HomeMy WebLinkAbout1998-010132 - nonbldg strct PERMIT
CITY OF ORONO PERMIT TYPE: i�;_�i �.j 'vt�;
., 2750 Kelley Parkway- P.O. Box 66 ;j�� ;_}��;.���
Cr stal Ba , Minnesota 55323 Permit Number:
Y y Date Issued: t��-��:-�:�'=��=�
(612)473-7357
SITE ADDRESS:
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DESCRIPTION:
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REMAR _ -
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FEE SUMMARY:_ __ _ : �,^� � . _,— . _,- - - -
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APPLICANT'PERMITEE SIGNATURE ISSUED BY:SI N TURE
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T�tal Fee: $ .,;,�;�� i =% Date Received:����%l�"
' Entered By: i Permit#: % - ��
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR C�NTRACTOR �
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JOB SITE ADDRESS: ���� .`���//�i7�����' ZIP:
2.-3�..�
NAME OF OWNER: t /1`>' l%� �-�'�"t�;��. PHONE: (home) �/ 7� - 7�� �
(work)
MAILING ADDRESS: � � S�; ���//y �/��,y CITY: � ���.���� ZIP: ��3�S�
CONTRACTOR � � � ��' " �'�Pi�ls PHONE: (� ��3 � ��%�
CONTACT PERSON:_/��-�.,�.5 S�h,n� � BILE AGER: ,�2 0,,2.- ��.� �G
MAILING ADDRESS: ��,? � � .� .�:, .�� _� /�i-� . Y_ S�% I`'��r�ZIP: ��
STATE LICENSE: #
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ARCHITECT/ENGINEER:� ��,Z�,��J � � /;t �G/�
MAILING ADDRESS:� � _Z�:
NAME: �,� , �����?`
TYPE OF WORK: New �cture
Move cation
PROPOSED WORK(describe ir ,.�r �.r� ,r�,
� � �� lti � -��%� J`c�c��- r=°.�`
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S 1 Q��7: � SQ. i�Li i va- a�c��vai a�.....��
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �C'; ��%��
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 City and with
the State Building Code; that I understa �his is not a pernut and work is not to start without a
permit; and that the work will be in�rdance ith the approved plan.
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APPLICANT'S SIGNATUR�:- �" � DATE: j� ��^�,��h %,�
NOTE! Parade o 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.
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Sec.13.04 RIGHTS OF SUBJECTS OF DaT?�
Subd. 1. Type of data. The righcs of individual on whom[he data is stored or to be stored shall be as set focth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confideorial dara concerning himself shall
be informed of: (a)the purpose and in[ended use of the requested dara within the collecdng"statE agency,poliacal subdivision,or sratewide rystem;
(b)whether he may refuse or is legally requiced[o supply the requested data;(c)aay Irnown consequence arising from his supplying or refusing to supply
• privace or confidendal data;and(d)the idenriry of other persons or enrides authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrieadve dam, pursuan[to section 13.82,subdivision 5, to a law enforcemenc o�cer. -
The commissioner of revenue mav place the norice reauired under[his subdivision in the individual income tax or prooem tax refund
instrucrions inscead of on chose forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher it is classified as public, private or confidenrial. Upon his further request, an individual who is the subjec�
of stored private or public daca on individuals shall be shown[he data wichout any charge to him and, if he desires, shall be informed of the contenc
and meaning of chat data. After an individual has been shown che privace data and informed of its meaning,the data need not be disclosed to him for
six mon�hs thereafter unless a dispute or acdon pursuanc to this secdon is pending or addidonal data on the individual has been co(lected or creaced.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of che data. The responsible authoriry
may require the requesting person to pay the actuai costs of making, cerufying,and compiling the copies.
The responsibie au[horiry shall comply immedia[ety, if possible, with any request made pursuant to this subdivision,or wi[hin 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 time,he shall so inform[he individual,and may have an addirional five days within which to comply wi[h the request,exciuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may conrest the accuracy or completeness of public or private
data conceming himself. To exercise�his right,an individual shall noafy in wricing che responsible auchoriry describing the nacure of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplete and attempt to noafy past recipients of
inaccunre or incomplete dara, including recipients named by the individual; or(b)noafy the individual thac he believes the data to be correc[. Data
in dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disctosed data.
