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Home My WebLink About1997-009167 - re-roof/tear-off _ _ _ . _ . . .✓ . � . PERMIT �IT�'OF ORONO � PERMIT TYPE: - 2750 Kelley Parkway- P.O. Box 66 - - � ' -� Crystal Bay, Minnesota 55323 Permit Number: ; ��.;�.��:�4�4 (612) 473-7357 Date Issued: SITE ADDRESS: . .. _. _ .-:..�_.�:x.�.__ _ , v _.. . :�'�� DESCRIPTION: _ _ .. _ .. _..,._ _. - . , �.;.: ._.; , >.;;._.._..�� ., :'r.. ._. � _ ,,...r. �:.. - - _ __ T�r�� d�__�;;t s`�i"',�`::V `*'>f~4!1'—� .� ._._ ... .,__`�'.= . :.. •.'!:i�. . . —. ..»_ . .._. ._ ._ E..�i..._. ��.• ��1 j: _i__{i i�� l/�i_�3: e:, �si, .., !':L... ._'_. — ��E-±�:; (�,._:;�, r��!,, `t`�_'.��1'��4 i .k�-iE..._ _��l��'s'1 _ _. .�: _ REMARKS: FEE SUMMARY: . .'�:;_..=:t-�� . _ � -. ". _ . _ _ - -_.�:�� ;-:�-� � _ � �'� "p' "' ' — _�.i _._j�~...! �C7.!~ . ..�.........�..�..�..� t,i_i 7J_.�. . ._L'? ��.. . .t.. CONTRACTOR: OWNER: .... ;,,:_- : : ,;: ..�,,_..; _ - - .��:�:::;:•� - _- _. . . .=��-.��:� _. . ��_;�� °;: ... .._. .., . .'�'# .�4 ...i'� � _ _._ __ •r : 3. :.... { .,� 4_:j {�`^'. i ..,_ 9. . t i �� .. ..'} _.._ . . .. . }.�� .� ....!'v,.....M i � . ._ . ;— y , f� t; . . _ .�F_ .� _. � K t. . ... z . � y :�T s � , �..,�. . . ... .�..,_.. �. _ .- . .�_... w: . . .-•. . . �_.� . � .i � . f � . �_t f = j „ ;,3� s;`��.� . , � ... ._.. �° �_ .. ii� ._ _ _..�._ _ ..._ _. _.....__ , .i_cwtt_P.`._. ,_.� I":_ . f�";. F L ._ ._. . .U.� , _ .._ . . ._ , ` � ' r I . . . . .. , s _J X � APPUCANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE � ' Total Fee: $ Date Received: Entered By: Pernut#: 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) OWNER OR CONTRACTOR JOB SITE ADDRESS: �`1�3 ��c��rl<<S �� c� ZIP: �� I_ r+ NAME OF OWNER: �I (Cl,�'� f C�Ule I 1�t �� PHONE:�(home) ��I ��1 �� (work) ��o 'C�a S � MAILING ADDRESS: IQ I� �cr nC S� �� CITY: Oro�D ZIP: r�" �3� / CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: . 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 detain: ��' 0� �� 5(ni i�q�� . � o n 1'IELv �11 n(LR��.S � �l2 L1-�P f()CC� ��h1�It S �u.( C►'�_� 1"5 • STORIES: I SQ. FEET OF EACH FLOOR: I � �� NO. OF BEDROOM5: �� GARAGE STALLS: ATT. DET. �. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � 1 �� 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 pernut and work is not to start without a permit; and that the work will be in a ordance with the approved plan. arr LICANT'S SIGNAT : � �� DATE: �'�� NOTE! Parade gf Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. J Sec.13.04 RIGHTS OF SUB.TECTS 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 reqirired to be given individual. An individual asked to supply private or confidential data conceming himself shall be informed of: (a)[he purpose and intended use of the requesced dara within the collecting'state agency,political subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data;(c)any lmown coosequence arising from his supplying or refusing ro supply private or confidenrial data;and(d)the idenciry of other persons or enriries au[horized by state or fedecai law to receive the data. 'fhis requirement shall not apply when an individual is asked to supply invesriearive dara, pursuant ro secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the norice reauired under this subdivision in the individual income tax or propertv tax refund instruccions instead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and wherher it is classified as public, private or confidenrial. 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 rhat data. After an individual has been shown the private dara and informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acaon pursuanc to this secdon is pending or addidonal 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 individuai 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 authority shall comply immediately, if possible, with any request made pursuant to chis 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 addicional 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 pm�ate data conceming himself. To exercise[his right,an individual shall notify in wridng the responsible authoriry describing[he nature of the disagreemen[. T'he responsible authoriry shall within 30 days ei[her. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of inaccurate or incompiete data, inciuding recipients named by the individual; or(b)noafy the individual that he be(ieves the data to be correct. Dara in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relacing to contesred cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. T'he 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. g, 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. ��,�� f� L �,�, � �� - First Viid�le �� iast )q�3 � r�� Address_ rd`7Q i '" 1/v ��J 1� ��I��L( � � � Ciry State Zip Phone I un rstan my rights as stated above. � c..Pl�v C � Signarure