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Home My WebLink About1995-007366 - tear-roof/re-roof PER�T CITY OF ORONO � � PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 _ _ _ Crystal Bay, Minnesota 55323 Permit Number: (612) 473-7357 Date Issued: : SITE ADDRESS: . . ... ._.._. ..— :=��=` =��:�_ :;, � _ . _ _ . ,.--R:i l - DESCRIPTION: >>��? .i��i.— . -:. ..e2 . , _ ._ �.—.. � .��::': . ..`�-;;.:,�:�=;_ _ . . f'-.,_,�. ��t;:, !:��3?—E��? .. "��'r. . � _� ,_.___r,::_:_ . f �'� Y` j�{ . 14��A '�,';,��+"� __ _r ..._�._fi! � ''.'��Y L�y� t.'i\L'ii�' ' �... � �.- �L.?'.•[ � ��Z � ...: ! 1.4�L .. � t � , � '�.M- 1 .E ^ =:1 �' �y:.. _L't .. . r J�: , �� ry', 7. I '+��_ y t` CC =.ii} cl � ..-t__ . __ "t�. ! :.,. .. .;;.:.• . . :.� � ��L�-;� REMARKS: — ' — =� � FEE SUMMARY: I -;��•s''_.. ��=.?��F . _.__--___ — — i ��_.'. '_ . :+'!�.' . _ . � _. ,.{F�.,'�:��,'� � f'p'i �, `,'' '�', ,��' F;'i � � CONTRACTOR: OWNER: — '�— : _ � . ' — .. _ . .� — — —__ , .. jf ,�, � .. _ ... .. _ .. • . ! . ... _ - t . _ i �� __ - ,.; _ , _ :. ,t' S _ ,: '-t Sy�:1� 'f �—� : << , i .._ . . .�__5 ....'_. . .�._.t_. 4 .�.._.'�. . i ,..._._ �_� _.'.;� .� _ ��:. _� . . 3�.. . ._ . ..». . __z .. _.. . . _ e _ ,_. . . .. i� ,�' . _. _.'" _.�:_�_. ", '-'� �•-. ,3'...:...: � �_.� i..��.E'.�'� ....__ .. .ta, �, . . . .. . .. _..i° _ _, t.s..._. r. .. �"s . . _..._ . • . .. - . . 4 ti; ! � i . f �i .r ,f•.,��i �$ �� j�'i� r"? ; � — �3 � i s � � :� ._, :.; . . ...,,... r . , ——__ . _ . _; _` � _.. .__. . : .. _ _..,. - _ .; , . _ , _ _ ,_ .._ . _ . .__: .__ L , � � � .m APPLICANT'PERMITEE SIGNATURE ISSUED BY:SIGNATURE . � , Total Fee: S j:� � �' s ' DateReceived: DateAporoved: Entered Bv: �� Pe:mit;`: ��_`� �° '%" ��`- CITY OF ORONO - BI��II.DING PERi1�IIT �PPLIC�TION :�LL ��'ORtiI�TION I�IL ST BE SL�1�ITTTED � FLZ-L BEFORE PL��1 REVIEti�'tiVII.L BE ST:�RTED --____--_----------------------------------- THE �PPLIC:�ti`T IS: w (,circ',e one) O«�ER R CONTRACTOR JOB SITE �DDRESS: %/�7% �/mwoc� d z�: �5�3� �-% �1�'�fE OF O`V�"ER: �� G��"��%C /C PHONE: (home) �f'T`o2 ��,�3 (�vor�) �Ta- i/J � �IAIL�G�DDRESS: �S'��/��: CITY:�rD�d ZIP: CONTRaCTOR: �c� C�'�✓,�C�C/� PHONE: 1�10BILE PHO\�E/PAGER: 1�IAILING�DDRESS: ��IY/G� CITY: Z�� ST:�TE LICE�ISE: � �RCHTI'ECT/E:�GLv`EER: PHO��E: 11�ILL\G�DDRESS: CITY: ZIP: N�tiIE: REGIS'I'R��ION n TYPE OF `�%ORh: New �i'D�� ddition `''��son'L��t�non ��Iove Remode'�:�lteration PROPOSED`VOR�i(describe indetail): �`��7r' �' �� d �G�� `j` /�7 S f��ii i'� � �� i"��' �- �d �✓'S STORIES: = SQ• �ET OF EACH FLOOR: �,Tp, pF BEDR001�IS: G�R�GE ST�I.LS: :�TT. DET. ESTLI�IATED CONSTRG'CTIOti V�,I.U?�TION(eYcludin�land): � /�� I hereby apply for a buildin� permit and I acknowledae thaL the information above is complete and accurate; that the work will be in coniormance with tne ordinances and codes or the C:ty' and with the Stace Buildina Code; that I understand this is not a permit and work is not to start withouL a permit; and that the work will be in accordance ��ith the approved plan. PLIC�tiT'S SIG�ATURE: � � ��./f�,> DATE: � �C� / � �iP . iVOTE! Parade of Homes events require separate permit a�proval by Police Departmenr and C1ty Council 60 days prior to the event. Non-permirted events will not be allowed. , I ' � . t Szc.13.04 RIGHTS OF StiBJECTS OF D�T?, Subd. 1. T}�pe of data. "Ihe nghts of individual on whom[he data is stored or to be stored shall be as se[Torth in this secdoo. Subd. '_. Information required to be�ven indicidual. .