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Home My WebLink About1999-011295 - tearoff/reroof . , PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 �-;�_3;; �;�;;�;; Crystal Bay, Minnesota 55323 Permit Number: t j_ . ._._i4 (612)473-7357 Date Issued: _ T _ v . f- SITE ADDRESS: ��. . _ i#'!�.`,_f'+%�_i� ,_,=t�.,� '-:;I: i:,t-j _ 'i t-•,,�i - _ - - "',��1;{:S DESCRIPTION: w...F�-1�'i��Tit"L' ;�'i�:"iRFYii �� _;_ _ �7 �;;� , y,-1'(ii i �.. ..`.t`f�}�,�. . .�. ... _.. _;R-—3��f:'•f�l;��'`+W�'I=_=1_!t`_L t-;f : i'"�� 3 i��; $u.�;"'�i�:: `-:1-—�i`�i;y t_�i�'�=�:� _ �.�:.=. .. . . , .... 4•==� Ht_T . `'•`.`�:�s!•'•`I'•�[!1F�i_ REMARKS: FEE SUMMARY: ::;�;�T�`ti�,3 " - . i:iiii .__..-_ �=��._ . ..°:�`_=� �`� :,-�{�i`f.r:=:1''�}:: w�.._.��_. -_ _ � i�}F._i,i {'"'F"F: . .._� . ��. CONTRACTOR: OWNER: _.. -- ; ;�;;} � y,'^S�.},;EY� f�... , -=�:-s`,iii��=�_� - - ;r Y �`s;';`.3i s �i'- :-�,;;J _._.. . _. •�-� _i-%�C.� i_ij��_�iti_� . .. . . . _. .�.�. - {• = -�- -- _ - - -- _ _;.i; '�i�.i - � - - -� - �i:��`�t: ' �E s`..._ Z_•I`•.i',.t�=i"�_.�:Z;_;v`__�i . .._?j`_ . .._''i`••'._'_ , _ . .�.^.� �.�.�:.,: I a...� . !~;_� #';:`"�`:.i: ! `..._ . ._._..'c_ r t ,.. . ._ . _.ir4.,.� _ ,< < � L r��:::�s` _�i' ?.� .t.. i-�i•:f:�;-- i�3 F i_ i l�`.,� � i F: € i. i.t�li'';�` t,S ;.., _.;�r �� :�� t �` : . . . � � , r;� : ,, . �� Y� _ .. _.._. .. _._.. .. . . { ._.. _. _ . _ _ _ _. �.-. -.-.-, ,- - - . '4h'i Ei`:t' ; ' '�;'( '; tj� ,! a:. " � -- '1 s {i.� - .1,"', •�i ;'. •; L �_. ._ ._ ..�• ;_ . •.,:: ._ : �� . __. _ . _. . .__ _ _ . . ._ _ _ _. ._ . _ _ ___ .._ . _. ..._. .... . . _ . I . _ . . . ... J � ��"�C�.J ( APPLI A� T PERMITEE SIGNATURE ISSUED BY:SIGNATURE � ��-� f 1 Total Fee: $ Date Received: Entered By: .C�� Permit#: ' � ':�� CITY OF ORONO - BUII..DING PERMIT APPLICATION All information must be submitted in full before plan revie�v will be started. (please print all information) ------------------------------------------ --�------=------------------------------------------------ =-- THE APPLICAI`'T IS: ctrcle on ' OWNER OR CONTRACTO�' �c �� c� v"r�� + C�,.� . � — c.v�. �'rr�c �J� �v'1��.�c; l�rky`f J JOB SITE ADDRESS: � �' �? S ��{e.-��G-, L �c �—'t{ ZIP: S `� 3 `�/ NA1�TE OF O��fi'ER: �l�vwtrt� J � ,��✓-�-•e v� k" PHONE: (home) ��73� i S ( � (work) �7�- g��;�b �iAILI�i IG ADDP�ESS: � Z`t��e-.�.�• /-G� � CTTY: Gt,/�1 y��ZIP: S:� �%/ CONI'RACTOR: I Gl c� � 1✓'�£'✓� �� Ct=�'�'^' a� PHONE: `t 7 .3 � cY��C� CONTACT PERSON: l Lt��s ��r.�ey� k MOB E/PAGER: � l�1 z-�"�� MAII�I\i'G ADDRESS: Z Z-�-S �r{?�d. L-�c �� CITY: �'v_,yz«��r ZIP: ".�5-3`1/ STATE LICENSE: # z-v v Zc� ARCHI'I'ECT/ENGINEER: PHO\TE: _ �ZAILING ADDRESS: CITY: ZIp: ---- rJAME; REGISTRATION# TYPE OF `VORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: ��' ` l��%C�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. �U ESTIi�IATED CONSTRUCTION VALUATION (excluding land): $ 1 7 �� 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. APPLICA��`T'S SIGNATURE: D�TE: � ,� � �� r NOTE! Parade of Homes events require separate permit approval by Police Department and Ciiy Counci160 days prior to the event. Non permitted events will not be allowed. l � . Sec.13.04 RIGHTS OF SLJB.fECTS OF D?�Ta ' Subd. i. Type of data. 