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Home My WebLink About1998-010758 - land alteration ` PERMIT �� CIT Y OF ORONO PERMIT TYPE: - w-- � - 2750 Kelle y Parkwa y- P.O. Box 66 �}�_•�`�_�'`` �-''u`'�� Crystal F3ay, Minnesota 55323 Permi t Num ber: �_;i;_=;?�,;T; (612) 473-7357 Date Issued: ;�-;;� =„=;;_; SITE ADDRESS: �:;.,:;�=: t��i� ==�i i_�, �-' . � . ��I. . i i��—� i ;—_�—•It;—•i�a 1 i:ef=. DESCRIPTION: 11-i:i_t�_7 {.i��1�. �t'L7'._� ii;:�1' 4'-`:'1'�EtIL. �'r��:r L_t-11�L� `��i��?i`.F'•i�r�_i�� REMARKS: FEE SUMMARY: i::��.�� `�� _--____.... u.�;:'� iii,� :��w}t.=i i—�F�� =L(_''• i�){i CONTRACTOR: OWNER: - ��°� j i�i�t� - '�:_��L��°_�E'r=; ��:;=?��±�I i1�.;! i t:�;;:;_ _,�;�::;; :��i = `��'•-��— 1'�f� `�� .��' t=.— —_— -:�— - i i, "+-� ' t `Cv f � .,-.-.�-:-.•., ,-.—:•.: -. . t i-a '-'z:``�7 . .��<<i i�;:�;`_ . ='__f�;�*�S'�;��tw#�,1 ._i :'i;�'.r:;t_ {_:-}_ ``�=i-�'_. .L 3'�t-`;:`�_i`.,��'i y;�� 1:� �. , _�. , ;�'}:� _ � ��_�•i. .�. _ � -. - - __,- _ _ _. ---:: �T "• .. `.-.r r_'_•3 F" - ___. {��r:�:1 r.;_.'..t T•`.-, �{�I 3)f_l^!-,?___ .. _�?. . _. . _ i �"'.... _ t _ _. .t ._...:-3F�..__ k I r: _ _ . . �_�. . i 'v t. � �i - � F'`! � f f;-s;Eyl11 I I ;�itt;il'�� .::i:•,�:_ '" y'i � iL ,^':,��:;�+1�"`�:I_{'�;� _.'_?_'_t,'•�?y;i r.i il,};� �•.',�Si t_1 {'_h`�-�'1i'yl'v ! � . L _ _ �f_ �3'�I:�. .____ i—+i IJ _ . .� l_`� � i � APPLI NT%P RMITEE SIGNATU ISSUED BY:SIGNATURE 1,�. . ,� . � � Total Fee: $ `jp,2� Date Received: Entered By: �c�; Permit#: /� !��Y CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNE OR CONTRACTOR 'Y'c^'��•S ,�':1'ryi ,, JOB SITE ADDRESS: � ��- ,��,�� ZIP: � �7�—� ��,�n7 ,�Z��2�� NAME OF OWNER: � � - 'c� "� PHONE: (home) �3 -, "2�� (work) MAILTi�1G ADDRESS: � ,,�. CITY: ZIP: -�,-�" �. CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: N�w Addition Accessory Structure Move Remodel/Alteration Land Alteration �./ PROPOSED WORK(describe in detain: /(f ��.��,,�� G�`?�'`�6'?��(�Q�rw1 STORIES: ti� SQ. FEET OF EACH FLOOR: NO. OF BE OOMS: GARAGE STALLS: ATT. DET. 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 a,�c�rdance with the approved plan. � ,� APPLICANT'S SIGNATURE: � � � - � ��<� %�DATE: j` G� �' � NOTE! Parade of Homes events r quir separate pernzit approval by Police Department and Ciry Council 60 days prior to the evi�nt. �Ion permitted events will not be allowed. 5 . � . Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. M individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the coliecting state agency,political subdivision,or statewide system;(b)whether he may refuse or is IegaUy required to supply the requested data; (c)any known consequence arising from his supplying or refusing ro supply private or confidential data;and(d)the identiry of orher persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant[o section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or prooertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is the subject of stored data on individuals,and whether it is dassified 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 without any charge to him and, if he desires, shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this secdon is pending or additional dara on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall compiy immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,exduding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, he shall so infotm the individual, and may have an additional 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 privare data concerning himself. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt ro notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that 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 determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminiscrative procedure act relating 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 �ity 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 permit 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 application or permit. First Middle Last Address City State Zip Phone I underst d my rights as stated above. , � . Sig ture �` 6