HomeMy WebLinkAbout1990-003332 - repl windows/shtrock PERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357 �'`-'��-'��r�'�
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER:
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� y � "JT f'�RMI F GNATURE ISSUEDBY:SIGNATURE
CITY OF ORONO - BQILDING PERMIT APPLICATION
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Total Fee: $ Date Received:
Date Approved:
Entered By:
Permit#:
AT.T• INFORMATION MIIST BE SIIBMITTED IN FIILL BEFORE PLAN REVIgW WILL B$ STARTED
(See Check-off List Enclosed)
-------------------------------------�___---------------------------------------
T`HE APPLIGANT IS: (circle one ) OWNER CONTRACTOR
JOB SITE ADDR$SS: � ^ v �(/��; � ���- ry�>ff N^ ,� ZIP: -..� ��. ��
(work)
NAME OF OWNER: � y Lt�'6�'_� PHONE: (home) �`�7� --��E� T
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MAILING ADDRESS: ��f / .� 1"��G�'• � _r UC�_ �: ���?�'i�r"? ZIP: �.�.(� `�
CONTRACTOR: PHONE:
�S.�ILING ADDRESS : CITY: ZIP:
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORR (describe in detail) : f/� ����( �'•n�`�� ,�� �,�f�i=,c'-•.� Q� !���:'��%�./ti
STORIES: SQ. FEET OF EACH FLOOR: ���'� � _
NO. OF BEDROOMS:�_ GARAGE STALLS: ATT. DET. /(/�i f'�' �
ESTIMATED CONSTRUCTION VALIIATION (ezcluding land) : $ ,,�,5� �
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.
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APPLICANT'S SIGNATURB: � DATE: � � ,
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��4�`� � ���: CITY of OROLITO
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�' " "� � �- �" `� Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
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� � • ��Y��`{ On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike 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 wil.l be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or 3icense.
3. The information may be shared with other iocal , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or Iicense requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review privat�
data on yourself.
6. Your full name is required to process this application or
permit.
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First Mid Ie Last
'��%'� �N��:�. 4A./�.r G�el��`'o'�'u
Address '
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City State Zip
�.�� � �. �-;_
Phone
I understand my rights as stated above.
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Sigriatu
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BUILDING&ZONING—473-7357 • ADMINISTRATIOIY&FINANCE—473-7358 � PUBLIC WORKS —473-7359
ASSESSING
513.04 RIGHTS OF SIIBJECTS OF DATA
Subdivision 1. Type of data- The rights of individuels on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be g��� ����' An.individuel asked to
suQply private or confidentiel data concera a tBmWit�h�in the collect ng state agency,
purpose and intended use of the requeste �b� whether he may refuse or is legally
political subdivision, or statewide system;
required to supply the requested date; (c) any known consequence arising from his
supplying or refusing to supply private or confidentiel date; and (d) the identity of
other persons or entities authorized by stat�u��e�kedlto supplyin est gat ve data,
requirement shall not apply when an indiv
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue Tng rolertv tax re�und instQuctionsunsteadhos
subdivision in the individual income tax •r
on those orms. . -- -
Subd. 3.
Access tc �ata by in�vidugl' Upon request to a responsible �
authority, an individuel shall be informed whether h=�gteeor confident alre Upon his
individuels, and whether it is classified es public, p ublic data on
further request, an individual who is the subject of e to himrlande if he desires, shell
individuels shall be shown the data without any ��'g After an individual has been
�e informed of the content and meaning of that �tthe data need not be �isclosed to
shown the private data and informed of its meaning, ��uant to this section is
him for six months thereafter unless a dispute or action p
, � pending or additional data on the indivif�e h� a e or p blic datarupongrequest by
responsible authority shall provide copies o P require the
the individual subject ofthe actual.costs of making,lcert fyingyand compiling the
requesting person to pay -
copies. immediately, if possible, with any request
The responsible authority shall comQly
made pursuant to this subdivision, or With lide e,�f Simmediateat ompliance e��.su not
excluding Saturdays, Sundays and legal YS
possible. If he cannot comply with the reQfive dat� withint hich toh omplynwi h the
individual, and maY ha�e an additional YS
request, exeluding Satiu'davs� SundsYs and Iegal holidays•
Subd. 4. Procediu'e �►hen data is not accurate or comQlete. An individual may
contest the accuracy or completeness of Pnot f � inrlwrit ng tthe�responslb e au hor ty
exercise this right, an individuel shall y �ible authority shall within 30
describing the nature of the disagreement. The respo
days either: (a) correct the data found to�e� lete dataeincludingreec pients namedt by
notify past recipients of inaccurate or inc p
the individual; or (b) notify the individu e in�v dualeslstatementof disagreernentcis
Data in dispute shall be disclosed only if th
• included with the �sclosed data. � 8ppe�ed pursu8�t to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.