'Ihe righcs of individual on whom�he data is sroced or ro be scorcd shall be as set forch in ctus secrion. Subd.2. Information reqirired to be given indiridual. An individual asked to supply priva[e or confidenrial dara concerning himself shall be informed of: (a)che purpose and incended use of the requused dam wichia the collecang Yute agency,poliacal subdivision,or statewide rysum; (b)whecf:er he may refuse or is.legally requir.d to supply che requesced data;(c)any lmown coasequcnce arising from his supptyiag or refusing m supp[y privace or confider.dal data;and(d)che idenary af ocher per�oas or enodes authocized by state or federel law to receive the dara. This requiremenc shall not apply when an individual is asked to supply invesd¢adve daa,pursuant to secdon 13.82, subdivision 5, to a law enfoczement o�cer. The ce^imissioner of revenu- mav pla-- �he nodc- rauired und-r this subdivision in the individual income tax or orooem taz refund instrucdons inscead of on[hose forms Subd. 3. access to data by individ�:al. Upon request to a responsible authoriry,an individual shall be informed whe�her he is che subjecc of stoced da�t on individuals,and whechu it is classified as public,private or confidenaal. Upon his further request,an individual who is the subjecc of stored private or public daa on individuals shall be shown che dam wi�houc any charge to him and,�if he desires, shall be informed of the eontanc and meaning of[ha[data. After an individual has be�n shown[he privare dan and informed of iu meaaing,the daca need not be d'uclosed to him for six manchs thereafter unless a dispute or acdon pursuan�to this secdon is pending ar addidonal dara on the individual hu been coilecmd or creaced. "Ihe responsible authociry shall providz copies of the privare or public data upon request by the individual subjcct of[he da�a. The responsible authoriry may tequir:che requesdng person to pay the accual costs oi makin2, cerafying,and compiling the copics. 'ihe responsible au�horiry shall comply immcdiately, if possible, wich aay request made pursuant to this subdivision,or within five days of the dace of the reques�,ezcluding Sacurdays.Sundays and Icgal holidays,if immediate compliance is not possib(e. If he cannot comply with the request wi[hin[hat dme,he shall so inform[he individual,and may have an addidoaal five days within which co compiy wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Ptocedure when data is not accurate or complete. rLz individual may contest the accuracy or completeness of public or private dara conceming himself. To exercise chis righc,an individual shall noafy in wridng�he responsible auchoriry describing the nature of the disagreemenc. The responsible authoriry shall wichin 30 days citt:er: (a)correcc tha daca found co be inaccurace or incomple�e and attempc to nodfy past t�cipiencs of inaccurace or incomplece data, including recipiencs named by the individual; or(b)nodfy the individua!thac he believes the data to be correcG Data in dispuce shall be disclosed only if[he individual's stacemenc of disagreement is included with che disclosed data. The decerminadon of the rosponsible authoriry may be appealed pursuanc to the provisions of tha admirustrarive procedure act reladng to concested cases. � DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri;hcs of subjects of data", we would like to inform you that your request for a pernut or license from the City of Orono or any of its departments may require you to furnish certain private or confidencial information. You are notified that: 1. The information you furnish will be used to decermine your qualification for[he 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 wich ocher local, stace or federal a;encies to the ettent 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 ri�hts under M.S. 13.04 (availabte upoa request) to review private data on yourself. 6. Your full name is required to process this application or permi�. i ,� 1 11t�i.�.. ��s J�� y �'u r� e ✓� - . First �fiddle Last Address Ciry State Zip Ptione I understand my rights �s stated above. ' =�__ Signature