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Home My WebLink About1999-011696 - tear off reroof E °`-- PERMIT �vITY OF ORONO PERMIT TYPE: 750 Kelley Parkway - P.O. Box 66 _ ;,rystal Bay, Minnesota 55323 Permit Number: _ :;� �; ;_ _ (612) 473-7357 Date Issued: :��, i _.�_=+�.� � SITE ADDRESS: _ ._—,,:;,:..� _,:,Is,:.� _ . .L_ :=f�i=��_�-.. ..__. _ . _� _- - — —_ — ;_��- — — DESCRIPTION: . - . ". _::f-�= !=:��;i�i=;� ='t�`'s }.t��``�_„ -'?'+t11.i..P.�*{�.._ W+j""'_�.za ?{ 'i i'•.i._i'��_�#J�E — -'- =t'f j't,"j:� �t:i�i)'�:; i ':�:r? F:;-.:_..,`-','!_4{_;I- _;!�n_!� _.si;�;:', �:{..,-:'� ;�-t;.»� . i:1r`_=��_`_��3 i �%-3=_ REMARKS: FEE SUMMARY: _.. _%€_'`[�: i t_.�. . . ; i_�� _ ��=._.� : ='}' •=.i �. �. . �_. '_..'�. ._.. _.. ._.._.._._._� - I �wt i.r; i -�.��_ "•f �_ . �'_? CONTRACTOR: . , OWNER: _ :.�;��- ._ i��.�;� _ — =��" . .__ _. � _ _ � — - - - -- - - _.. .._ .- . . ._:t_. _.:._ �e,.. _��-�;°� �-��t_=_ . . , ___ {.;_:�-'�?`_. �°�-— � '�v s r's' � `�:;f�;��;��ar`_:°_; ='i�i�j�=�; �°�k __ � _� ;`''"t'"•:��._ .��' ._1__''�_ _ . __ {`''_i_al ._ `_`_. .. .I - . . s. _ _.._.. . _ - _ .- - � =.,,s,�__. .. ..,—. ._.f. {- v!.r ;a. ._. _.�'.�w� r i_�r:�f�. } �.L : :: -;;' -� I :- _ �1-: 6 ._ i�.� . . _ ?'��Y:, .� . . .._ C.';",�„v't j#>?�.:��.�_ . _:.T __;'`� � - . . . -�y_^ - - —. _._ �_ _ . _ . ... , . , � �T'>.�'j .�7;'.,{'S : ' •y?.� L i}+..�i' 'e.{�;'°�.: �"'..—S(°Ei"t `• t,z�ii� ' � i^�i :�•i r-=-,., i - F' - -Y.t - (yt-«t F`: -- - _ 2`F� � � . i t I t 3n -; �., '•� s�i i �y ,'. .. ,i. j .,;•}�t' " .. . F ! _ L : : � i ._.. L •i._ . ._ _ . » . _ . _•�_ _ . . iµ_.. _ ... ..__.. .. _ _ _ __ .. ... . _ ._., ._._ . . _ . � _.. ._ . ._ .... ` J � arn� � APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE � . G' Total Fee: $ //�3� S � Date Received: � `�� Entered By: Permit#: _!I o��(� CITY OF ORONO - BUILDING PERMIT' APPLICATION � I A.11 information must be submitted in full before plan revie�v �-ill be started. . (please print all information) THE APPLICA.ri'T IS: ' (circle one) O��NER OR CONTR.ACTOR � ' ZS� �A ��=r2rti��sl zrn: JOB SITE ADDRESS: ; � I�'AI�IE OF Oti�TER: C-v''t�r' S 1 A T`�_S PHONE: (home) (work) � �' � ZIP: �IASLING ADDFESS: I-1.�- S r1fi��r��,� CITY: CONTRACTOR: ��,�', � C i�- � ,.7�� C�� . PHONE: � /� � � S -� � CON'TACT PERSON: b �� lYiOBILE/PAGER: �-� 7 — 3 � r � MA1LI�'G ADDRESS: s � S— �_`-��,�,._ � _ CI1'Y: r'� L�,., r�..I ZII.': s s 1 E � � ;� STATE LICENSE: # _ �;� `i � ARCHITECT�E�GII�TEER: PHO`'E: � �7A.ILI�i'G ADDRESS: CIT'Y: ZIP: �T�ME: REGISTRATION� TYPE OF S'4'ORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration _ '`- � �� 1�.� (Z a.=! �` PROPOSED'�YORK(describe in detai�: ► �`7`s f� � STORIES: SQ.�'EET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � . . . . . J,3. . ESTIl�IA1 ED CONSTRUCTION VALUATION (excludi.ng land): $ �`�� `� - I hereby apply for a buildino permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance wich the ordinances and codes of the City and with the State Buildi.n� Code; that I understand this is n t a permit and work is not to start without a pernuc; and th�� the work will be ' accordance w th th �pproved plan. � �� --- APPLICA.i�"T'S SIGI�'AT'URE: � DATE: �— �� t� NOTE! Parade o Homes events require separate permit approval by Police Department and � City Counci160 days prior to tke event. Non permitted events will not be allowed. . J . . I . 5ec.13.04 RIGF�'S OF SUB,TECTS OF DATA ' Subd. 1. Type of daca. The righcs of individual on wham the dam is scored or ro be stor.d shalI bc as sct forch in this secrioa � Subd.2. IaformaGon reqirired to be given iadiridual. An individual uk:d w supply privam oc confidendal daca concerning himseif shall I� be informed o,`: (a)[he purpose aad inrendcd use of the requessed dam wit4in the collecdng Zate ageaty,poliacaI subdivision,cr sra�widc rystm; � . (b)whec,`.e:he r.3y r.