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Home My WebLink About1999-011382 - re-roof PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 ;-;;_;r�._;',?;�ti;; Crystal Bay'Minnesota 55323 Permit Number: . ._.,�, . Date Issued: �~�`' � �� (612) 473-7357 _ _ . _ . SITE ADDRESS: .__,,_.cWi,;; �;'—i'�'4�`t��; ``' `:i � — f �7_.� � , -—}..;:;L—(,:::�.:� DESCRIPTION: t-�Si1 ; •":1;"y� {—'�_'Y'i'�ijt. I j`��_? `j�—�;�,..::'['�.`=..i°E�,tEj`�_ s=�3¢� s:,t�ll'z t.}°s,F�'i:; ��f.:�:� f-�tW�—t�`S_S; #;� i;F=i:�:r�� i:�_:�:jf; :3._:� G:'t__i' . rit-:°=:i i_ti-(y j' i;�i, REMARKS: FEE SUMMARY: s,�: � 4,_;T �- ;,_��._;_.,-, , I="�:;�{ �..-:, i �- - �t�� ;�':�:� �� . ___ '_�Elt'i�'g��,i'=i:� _.�_.._...___ x'�.�'.-��.:�.� I c_.i__:i �'�;F:' ��.i �,.�r , `�:!_! CONTRACTOR: _ ��,�,� „�.,...�;. _ _;; . �;f_ .OWNER: {f — i 1 r=ti;'_� I vt. �;�'�t f_t_tl�E _�i � tF••i�.�.,„t_il.�:, I fYf-11-i�'q'� •�"i�.�:_.,Y �'�_ • - �� ,,.. .L��4_} '�-?F?t��. h`t! ,_;_L.i_f !W�`-��` �ir.�.�,f ��1.... _;-;j-�T�,ii�;F�i°_:'':�„�,I i°7�`Y -_ � _ i,,�'i�if.;i,i ��L'_;'-;f . =,'!.�_.t :i"_ --- -'1 �. ;:;; — i-:__ _. ___!'._ _'_ ._._. . .'-�-'._._. . ti._.. t�i}-.`� _ --. .. .- - - - - . . _ !'�. .. .__ � `.r� r ._.�=-xi. _. .. . .'_'�'�.�'' � . . _. „ ,.� ... �. . „ . � . , -,._____ ,.,._�_.- --.._:.__ M .. _ :_,�,._ y;� F;^; ' �'�'_' '"�t"':_�`.�� { ' ,�__� :—!_�..._ {�;i s1—:`;:., +T�`•! ._ . ;, j.�. ; _'..E f. .� _;..4�f._ F:4}= s ;. `as :__ s� i'�'r , _ � t ;.> ._� — iif1 . ," . . . � '.nrii '_ . . . _.. " ' . _. �_._. . _ » ... . . ... . I r _ . . s_ L . .'_' � s f`•.._.r :.,.,: :_�� r; i 1—. ..��" . ._. . ., _.i_ i 1 1 t .`;� i I a� -�.`- P'�';..F �k jy� �..�I _ . ._ _ . ._ _, . .. � -7l��r� � �`�� APPLICAN ERMITEE SIGNATURE ISSUED BY:SIGNATURE � , Total Fee: $�=� - ��-`5�' Date Received: Entered �y: �= Permit#: %�3- -�. � . ` . CITY OF ORONO - BUII�DING PERlVIIT APPLICATION All inf�rmation must be submitted in full before plan review w-ill be started. (please print all information) THE A.PPLICAI�'T IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��.�I v �y v; C:� �IU�e z�: I�TA1�iE OF O`ifi'ER: %�r y ��t �c ►� PHONE: (home) ' (work) �IAII�I`i TG:�..DDhESS: ��-1 C� �3e,��,�..:� a�� CITY: �� c� �e> ZIP: CONI'RACTOR: C►�� ;�', ��n� ` ,�c PHONE: �-I�� _ �.�0 1 COi�1TACT PERSON: T, n�, MOBII.E/PAGER: MAII..�'G ADDRESS: f�/��, �<,,. �c �. CITY:C�c�-��, ZIP: STATE LICENSE: # 3�� . ARCHITECT/ENGIl`TEER: PHONE: MA.II.ING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF �VORK: New Addition Accessory Structure !C Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: �e�,- �;�' �N,.�� p r� � STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDR00�1S: GARAGE STALLS: ATT. DET. EST�IATED CONSTRUCTION VALUATION (excluding land): � ��`� �� I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that che work will be in conformance with the ordinances and codes of the City and with the State Buildin� Code; that I understand this is not a pernut and work is not to start without a pernut; and that the work will be in accordance with the approved plan. APPLICA1tiT'S SIGNATURE: �� D�'TE: ��9� NOTE! Parade qf Homes events require separate permit approval by Police Department and Cily Counci160 days prior to the event. Non permitted events will not be allowed. 4 . Sec.13.04 RIGHTS OF SLTBJECTS OE'DaTl� ' Subd. 1. Type of data. The righ�s of individual on whom che data is stoccd or to bc storrd shall be as set forch ia[his secaon. Subd.2. Information req�rired to be given indiridual. An individual asked to supply private at confidendal data concerning himsetf shall be inform:d of: (a)che purpose and iattnded use of[he requuted dam wichia the collecang State agency,polidca!subdivision,or sntewide rysum: (b)whed:ec he may refuse or is_legally requird to supply che rsquesud data;(c)any 1¢iown coascquence arising from his supplying or refusing to supply privace or conndenaa!data;and(d)the idenary of o�her persons or enriaes authorized by sc�ce or federa!taw to ceceive che data. 