HomeMy WebLinkAbout2001-P03807 - re-side � � -, PERMIT
C I TY O F O RO N O Permit ►vumber:
2750 Kelley Parkway - PO Box 66 Po3go�
Crystal Bay, Minnesota 55323 Pet'mit Type: MinorAlterations
(952) 249-4600 Date Issued: si14i2ooi
SITE ADDRESS: 255 Crestview Ave
LONG LAKE, MN 55356
P��: OS-117-23-14-0021
DESCRIPTION:
Proposed Use: tcesidentiai
Permit Class: Building Census Code 434
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 70.25
APPLICANT: MICHAEL MCCALL OWNER: MICHAEL L MCCALL
NII�1 255 CRESTVIEW AVE
LONG LAKE MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF NIINNESOTA BUILDING CODE REQUIREMENTS.
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APPLI ANT PERMITEE IGNATURE [�$UED BY SIGNATURE
Copies: City,Applicant, Assessor, Finance Page 1
Total Fee: $ Date Received: `� � ��� - �'\' �
Entered By: �<� j�� Permit#: f� C :3b l, -�
CITY OF ORONO - BUILDING PERIVIIT 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 CONTR.ACTOR
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JOB SITE A.DDRESS: ��S-� ��C�� f/i��,/ ��� Z�: . �S�S�
NAME OF OWNER: � ��z � �'(�� /� PH0�1E: (home) �,S��75
(work)
l�iAII..ING A.DDRESS: �-.�S C t�r-`S'f�v ��,.r�CITY: G�✓=.��� ZIP: SS�S"L
CONTRACTOR: /��,��c G����.� _PHO�TE:
CONT'ACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: Z�:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHO\TE:
MAILING A.DDRESS: CITY: Z�:
rJ��; REGISTRATION# �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_1� Land Alteration
PROPOSED WORK(describe in detai�: �'C S'%�� 1,�/r�7`�, l�/�ac. � ����t�--,
STORIES: � SQ. FEET OF EACH FLOOR: aCk� +�,� �O�U �/�.�
NO. OF BEDROOMS: �- GARAGE STALLS: ATT. —� DET.
ESTII�i IATED CONSTRUCTION VALUATION (exclud.ing land): � �O
I hereby apply for a building pernut 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 Buildina 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 accor an ' the p ved plan.
APrLIC
ANT'S SIGNATURE: �G� �' DATE: %� --o/
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NOTE! Parade of 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 SLIB.TECTS OF D:�Ta
Subd. 1. Type of data. The ri¢h�s of individual on whom[ha data is sto:-�c'.or co be s:or`d shall be as set forth in this secaon.
Subd.2. Information reqirired to be given individual. An individual ask�to supply privatc or confidenrial data conceming himself shall
be informed of: (a) [he purpose and incended use of the requesud daca ui�in the coll�caa;'state agency,potidcal subdivision,or stacewide rysum;
(b)whecher he may refuse or is legally required co suppiy the requested dan;(c)any Icowa coasequecce arising from his supplying or refusing to supply
priva�e or conndenrial data;and(d)the idenri[y of orher persoas or endda z��horized by s3�e or federl law to receive the data..'Ihis requiremeac shal]
noc apply when an individual is asked to supply invesrieaave dara, purs��c to seccoa 13.82,subdivision 5, to a law enforcement officer.
'Ihe commissioner of re�enue riav place the norice reauird ard-r this svbdi�ision in che individual income tax or oropercv tax reFund
inscructions insread of on those forms.
Subd.3. Access to data by individual. Upon request to a r.szonsible a��:or.ry,an individual shall be informed whether he is the subject
of s�ored data on individuals,and whe[her it is classified as public, privac�or confidery al. Upon his further request,an individual who is the subjecc
of srorad private or public data on individuals shall be shown the daca wi:;.ouc any c:.3r3=co him and,-if he desires, shall be informed of the concenc
and meaning of chac data. After an individuai has been shown the priva�:za�and i�:�r'=d of its �eanin3,the data need not be disclosed to him for
six mon�hs chereaiter unless a dispuce or acrion pursuanc to this secrion is�ending o:a��i�onal da�on the individual has been collected or creaced.
The responsible auchoriry shall provide copies of the private or public da�a u;on requ_s.by c::�individu:l subjecc of the data. The responsible auchoriry
may require[he requesdng person to pay the actual coscs of makine,ce.�:;ing,and coc�iling the copies.
The responsible authoriry shall comply immedia�zly, if possibi=,wich any reqLest made pu:suant to this subdivision,or wi[hin five days of
the date of the requesc,excluding Sanirdays,Sundays and legal holidays,ii ir..medi2te cer..pliance is r.oc possib(e. If he cannot comply with the requesc
wi�hin cha�ame,he shall so inform che individual,and may have an addicer.al five da;sµ7�'�in which to comply wi�h the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. ?.n individuzl cay conrest tht accuracy or complereness of public or prieate
dara concerning himself. To exercise[his riehc,an individual shall nodfy ia wriring c.=r_sponsible aufr.oriry dzscribing�he namre of the disagreemeoc.
The responsible au�horiry shal(wichin 30 days eirher. (a)correct[he da�tcund ro be inaccurate or incomplete and attempe to nodfy past recipienrs of
inaccurace or incomplete data, including recipiencs named by the individL�l;or(b) roc.ti�Gze individual thac he believes the dara to be correct. Data
in dispu�e shall be disclosed only if[he indi�idual's sta�emenc of disagre��anc is i^.c:�_�ed wich[he disclosed data.
The de�ecminaaon of the rzsponsible authoriry may be appea�:�pursuac:to �':=provisions of[he adminiscrarive procedure act relaang to
contesced cases.
DATA PRN?,CY AD«SORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects oi data", we w�ould like to inform you tha[your reauest
for a permit or license from the City of Orono or any ot ics depas:ye�ts may require you to furnish certain priva�e or
confidencial information.
You are notified thaC
1, The informacion you furnish will be used ro de:ermine�'ou:qualification for the pemut or license requested.
2. You may refuse to supply data, buc refusal nay require that che Ciry deny the permit or license.
3, The informa�ion may be shared with ocher loczl, state or federal a�encies to the extent necessary to process
the permit or license.
4. If your requested permi[ or license requires Council accion to approve, some information may become
. public.
�. You have certain rights under M.S. 13.04 (a�ailable upon request) to review private data on yourself.
6. Your full name is required to process this aoplicacion o: permic.
First �liddle �t
Address
Ciry State Zip Phone
I unde d y r��h tat o . .
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Signa[ure