`use or is,legally tequir.d to supply,the rquesud data;(c)any Imawn caasrqucnce arisiag from his supplyiag oc refusing to supply I privace or con.=tdar.dal dati;and(d)ehe idendry of other per�oas orenddes au�orized by sc�ce or federal law co rrceive t�e daca. This r_quire�cac shall � not apply w�en an ir.dividual is asked to supply invesagadve daa,pursuanc ta secdan 13.82,subdivision 5,w a law enfatcement officer. . 'f�e ce_clmissioner of revenuc mav oia;e the nodc- r�uir-d und-r chis subdivision in the individual income eiz or orooem tax refund insrrucdans inscezd of on chose forms. Subd.3. Aecess to data by indiridual. Upon requesc to a responsible aurhoriry,an individual shall be informed wht[her he is the subject � of swr.d dan on individuals,and whecher ic is class�ed u public,privaee or conEdenaal. Upoa his furcher r_quesc,an icdividual who is[he subjecc � of scor.d private or public data on individuals shall be shown[he daa wichout any charge to him and;if he desires,shall be infocmed of[he eonten� ar.d meaning of that data. Aher an individual has been shown the pcivate daa and iaformed of ics meaaing,the dara aead not be disclosed to him for I six moncfu theceafcer unless a dispuce or acaon pursuanc to tivs secdon is pending oc addirioaal dac3 on the individual has been eolle:c:d or ereat�d. Tae resporuibie aud:oriry shall provide copies of che privam or public daca upon request by the individual subjcct of[he dam. Tha respotuibie autfiotiry � may requir_ �he r.quadng per�on to pay the accual eoscs oi m�king,eertifying,ar.d eompiling che eopies. The r.sponsible authoriry shall eomply immediaccly, if Qossible,wi�h any request made pursuant to this subdivision,ar wichin five days of the date of the request,ezcluding Sacurdays,Sundays and legal holidays,if immediace compliacce is notpossible. If he canaot comply with the request wichin that dme,he shal!so inform the individual,and may have an addidooal fiv:days wichin which ro comply wich the request,ezeiudiag Satuidays, i Sundays and legal holidays. . Subd.4. Procedure whea data is not accurate or eompiete. An individuai may conc:sc the accuracy or eompieceness of pubtic or private dam concerning tiunself. To exercise chis right,an individual shaIl noafy in wridng che responsble auchoriry dascribing dse naeure of the disagreemeac. 'Ihe respoasible auchoriry shall within 30 days eict;er: (a)correcc ehe data found co be inaccurac:or incomptece and attempc to nodfy past recipienc�of inaccurate or incamplece data, including recipieacs named by [he individual; or(b)nadFy the individual that he believos the data to be correc4 Dati in dispu�e shall be disdosed only if the individual's statcmenc of disagreemenc is included with the disdosed data. j The dtcerminaaon of the responsibla auchoriry may be appealed puc�uanc to the provuions of[he admuuscrarive procedu�e act mlaring to ; conmsud cases. . 4 DATA PRIVACY ADYISORY In accordance wich M.S. 13.04, Subd.2, "Rigbts of subjeccs of data", we would Iike to inform you that your request for a permit or license from the Ciry 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 qualifica[ion for the permit or license requested. 2. You may refuse to suppiy data, but refusat may require that the City deny the permit or license. 3. The information may be shared wich ocher local, scace or federal agencies to the excent 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 certa.in ri�hts under M.S. I3.04 (availabie upon request) to review private data on yourself. 6. Your full name is required to process this applicacion or perm.ic. l��)�-n.,�,�-� � ��n�� -j� First �fiddle I.asc � � �J � � � � N �s� i� ✓J t,�.�� Addreu �y'1'��v,�...-7 a�r�'� �S� � � �� t-1 �7�:3- — � �- � c3- Ciry ( Sate Zip Phone —� \ ', I underst d m ri�ht9!as"stated al�o've. '� (, �� ` / � � �/ Signacure