HomeMy WebLinkAbout1995-007390 - tearoff/reroof . PERMIT
�` �ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - -- =' --
Crystal Bay, Minnesota 55323 Permit Number: :��-�=�,__ ��.T
(612) 473-7357 Date Issued: - _� , -
SITE ADDRESS:
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DESCRIPTION:
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CONTRACTOR: � �==�_��_°= '==.�?i=. ' - . - OWNER:
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APPLICANTiPERMITEE SIGNATURE � ISSUED BY:SIGNATURE��'�•
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Total Fee: S /,! �- �'�� DateReceived:
Date Approved:
Entered B��: ,.���; Permit�: f%'>���i
CITY OF ORONO - BUII�D�G PERI�IIT APPLICATION
AI.L �`FORtiL-�TION 11I;ST BE StiB�jTT�D ��ZL BEFORE PL��1 KEVIEtiV ti�II.,L
BE ST:�RT'ED
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THE �PPLIC:�:�'T IS: (circ;e one) O`VNER�R CONTff:��'I���'�
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JOB SIfiE ADDRESS: �f E �ft�'y �-�<�5�. 1�� ZIP: �539�
�1Ai�iE OF O�Vti'ER: ,�fCftf��� � ��� �` �/ PHOVE: (home) �{� 3— � �U�
(work)
C i���'` c i{/tS�/��ITY: ��ti� ZIP:� � ��
l�I�,IL�G�DDRESS: //E /
CONTR�CTOR:,S��r4- ��d�/ ��
PHONE: �.� � �` �`�
110BILE PHO'YE/P�GER:
�1AII.I�i 1GADDRESS: ��� �-X C��L Siv/c' /��i/�ITY: ��Cr���5 �ZIP:__����
ST�TE LICENSE: � /�1 � U
ARCHTI'ECT/ENG��ER: PHO��E:
I�IAILL\G�DDRESS: CITY: ZIP:_
N�y�: REGIST'RATIO� #
TYPE OF `VORIi: New ,---����}e� � Accessory Structure _
Move �RemodeJAlter3Ers�} I�ci Alteration
PROPOSED�VORh(describe indetail): ��'�`"��� � �s' ���� � " ° %/��'"'� `' �
STORIES: _ SQ• �ET �F EACH FLOOR:
NO. OF BEDROOI�IS: G�R�,GE ST.-�LLS: ATT. DET.
ESTL`�TED CO�'STRLTCTIO�V�I.U�TION(eYcludin�la.nd): S �/Z� � —
I hereby apply for a building permit and I acknowledQe that the information above is compleie
and accurate; that the work will be in contormance with the ordinances and codes of the C:ry
and with the State Buildin� Code; that I understand this is not a permit and work is not to start
without a permic; and that the work wil- e in accordance with the approved plan.
'�tT'S SIGNATURE: � ✓��—`'"�--E� DATE: L
APPLIC� .
�VOTE.' Parade of Hames events require separai��edl eaent�willbn�becal�wed. ent and
City Council 60 days prior to the event. Non pe
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Sec.13.04 RIGHTS OF SUBJECTS OF D.�.T�1
Subd. 1. Type of data. 'Ihe neha of individual on whom[he data is stored or to be stored shall be as sec for[h in this secdoo.
Subd.2. Information reqirired to be�ven indicidual. .�n individual asked co supply private or co�denaal data conceming hunself shall
be informed of: (a) the purpose and intended use oi the requested data wichin the collecring'state agency, polirical subdivision, or stacewide rystem;
(b)whe�her he may reruse or is legally required to suoply rhe rquested data:(c)any Irnown consequence arising from his supplying or refusing to supply
priva[e or confidendal data:and(d)the idendry of ocher eersocs or enddes au[horized by state or federal law ro receive the data. This requirement shall
❑oc apply when an individual is asked to supply invesriganve data. pursuan[to secdon 13.82, subdivision�, �o a law enforcement o�cer.
The commissioner of revenue mav olace �he ^odce r:auired under �his subdivision in Lhe individual income taz or orooem tax retur.d
ins[ruccions instead of on:hose forms.
Subd. 3. Access to data by individual. L'oon reauest to a responsible au[horiry,an individual shall be inlormed whe[her he is[he subject
of s[ored data on individuals,and whe[her i[is classitied as puolic, pnva�e or contidenoal. L'pon his further request, an individual who is the subject
of stored privace or pubfic data on individuals shall be shown tae da[a wichout any charge to him and, if he desires, shall be inYormed of the content
and meaning oi that daca. .-lfter an individual has been shown[he pnvace data and inrormed of iu meaning, the data need not be disclosed to him for
six months chereatter uriless a dispu[e or acdon pursuanc�o chis secnon is pending or addidooal data on the individual has been collected or crea[ed.
The responsible au�hority shall provide copies of[he pri�a�or pubtic data upon request by rhe individual subject oi the data. The responsible auchorirv
may require the requesnng penon to pay che acmal costs o[making, cer�ryin2, and compiling the copies.
The responsible authoricy shall comply immedia[ely, if possible, with any request made pursuant to this subdivision, or wi[hin five days of
the date of che request, excluding Sa[urdays,Sundays and lezal holidays,if immediate compliance is noc possible. If he canno[compty with the request
wi[hin tha[time,he shall so iniorm[he individuat,and may have an addidonal five days within which to comply winc�he request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuncy or completeoess of public or private
data concemine himseif. To exercise this riehc,an individual shall nodfy in wndng the responsible au[honry describing the nature of the disagreemenc.
The responsibie au�horiry shall within 30 days eicher: (a)correct the data found to be inaccura�e or incomplete and attempt to nodfy past recipiencs of
inaccura[e or incomple[e data, includine recipien�s named by [he individual; or(b) notify the individual that he believes the dara to be correct. Data
in dispute shall be disclosed only if the individual's sta[Pment of disaereement is included with tf�e disclosed data.
The determinanon of the responsible authority may be appealed pursuan�ro the provisions of the administrauve procedure ac[ reladn2 [o
contested cases.
DAT:� PRIVACY :�DVISORY
In accordance with M.S. 13.04, Subd. 2, "Righ[s of subjects of data", we would like to inform you that your request
for a permit or license from the Ciry of Orono or ��ny of its departments may require you to furnish cenain private or
confidential information.
`i ou are :ocified chat:
1. The information you fumish will be used ro determine 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.
;. The information may be shared wich o�her local, state or federal aaencies 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.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
(. Your fuil name is required to process this applica[ion or permit.
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I understand my rigbts as st� above.
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