'Ihis requiremenc shall not apply when an individual is asked to supply iavcsdgaave daa,pursuanc to secdon 13.82,subdivision 5, w a Iaw enforcemeat o�cer. 'iTu ce;�missioner of revenue mav oface the nodce r.auired und:r chis subdivision in the individual income caz or oropem raz refund instrucrions instead of on[hose forms. Subd. 3. Access to data by individual. Upon requesc to a responsible auchoriry,an individual shall be informed whzcher he is the subject of scored dacs on individuals,and whe[her it is classified as public, priva[e or confidenaal. Upoa his further tequost,an individual who is the subjecc of stored private or public daa on individuals shall be shovm[he data wichout any charge to hira and,'if ha dzsires, shalI be informed of the content and meaning of that dara. After an individual has been shown[he privace dan and informed of ics meaning,che dara ne:d not be disclosed ro hun for six monchs thereafter unless a dispute or acaon pursuanc to this secdon is pending or addidonal dara on[he individual has been collecced or crea�d. The responsible authoriry shall providt copies of the private or public data upon tequest by the individua!subjeu of[he data. The responsible authoriry may require [he requesang person to pay the accual cosu of making,certifying,and compiling che copics. 'Ihe responsible authoriry shall comply immediately, if possible, wich any requesc made punuant to this subdivision,oc wichin five days of the dace of che request,ezctuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he canaot compty with the request wichin rhac dme,he shall so inform the individual,and may have an addidoaal five days wi[hin which to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may con�est[ha accuracy or completeness of public or priva[e data conceming himself. To exercise this right,an individuai shall noafy in wriring the responsible authoriry describing the nature of the disagreement. The responsible authoriry shalt within 30 days ei�:er: (a)correct[ha data found to be inaccurdte or incomptece and aaempc to nodfy past recipien�s of inaccurate or incompiece data, including recipiencs named by che individual; or(b)noafy the individual thac he believes rhe data to be correct. Data in dispuce shall be disclosed orily if the individual's statemenc of disagreement is included with the disclosed data. The deceaninadon of the responsible authoriry may be appealed pursuant to the provisions of che adminisaarive procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Righcs of subjec[s 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 fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determi.ne your qualification for[he permit or license requested. 2. You may refuse to supply daca, but refusal may require that the City deny the permit or license. 3. The information may be shared wich other local, state or federal a;encies to the eLcent necessary to process the permit or license. 4. If your requested perm.it or license requires Council action to approve, some information may become public. 5. You have certain ri�hts 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. �� i e� e v^1 c. � ( -7�}-� ' �-c, � Fitst �fiddlt Las� �S3 ..i,��n1 �-�c�� N �- - Address �''l e� �� c� �/�'�/� �5 3� � � 7'2 a-�� Ciry Sace Zip Phone I understand my ri;hts as stated above. r f Signa[ure