _. _______ �.<..�'�:�:� 3�•_::�t.w:'. - :_ _. _. . �_- CONTRACTOR: OWNER: _. - _._. : .. __..,. .. . , � .� � fv`� - 'i � : i�i r;;;�i=.=�=:`:' �'i -,.-;; - - - ,,..: ; ` �:.=::�.:;�.-;- . .__, .._ _ . ..... -� . _ � ' � ' ; :F _ , �_...._ ; ._ . , . - r i '-� ° '� _.. ., ... _. _ .. _. . . ._ . . ..,._ ..__ . .__. .._ _. ,. . ._ . �_. ._. .. _. ; . ._. __ _ .._ .. _ _� _.. :;a�� ... _=.. :...�. �;. :.�• �.:: ..__�.'.? . . , _ ._.�... . .. . . _ -� ; : .. � _ . _.... .. _ _� . _. - _�_. _. .. - _ _.. .. � ` . .•, � . :-l: ; :.�.. ,. T_ .. .. . _a .• x. . :.f—, : L - � { , � s� .. ,_. =��: _•-;`'•-?..t ._ , ;'-^�' � _. �"`.�. i: ..__ .. . . . f_ . .. .._S- -: _ _. ... ,_ '�...„ , _. ..._E E..f } :" . J l � APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE � �,T„otal 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: I � � �2' 1'' � ZIP: � � ��p � NAME OF OWNER: � V�,� t,Li I � �7 (;r� PHONE: (home) 11 - �� (work) ?��T�� MAILING ADDRESS: � �� ;�� ff / � CITY: (.� r r��[Z_ZIP: C� � (/� � CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� - � � G-�-� STORIES: ' SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �_c-. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ `� CC�-'C% . I hereby apply for a building 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 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. LICANT'S SIGNATURE: ��/} `�G�L�/� DATE: �' APP �' , . NOTE! Parade of 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 SUBJECTS OF DATA , Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqiric�ed to be given individual. An individual asked to suppiy private or confidendal data concerning himself shail be informed of: (a)the purpose and intended use of the requesred data wichin the collecting'state agency,polirical subdivision,or statewide system; (b)whether he may refuse oY is legaily required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply private or co�denrial data;and(d)the identiry of other persons or enrides authorized by state or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply invesriearive dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the notice reauired under this subdivision in the individual income tax or propertv tax refund instcuctions instead of on those forms. Subd. 3. Access to data by individual. Upon request to 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 shall be shown che data wichout any charge to him and, if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the private data and infocmed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuant to this secdon is pending or addi::onal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actuai costs of making, certifying, and compding the copies. The responsible authoriry shall comply immediately, 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 that titne,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding 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 or pri�•ate data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of[he disagreement. The responsible au[horiry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nocify past recipienu of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disc(osed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrarive procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�hts 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 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. Z. You may refuse to supply data, but refusal may require that the City deny the pemut or license. 3, The information may be shared with other local, state or federal agencies to the extent necessary to process the pernut 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 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. � C� . (,U�� First � Middle Last � � Aa��rU c7� ��1�� <�,��/- ��l—�9 � � � City State Ztp Phone I understand my rights as stated above. �,�� .�� ` �� ,L..� S nature