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Home My WebLink About1999-011364 - tearoff/reroof PERMIT CITY OF ORONO PERMIT TYPE: 27� Ke!I�,c Parkway- P.O. Box 66 - - - - - Permit Number: ° � � � � - Crystal B��, Minnesota 55323 Date Issued: '-''=j�'.=��=°'�-�N' (612)473-i�57 ��::ti.r___. � - '_�'� SITE ADDF�ESS: =:�� , ..-;�_. .�._.=:;�''. �� E'•i —i i�-— —<��..—�i:!7.-` DESCRIPTION: 3��',F:f i'r-i-;:�';-�;`�f;�;�= ��.�{�. 4 i1�.}Z°� ��?=�~{3:_�. ..•._.�=F�. . .�. ... _. y 4....�{�,,,��1�L�i� .'�.t.1��i�f�S�i_.. �j{y`i �i...t�.i lv L:;�IWi Y L:. 'i. ' r ("':'�.��...��;,E�_t�... ;=F`�= i_:r?il y l.�r ��t��_ cj.;�.;:{. i=si._� . E?s�`•��.L 4Jj_j•i�1 r�L.. REMARKS: FEE SUMMARY: V;V;_._lii-�i i ��i#`u , ;,f�� j':_ . _ f _;. t��.�a,'�;-_' f-:::' �'�'-� , ''-� ��3_i;�r_:`�._:E'��:'� _...__,._._._ �'�• � t„�:.:�,a,i r r�� M�.�j..... � .�.�a� CONTRACTOR: _ :�;;�:�:; ; ;_.�,;�,�. _ ._;-� � �;-; .OWNER: ____- r;�' _€v�r,�°_:i�i t_ti�:!?!_�i:°,i 3,(�Ji�:' i`� _`��_` i i{_%_)::��:::°:?�' i_';_ :. - g�=i _ -;�i��• s`•3 i-�;:,�� i ()[„1 _ _ s`;�:-`s'��;�.�==i'`:�'.Y �'''�._�_ .. _. . .,.. -. - - - <-� : r,Er,:r.-.'�-`�.fi i:- f': --�.;�.. -tl�tF:;�j �ri'e "� ;�; �'� : : , � . :,,.,: r�,: . . ,._ • -, � �'... . ._ _ _ _ .. .. . ..i i.:.. _ ..�_ ._ . .._ ._.. .. ._ ,....�. .�._ r,. _ �_ - ..�. ' . . .. .� .: ..� ^{ . .. ..... �._i� 1..fL_t- � [� ' ', ',.,; �', _ , ': ._.? �( Ci.%3`�'r,:,�"',.:_. S •:' 1__�?_.!"'.j°�.L•� ' {3_.v'.� �i„{ i }F-ie�..� . . ._., �.�.. .__ _��., .I_.'i4__. I...'.? . . ... . ... ...._ . ._.._. , � i >;i��-;-- < <�� {,,' � 4 �`7 -� ! - S t .4�i 1 �: r.,E i r"'i= s�1; `�.I i '".I�'.. i-��._:. ;'-�'_ _t . ='_1`�� _-i�'•;�.:�._ . . . . . . _ . _. .�� ..__ - - - - - • - — ��_�:�,.,; � _ - - � - . - - , t„� ,;��._. �k t , .,.,W•_..._. .�y�: '•ryi' f'; � f\i(;:'" -�3 �~t�-i •�l1 ; {�, !- .t :•''3= � .. ._ _. ._. _. . . . . _. _.. _ . ___ .„ . . _. _ _�_ _. . _ __. _. ._... , _ . .».�. ... . . _ . � C l A CANT%PERMITEE SIGNATURE SUED BY:SIGNATURE Total Fee: $ / � �- `� � Date Received: Entere� By: /3'I(1i Permit#: �13 4 �. CITY OF ORONO - BUII.,DING PERNIIT APPLICATION All information must be submitted in full before plan revie�v will be started. (please print all information) -----------------------------------------_ __------------------- -- -------------------------=-- THE APPLICAI�'T IS: (circle one) OWNER OR ONTRACTOR JOB SITE ADDRESS: �� `� (� (" � �e v� �' �,�� I 1 ZIP: NA1�iE OF O`VI\'ER L,� � w� U� (� � �� PHONE: (home) ��=� �vl �I (work) �IAILPIG ADDF.ESS: CITY: ZIP: � � � — CONI'RACTOR: �'�I��v� �(��v�S l , PHONE: � �� CONTACT PERSO�': �e �u-� MOBII,E/PAGER: �(�3 �-'�� MAIL�'G ADDRESS: 33 l '-� 1�1 � � w�'� l u() CITY: C r�S� ,/� l ZIP: '��- STATE LICENSE: # �3� � `( ARCHITECT/ENGItii TEER: PHONE: �IAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration ✓ Land Alteration �PROPOSED WORK(describe in detai�: /��/�F ��'��'�� `�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDR001�1S: GARAGE STALLS: ATT. DET. ESTII�iATED CONSTRUCTION VALUATION (exclud.ing land): $ `�, � �, 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 pernlit and work is not to start without a pernut; and that the work will be in accordance with the approved plan. APPLICA��rT'S SIGNATLTRE: �'� % DAT'E: �� % % R'OTE! Parade o 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. Sec.13.04 RIGHTS OF SUBJECTS OF DaT.