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Home My WebLink About1999-012322 - replace windows � _ � PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway - P.O. Box 66 Crystal Bay, Minnesota 55323 Permit Number: (612) 249-4600 Date Issued: SITE ADDRESS: ;;.,. , ; _ _. _. . , DESCRIPTION: ;� ,:: , �: _,, . , , . w � �. , , : ., ;-:� �.`.,�,:; : y.. . _:!. 7i-.2�. � � . .. _ _ . . .' ... .... .�.._. ._ . _..... . I 3 i ��i Wi i�f f'}�;' i ° .r.`.'F��; :i i` �'wt~v v f-i � L ' REMARK : '' S i FEE SUMMARY: . . _._i i;:. . ,[' d�'� . _ ... _ =?.�+•�:=� (_��:; ".._._. . �tw s�-;;„-,3w��. — �"E tt�c�._ri �•,=_ ._.____..__._ ___. . � _. CONTRACTOR: OWNER: - - ��} r:�: ;} — _., _ `: , ._,. ..,.__ . :� , ,.} . � _ ;4,� M� � .��;_•�_� �_ ; F i t }._' � ,t. — '-„'-�t i ��—':"�'a ':—si'S�• . ._, .___._ . F _ . _..,_ .. �.. . . � � _.i�;�s`t�W"k' {_.�—. _ _�..._ . _ . _ S . . . ,. ' -• _ ,•• ,.,:,- -— _ � . ., •�.,. ._._ '�. �i:� „(Rf_! . . !'.�`�Sf�t:��:��.._�; ;-f' S � ; :: ` � C _ r�? ' t { �l ' { � i'� 5 �� . _ : �^•: <; L ' . _. _ . . . . . . .. _ .._. . _ _ .. ._ . . . _ .. . � ' -',y� APPLICA T PERMITEE SIGNATURE ISSUED BY:SIGNATURE s� Total Fee: $ �� L'� Date Received: Entered By: Permit#: � �?�',��-- CITY OF ORONO - BUII..DING 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 JOB SITE ADDRESS: /� S C Y��L'¢CC- z�: .5� 3 S,� ��%�za�-zQ�� d�� NAME OF OWNER: �`7'Q,�G�� S�C�G� PHONE: (home) 6�Z "�17.��8S 6 Z (work) S�sn -� MAII.,ING ADDRESS: /3�G Y��L-�P�L�CITY: Lal�� ZIP: 5 S 3 S G CONTRACTOR:�� aG! �r�C�So��i PHONE: ( /�-�7.��Z CONTACT PERSON: /,<a.��r /,��a��'�OBILE/PAGER: MAILING ADDRESS: /3� C �'C'i��T PG�fCG-'CITY: �a k 9�G�.�� ZIP: ✓�3 S� STATE LICENSE: # —� ARCHITECT/ENGINEER: PHONE: �LAII,ING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration ?{� Land Alteration c�lc�''Q'�r�q�ff�c�� PROPOSED WORK(describe in detai�: ��/a'c � �-O /G� a?/S d� �`� � �oYfG�v r�s� s�� o� /�o�/S� u��t� � �a y wr�cld�r/ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 02 D�• D� ��oo 'S�r� 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 with the approved plan. APPLICANT'S SIGNATURE• ��I ;�� , "/��.�� DATE: �/�°C Z�� 9� NOTE! Parade of Homes events require separate permit approval by Police Department and City Counci160 days prior to the event. Non permitted events will not be allowed. Sec.13.0.4 RIGHTS OF SUBJECTS OF DaT�1 Subd. 1. Type of data. The righ�s of individual on whom the data is stored or�o be stored shall be as set fonh in this secdon. Subd... Information reqirired to be�ven individual. An individual asked to supply privace or confidendal dara coocerning himself shall be informed of: (a)the purpose and intended use of che requesrPd dara wi�hin the collecting'snte agency, polidcal subdivision, or sratewide system; (b)whe[her he may refuse or is legally required to supply tbe requested data;(c)any kziown coasequence arising from his supplyin�or refusing to supply private or conndenrial data;and(d)the idendty o[o�er persons or endaes authorized by sca[e or fedezal law to receive the data. This requiremenc shall noc apply when an indie�idual is asked�o suppiy in�esaeadve data, pursuanc�o secdon 13.82, subdivision 5, to a law enforcemen[officer. The commissioner of re�e�u mav ola-� che nodce reauired under[his subdivision in the individual income_tax or propzrtv raz refund insttvcrions insread of on[hose forms. Subd. 3. Access to data b�indi�iduaI_ lipon request to a responsible au�horiry,an individual shall be informed whether he is the subject of stored data on individuals,and whecher ic is cfsssified as public, private or confidendal. lipon his further requesc,an individual who is the subjecc of stor•d private or public data on individuals shall be shown the dara wi[hout any charge to him and, if he desires, shall be infoaned of the content and meaning of[hat data. Aftzr an individual has been shown the private data and iniormed of its meaning,the data need not be disclosed ro him for six mon�hs thereafrer unless a dispute or acrion pu;suan[to [his secdon is pznding or addidonal data on the individual has been collected or creaced. The responsibie auchoriry shall provide copies of�he private or public data upon request by thz iadividual subject of[he data. The responsible authoriry may require�he requesring person to pay the accual costs of makine, certifying, and compiling the copies. The responsible au[horiry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of che request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is no[possible. If he cannot comply with the request wi[hin thac time,he shall so inform the individual,and may have an addirional five days within which to compiy with[he request,exc!uding 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 this ri¢ht,an individual shall nodfy in wridng che respoasible au[horiry describing the na[ure of the disagreemenc. The responsible auchoriry shall within 30 days eiL`:er: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccumte or incomplete data, including recipien�named by tbe individual; or(b)nodfy tt:e individual that he believes[he dara to be correct. Data in dispute shall be disclosed only if the individual'i statement of disagreement is included with the disctosed data. The de[erminarion of the responsible au�horiry may be appealed pursuant to the provisions of the administradve procedure act re(aring ro contesced cases. DAT� PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Riahts of subjects of daca", 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}�ou furnish will be used to determine your qualification for the permit or license requested. �. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared wich other local, stace or federal a�encies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some informa[ion may become public. �. You have certain ri�hts under N1.S. 13.04 (available upon request) to review private data on yourself. 6, Your fuil name is required to process this applicacion or permic. �//G(�� Q�� /I G� �`Ss� � � Las[ Firs[ 1 �� /3 S C l��C/�T f'��C� `��Sa�r� La'!�� /<.J �S,�S� lo/Z -�/7.T�S� � Ciry Sra�e ZiP Phone I underst d my ri�hts as stated above. � Signature