�.n individual asked to supply private or confidendal dac3 concecning himself shall be iniormed of: (a) the purpose and incendzd use oi the requested daca wi�hin the colleccing'state aoency, pol[dcal subdivision,or sta[ewide system; (b)whe�her he may reiuse or is le�ally required to suppiy che;equested daca;(c)any known consequence arising from his supplying or refusing to supply private or confidennal daea:and(d)rhe idendcy ot other^ersons or er,ades authorized by state or federal law ro receive the data. This requirement shall no[apply when an individual is asked to supply invesoganve da[a. pur�uant[o seccion 13.32, subdivision�, to a law enforement orficer. The commissione: oi rever.ue ma� olace �he r.odce reeuired under chis subdivision in Lhe individual income [az or vropem tax refur.d ins�:uctions inscead uf on �nosz forms. Subd. 3. .�ccess to data by individual. L"pon reauesc[o a responsiblz au[honty,an individual shall be inforcned whe�her he is the suoject ot stored data on individuals, and whe�her it is cfassitied as puolic, pnvaee or contidendal. lipon his t"ur[her request, an individual who is[he subject of stored priva[e or public data on individuals shall be shown the data wi�hout any charge to hun and, if he desires, shail be informed of the conien[ and meaning of tha[data. .-�fter an individual has been shown�he pnvate daca and informed of ia meaning, the data need not be disclosed to hun ior six months[hereatter unless a dispu[e or acdon pursuan�:o �his secdon is pending or addidonal data on the individual has been collec[ed or created. The responsibie aurhority shall provide copies oi the pri�ace or puolic data upon request by[he individual subject or the data. The responsible auchority may require che requesnng person to pay the acmal coscs of malcing. cerdfying, and compiling the copies. The responsible authonty shall comply immediacely, if possible, with any request made pursuan[ro this subdivision, or within five days oi the date otthe request, excfuding Sa[urdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannoc comply wich[he requesr wi[hin[hat cime,he shall so iniorm the individual,and may have an addidonal five days wi[hin which to compiy wich the request,excluding Saturdays, Sundays and legal hoiidays. Subd.4. Procedure when data is not accurate or complete. An individual may concest[he accuracy or completeness of public or private data concemine himseif. To exercise chis rieht,an individual shall notity in wri�ing[he responsible auchority describing the na[ure of the disagreement. The responsible auchori[y shall wichin?0 days ei[her. (a) correct the data tound to be inaccurate or incomplete and attemot to norify past recipients oT inaccurate or incomplete data, includine recipien�s named by the individual; or(b) nodfy the individual that he believes the data[o be correct. Data in dispute shall be disclosed only if the individual's stacemen[of disagreement is included wich the disclosed data. The determination of the responsiole auchoriry r.iay be appealed pursuant to �he provisions of the admuustradve procedure act relanne to conces�ed cases. DaT:� PRIV?,CY aDVISORY In accordance wich M.S. 13.04, Subd. �, "Rights of subjects of data", we would like to inform you that your request for a permi[ or license rrom the Ciry or Orono or any of its departments may require you to furnish certain private or confidential inTormation. :ou are r.ocified chac: 1, The information you furnish will be used to decermine 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. Ihe information may be shared witn ocher 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. �, You have certain ri�hts under �1.5. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. r � �-�,r�/C� c First �tidCle Las[ � �/� �� ,�� d /� � ,:� Addres / %� � (y J�,� �� .�.3 <n Lf �� 4 i Ciry Sta�e Zip Phone I underscand my rights as stated above. Signa[ure