HomeMy WebLinkAbout1997-008785 - replace siding �. PERMIT
` CITY OF ORONO
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
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Crystal Bay, Minnesota 55323 Permit Number.
(612)473-7357 Date Issued: :
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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APPLICANTPERMITEE SIG ISSUED BY:SIGNATURE
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Total Fee: $ Date Received:
Entered By: ,,�'-?-�' Permit#: �'��'S��
CITY OF ORONO - BUILDING PERMIT 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 CONTRACTOR
JOB SITE ADDRESS: ��Cl (�r^e�`�"'V���%�✓2. ZIP: ���S �P
NAME OF OWNER: �q��/ ���,� PHONE: (home) � ,S-D�r7
� (work)
MAILING ADDRESS: ��� �:('C'S�t/�G�✓�i/� CITY: � � ZIP: .�S�S�
CONTRACTOR: �,�.,n ����! �rt�c�4v'S I`n L PHONE: "J��a- `��C? O
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRES5: _ /�j ��S���, CITY: ZIP: �
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: _ti fr��� 'c���r i f r-��S ►� i�C nr, ,�c�c��� r��'�QC-e
rC�-�--�-�n �✓•�c;� N�(4cP S���c3�� r,A �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � �� �L�
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 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 with the approved plan.
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APPLICANT'S SIGNATURE: ��Z�vu�l/�� DATE� � �S '�
NOTE! Parade of Homes events require separate�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 DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be scored shall be as set forrh in this secdon.
Subd.2. Information reqirired to be given individual. Art individual asked to supply private or confidendal data concerning himself shall
be informed of: (a) the purpose and intended use of the requested data wichin the collecting'state agency,poliacal subdivision,or sratewide system;
(b)whether he may refuse ot is legally required to supply the requested data;(c)any known consequence arising from his suppiying or refusing to supply
private or confidential data;and(d)the idenary of other persons or entiaes authorized by state or federal law to receive the data. This requirement shall
no[apply when an individual is asked to suppiy invesogaave dan, pursuant[o secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or propertv tax refund
instruc[ions 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 confidential. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to hun and, if he desires, shall be informed of the content
and meaning of[hat data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed ro him for
six mon[hs thereafter unless a dispute or acaon pursuant to [his section is pending or addioonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subjec[of che data. The responsible authoriry
may require the requesting person to pay the accual coscs of making, certifying, and compiling the copies.
The responsible authoriry shall comply immedia[ely, if possible, with any request made pursuant to this subdivision, or within 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 the individual,and may have an addiaonal five days within which to comply wi[h 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 concerning himself. To exercise[his rieht,an individual shall norify in writing the responsible authoriry dzscribing the nature of the disagreement.
The responsib(e authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, inciuding recipients named by the individual; or(b)notify the individual tha[he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The de[erminaaon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relaang 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 pernut 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.
(. Your full name is required to process this application or permit.
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I understand my rights as stated above.
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