The URL can be used to link to this page

Home My WebLink About1997-009198 - tearoff/reroof � �` PERMIT CITY OF ORONO PERMIT TYPE: � : 2750 Kelley Parkway- P.O. Box 66 '�`=` = = � Permit Number: �''��'��'''j=� Crystal Bay, Minnesota 55323 �- Y V � _ , (612)473-7357 Date Issued: _ . . _ _..- ... . SITE ADDRESS: ._.__._ _� ,.._ . . �.. .;��'��. ��;=; _.;� DESCRIPTION: . _. . . . ��-,- .`�s�i �. ._.... ._ _, =;f 2 —.. ..#_'�iT,� _�i=—r;:�'_;'. ..._=1�_�,.:'�`__ F'iSi,'l, : t�� i�..F Sd_.•S�F�i'�, F �'�i r�t..��F? ::,�.._"�':!:_ eiI" (_t?ll•_E_�`�J (�,_1�� .:_�;� �-jL 1 . ._:=i's_�`1`;r T 3-i'_ REMARKS: FEE SUMMARY: ::.: : : :......: _ _ - _.. . . . . ... _.. �•t_. _;1_7;, �.;.=._,r=' E':�_ �'s.�:� . . _ ==_�i'=�`ict�',=if-:. �._.._._......_. �� "I.� i f.�i : i—_.:�•: �� .:..� . _ _ CONTRACTOR �� - � -` OWN.ERa _ _ _ _.^_.- ._. . .... .�.. ._ . :.._.4� i_..� _� . . . .'.� ... ._ _."'. ... _ � _. .. - — .. _ .�i��.� _�fi"S��'%�. i_�!i . ._. .. ._... ._e..S;-,T s� °xiFi L Ly'Ir�_:Y i_{f,...i�'ui_ P�S�. �_ �_i i . .. ...__ . _ ._. _. . ... '-F f ' ' . ... ,..; . . . —._...'v.- _ ' ' . ._ ._ _, . ._. . _ . " r .. :f� � � T i_.::is... : %..:i��L._ F _ _..I F f� '-Y�t .. ._... , ». ........: i �. ... , e�i: ii".". i �. .. < < ., ° ."x 3". . . . . . �, # � r. :.�_ . �.�_.. ...•_t.1yv� "" .___. .� _ _..._ . _ : e ..... _. ... 1�...'. : � -. . . .. ._. .�.. ' �4�'•' �i':tt= r�i:�j�;��:'!��-� 1_i t ;ry�l { ;-3; � (�.`-t"=�'.. . _. . ._ . .�.:(_. � _%_4;":.t`�... . .. ._._� ix;T?-3 i r=1_.� _ ... � 1= _. •,_ _;_i! _.:_._ .. � _ _ - ; i;-;i_Eill�_: i�;'r,:�;��,! .t �._ . _ ..., '.Y. . _. ' ir ,'i_ _.._ -�` ? �' _ _ __.._. _.r ._. ;�.�i__ .__ �t, + i _�. _. a { '� . ;, ,,_e.:= .— �, : _. _ � � J � APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE � � Total Fee: $ Date Received: Entered By: ��, Permit#: �=t�� ti i�' CITY OF ORONO - BUILDING PERMIT 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 /� �% �-; � i JOB SITE ADDRESS: / d�' i ��/� � /G� ��GIP: NAME OF OWNER: �?�� a��,��'�r"; PHONE: (home) ��7 (work) MAILING ADDRESS: CITY: ZIP: , � �/ -� CONTRACTOR: �-�� °�f� PHONE: �'�� ..�^�k � � � CONTACTPERSON: ��r��Lz �MOBILE/PAGER: `-�/�� .��'�- MAILING ADDRESS: G/�'�/D ��YL�1 S:'c�' CITY: S',,C f� ZIP: S � STATE LICENSE: # I� S D -T ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration ` � �;� ,j � �` � �.�1 ' PROPOSED WORK(describe in detai�: ; -1 .� i ,: _ - ' , s �� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. /� r�;- ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� .'� �/� 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 Ciry and with the State Building Code; that I understand this is not a pernut and work is not to start without a permit; and that the work will be in accordance with the approved plan. ��' � ' ,(�, �> � `� � _, APPLICANT'S SIGNATURE: `�1if/(��/�I /�'�%:%if-r;�� DATE: T - � � - �� c., NOTE! Parade Qf Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. . � Sec.13.04 RIGHTS OF S[JB.TECTS 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 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,polirical subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or refusing to supply private or confidenrial data;and(d)the idenriry of other penons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesdeadve data, pursuant to section 13.82,subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the nodce required under this subdivision in the individual income tax or property tax refund instcucaons instead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,-if he desires, shall be informed of the content and meaning rF chat data. After an individual has been shown the private data and informed of iu meaning,che data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secrion is pending or addiuonal data on the individual has been collected oc created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authoriry may require the requesting person to pay the acrual costs of making,cerrifying,and compiling the copies. The responsible authority shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to compiy with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in wriring the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccucate or incomplete and attempt to noafy past recipienu of inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual thac he believes the data to be coaect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminisaadve procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request for a permit 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. 2. 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 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. 6. Your full name is required to process this application or permit. � �- � ! C� :� �f /��/ �� "��: , �-,-�, �� Firss _ Middle Last �/' ''��i� � .i-�� /-'aL ��0 ��E'� i .� ,— �- Add`e�s� � �// /'� l�, ' � '� / � '�i� � ��/ l'��7 � % � �� :- �!� / A � � � f" 1 U C�ty State Zip Phone I understand my righis as stated aboye. � , ; �-/ ��//� � n i�i,��Ci("� , Signamre ' �