� ' Subd. 1. Type of da[a. Thc righcs of individual on whom[he data is s�oced or co be stnrrd shall be as sec forch in this secaoo. Subd.2. Information reqtrired to be givea indiridual. ?.n individual asked to supply private or confidearial dam coacerning himself shall be informed of: (a)the purpose and incended use of the cequured dam wi[hin the collecting�tate agency,polidcai subdivision,or smcewide rystem; (b)whet}:e:he may refuse or is.legally requir.d ro supply che rquesud data:(c)any latown coasequence arising from his supplying or refusing to suppfy private oc conndenda!dara;and(d)the idenary of ocher persoas or enrides authocized by stace or federal taw to receive t�e data. This requirement shall noc apply when an individual is asked to supply invesdgadve data,pursuan[co secdon 13.82,subdivision S, to a taw enfoctement officer. The ee�missioner of revenu� mav pla-� che nodc- r�uird urd-r[his subdivision in the individua! income t{x or oropem taz refund instrucaons instead of on those forms Subd. 3. Access to data by individual. Upon request to a resQonsible aurhoriry,an individual shall be informed whether he is ehe subjecc of stor.d dac�on individuals,and whecher it is classifi:d as public, privace or confidendal. Upon his furcher request,an individual who is the subjecc of stoted privace or public dara on individuals shall be shown[he dam wichouc any charge to him and;if he desites, shall be informed of the contenc ar.d meaning of rhat dara. After an individual has been shown che privace data and informed of ics meaning,thc data need not be disclosed ro him for siz monchs chenafter unless a dispute or acdon pursuan�co this secaon is pending or addidoaal dam on the individual has been collect�d or creared. The rosponsibte au[horiry shall provide copies of che priva�e or public data upon request by the individual subject of[he da[a. 'Iht responsible authociry may tequire the requesdng person to pay the actual cosu oi making,cerrifying, and compiling the copies. 'Ihe responsible authoriry shall comply immediatety, if possible,wich any requesc made punuanc to this subdivision,or wichin five days of the dace of�he reques�,ezcluding Sanirdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply wi�h the requesc within[hat dme,he sha(1 so inform the individual,and may have an addidooal five days within which to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. P.n individual may eontest tha accuracy or compleceness of public or private dara concerning himself. To ezercise this right,an indiviCual shall noafy in wriring the responsible au�horiry describing the nature of the disagreement. The responsible auchoriry shall within 30 days eiti:er: (a)correc�tha data found to be inaccurate or incomplete and attempc to nodfy past recipiencs of inaccurate or incomplece data, including recipiena named by the individual;or(b)nodfy the individual thac he believes rhe daca to be correct. Data in dispuce shall be disclosed only if the individual's stacemtnc of disagreement is included wi[h the disclosed data. The decerminaaon of the responsible au�horiry may be appealed pursuanc to the provisions of tha admuristrarive procedure act reladng to contested cases. � DATA PRIVACY ADYISORY 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 permit or license from the City of Orono or any of its departments may require you to furnish certain private or confideatial information. You are notified that: 1. The information you furnish will be used to decermine your qualification for the perm.it or license requested. 2. You may refuse to supply data, but refusal may require that the Ciry deny the perm.it or license. 3. The information may be shared with o�her local, scate or federal a�encies to the eLtent necessary to process the permit or license. 4. If your requested permit or license requires Couacil action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 (availabie upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. ,�l/f ��;��✓, �/�t�./�/� First �fiddle Lasc �}� S .� /��C�� -��0 � /4�'� �-��l S',�-r�+- 1 y�� Address - Ciry Sace Zip Phone I understand my ri;hts as st ted above. � Sign ture