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Home My WebLink About1997-008668 - land alteration PERMIT �ITY OF ORONO PERMIT TYPE: ` 2750 Kelley Parkway- P.O. Box 66 =i°=`= =� µ � Crystal Bay, Minnesota 55323 Permit Number. ;;�_,`:�:;,_`,,'.:'�=-�` �'"` ':` (612) 473-7357 Date Issued: _ SITE ADDRESS: `r�... _.'.' t4:;;°��`-.`:;:l�,�i�,€i�i'.,� j :�: '�� ::,: •� �,� . -,;-., ; :— — - . .. . ' ... _. � _,.._ _ _.—.t}d.?i 7 T�s DESCRIPTION: �:�i�. :�;,r—_'}-. �'�r�I'C','t i;. j,y;-�r=. 1._(-1i�l�_} [��__ 1 �i!'.�i��I�[;t# REMARKS: , ;: : ;: �.:' = ' �..�! l 1 i 1 �_l�''v _ _ _::°'_' FEE SUMMARY: �=;�.�=� , ._._. ______---'��''�; ;�;.�, ..!��'�..��f j��-.:_a `r j��f:'t_'t CONTRACTOR: OWNER: -- .-�::;:=+. m_:_:�:-_. - ? i.I`;fi�i%��ii-i��t�i !_�'•`.�`?'�, �.�t�i i!'.Yi�t��Cit=.iJ .!i.,�.;=,f: i,:j:'��;,:�1f#s�il,i j r; ��;;.,_,r,,�;^; `•+_�� _�}�,:=;�a`�-� . , :,._ � -., r;�• .__E..ti .- ,- --i ;�:� 3:�;.;; - - _ : .�._ . • !,;._ � ;. i'ts= � , _ _ �_ <<-- :�. � . . �-,`--I't.==s•.1��•�•`+.; krt�:i?.�t��' ;'j(„.!�!_�..._.. . .._ a �..z.`;°!�`:. .� i f.jf;: `_, �_� ?°��'��C.". :. .`:�?ii.... t.�'`i`'?',`!A{:i�:':fi;:�r`.1'Y �� . ._._ _. .__.. . : . . . �..i�� {"' , . '_,L'L �_ � L. T�.:..2 :,.Ki�_t J.:.... vL_ ;'1 { i � t q, j,:' 3 � ^y�. ;., _, .; _ . _ . : : . � ..�.. r� ;_,: F��SS`:[...�"�_e . � 1 L.. � [""i�._f... T'f� C't� . �,:'q —s ! � t ? il"� T�,t 3 + # '� ��:.: �. . _ _, . . _. ... . ._. _. . .. _._. :: .. ��i. i C"� . ._. ._ _. _. . .. 1 1<i�t��t 7! I ��"•�;€�It �`�I 1 E > (•j T *�'i;-'—�I I S +�� '•f �i 1�'.�•`, f�.� ��;- ;-,'�.1:};.' " ::}-" ��.."_ � .—..-. - ,�...».,t'('__ .... j'... 'i�._ '...'�i.... ,i i: ._�� r�E h._ �.� I i 1 ! L.. ..ri' .L�'f'�._»-... .. !'� *','_'e•� _ �_ ._) _ ... . _'.L E'•.».I�S� : f • L � � ��i?�� C�o►�f��yrJ .J APP�ICANT%PERMIT SIGNATURE ISSUED BY:SIGNATURE �C,�!,�-.c.�'s-' � t c Total Fee: $ Date Received:�,Z�j' , 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 �,THE � �:`-:f�!`'�c%�? ��f`��'� /'.,,:,�,rt�,�,�;�, �..�z� (,:��.-��r��/„%j i� ,-�r,�'� r JOB SITE ADDRESS: '{��'� L!PcI�N�,-� T��t, 1 ZIp; _S:J�,� �j NAME OF OWNER:��r�i{'�`T�ll�i�„�.��{f �'��'r,'/l PHONE: (home) `'l`I�-0��6' X63-�.?�'/ �/ (work) MAILING ADDRESS: �/.j0 /�Pn.�pi� C/T� ��XC Crr �T�:�' r_f�, ZIP:t i.� 1 _r.s'�.r9 �:��t-. /`tr,��,�� r,'/a,�„ CONTRACTOR:��r( �i�{�F'toi� �Y1 J�,,,�io�� PHONE: CONTACT PERSON: ,<�ti�,e( f✓.,��;cc ff MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT �NGINEElY: ��PrC�C f.�S�CC�'t+�P1' T�C PHONE: `��`�" y�~� � MAILING ADDRES i;��,;;; , �'�f�'f�lrr� �t'�'}t-: CITY: %'?u�Yr i��.� ZIP: S'�.11-` NAME: /1"�� c�e.�;/ '4� �r i' REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration�_ PROPOSED WORK(describe in detai�:�`��r-��u�� u�;'�(-'�:'��'�'��'�� c� � �.k, �"� •��,.,�� l. c''f 'I��v"F�, '•i �if�' t 'l ��'�uC�� l t'-��^�..I �.� ��'�/i(r�rt'Ic'l�/ ��lOL� �c.��`C �'Qt•'�j �i /'�c.c'!t'r�A I U-tQ r��,�-lr��<<;� �1 cr� c�.,rl��-� �;, -��: ! J-lT.�c��,��' • STORIES: ti�q- SQ. FEET OF EACH FLOOR: N� NO. OF BEDROOMS: �,A- GARAGE STALLS: ATT. �ti-�-- DET. .�if}- 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 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 ith�he approved plan. APPLICANT'S SIGNATURE� " �% DATE: �/� ��' � (,�!%�l,�,��.�i ��:�,�f�-.�� NOTE! Parade of Homes events require separate permt"t approval by Police Deparhnent and City Council 60 days prior to the event. Non permitted events will not be allowed. � ' ' � Sec.13.04 RIGHTS OF SUB.TECTS OF D�T� Subd. 1. Type of data. The righrs of individual on whom the data is s�ored or to be stored shall be as set forth in this secdon. Subd.2. Information req�rired 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[he requested data within the collecting"state agency, poliacai subdivisiou,or statewide system; (b)whether he may�efuse oT is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing ro supply private or confidentiai data;and(d)the idenciry of o[her persons or enriaes authorized by s�ate or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrieadve data, pursuan[to secnon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the notice reauired under this subdivision in the individual income tax or prope_m tax refund instructions ins[ead of on those forms. Subd. 3. Access to data by indi�idual. 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 cfassified as public, private or confidential. Upon his further request, an individual who is the subject of stored private or pubtic data on individuals shall be shown the data wi[hout any charge to him and, if he desires, shall be informed of the concent and meaning of that data. Afrer an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to hirn for six months thereafter unless a dispute or acrion pursuan[to this section is pending or addiaonal data on the individual has been collected or creaced. The responsible au[horiry shall provide copies of the pnva[e or public data upon request by[he individual subject of the data. The responsible au[horiry may require the requesting person to pay the actual coscs of makin¢, certifying, and compiling the copies. The responsible authoriry shall comply immediately, if possible, with any requesc made pursuant to this subdivision,or within five days of the date of[he 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 the individual,and may have an addiaonal 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 private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authority ducribing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incomplere data, inciuding recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispute shali be disclosed oniy if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng 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 thar. 1. The information you furnish will be used to determine your qualification for the pemut 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 pernut or license. 4. If your requested pernut or license requires Council action to approve, some informa[ion 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. First Middle Last Address Ciry State Zip Phone I understand my r' hts as stated ove: - v��'`��_ �, B / L 1 Si nature ��G+ �.f ��'C J��1i'T.�C J /