The de[erminarion of the responsible authoriry may be appealed pursuant to the provisions of che admirustradve procedure act relating to
contesced 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 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 perm.i[or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit 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 applica�ion or permit.
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Ciry Stare Zip Phone
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I underst 'my ri�hts as state ove. — ,
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Sign
BONESTR�O ROSENE ANDERLiK � 61263b1311 04/23/98 11 :26 � :02 N0:369
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' RQ�C'��� t�t:it M/.I � rrr TC. nd ii m�PA �f ifui CIA S�riiW r �ii ulln�il.
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f�i?1tiiJ 1S/ �n�.ter I F ';ritiY ii.i._SR�Ly.CC.. RuUi•,f f.f�u.•.rr;. A I.A • M3iF:.'l.I L�ri�:,n,P(..
. /� i h41c�u�rl 1' I�:.,�.�tm,rn�. P.L . tu.�Y K.f�eW.Pf . krnrirrn G•.�n<yr,���nr,. i�r� . n.a.,,b f f."_�il,.I-�.E � .
. Li��V���r�C . �:idnCY I'V/iflicl�llS'vfi.f.C.,LS.• Fulirrt �.Y,tV�ml!h
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or�:... , . I'a�.�i.G�.cnesaa�.'a�inn,.., .,���� ,� ri<,,��,.i,Mf4- rn�iw,,��r.er.. ����i
�ngineer� & Arch�te[ts
Aprtl ?4, 1 y��8
Mr, (ire�,, (iui�p�t
('ity ��f�[)rc�nc>
T�.(7. Box f,�`7
(�'zyst�il f3ay, N9N 55:�2:3-OU(iG
Rc: tT5 WeSt Wirelcss Ante�lci� l�i�tallaticyn
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� BFtA Fiie Nc�. !39 C:ien
De�r Cit•e�'
!�3 I'E;(�i1G5�(;i�, 4ti'Z t73V� C�1'1C'�'�'4'i� t}1C p�f1T1y fT()Ill �15 uV��St �OIt11't111It1Ci1L1UIlti £oI �.11e �11tZI1T1�9
installation on the water tvwer. I3ased upon our review, wc dq ni�t yee �ny hanntul sti1��;-tural �ffecis
;
of the inskallation on the water tovver.
$15�d upnn the pla►�s suhmlttu�l by US West (,:`o1�-►t�u��i�,��i[��is, one conccrn th�t we do have relates tu
thc p��intin� of areay ir�z}�acted by ihc Stl1i� �veldin�; or Uol#i��g ott tlte exisfin� water to�ver. 7"�uc,l�-up
paintin� ��'�i� nat s�ecitied, but sl�ouli] b� ci�r-uparaUle ro �}hintzng nf a nc�� ����tcr tower or re�,aintin�,
an existin� water t«w�r, 33elow is a ��aii�tii�� specification thsit wut�ld be appli�.�t�le for ihis work:
1. �rqvic�c. an �,�"iP�'-�}'-h �itrf;tc.P, "C,o�nmerci�l Rlcgst (..'le�tnin�y".
Z. Prirner, onc (1) cc�at c�f `i'nemec Hi-Build Epo�cuIi►�e 5eries C,f;, 4 to 6 mils clry f]n�
thiukness.
3. l�inish coat, one (1) coat of Tnemc:c Endurashield Series 73, 2.0 to 2,s a�y tai�„
thickness. "I'lie color oCthe fini5h cc�at should t�iateh the�xisiin� wate�� towrer.
4. lnstdll paitat in accordancc�vith p�iint����nufacturer's recomntcncl�ticros,
, �T'h��ik you Pu�•tl�c upportunity cc� revie•�-tl�ese plans,
if y��u h�vc as�y c�u�titiun.w r•elative to the revicw or I�ave fur-tl�et� questit,iis, p�e�ise �-unl�i'I �Z�e at �0�-
489�.
Sin��r�ly,
Bc7Nk',5"I�ROO, KOS E, ANT]hJZ1.IK cYc. ASS�C'I/�T'E5, 1N(.'.
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1 Jc y. ll`C'e►-t�sch. P.L.
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ce: (,alenn C�e�ok - Bo�leskroc> &: Associates
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���5 W�st ��igF�w�y 3G • 5t, P�U1, MN 55113 ■ 6?�-b�G-4G00 � F�x: 612-G3G-1311 --•