HomeMy WebLinkAbout1998-010244 - roofing back side PERMIT
�ITX•OF ORONO PERMIT TYPE:
�150 Kelley Parkway- P.O. Box 66 +�,t 1 T E [:i i isi;
Crystal Bay, Minnesota 55323 Permit Number: ;`i�;_;���
(612) 473-7357 Date Issued: ;.�:_ ,_�;:;,w,
.e._ . i _ , ,!r
SITE ADDRESS:
>;�.1� �-I I���-i L:'-;
.F;;
�` � . �4 . � ��t�—� i ;—;�:;:_•—��;—i P:"'s i ;f
DESCRIPTION:
f;i�li!1- i :,;i� ��i;�:��:: ��i i;�—
t.�+..,f 1 �.t.:.�1 il'� t=`�a'#'��i T. �`,r'�'�' `=�F—H!!'.:r'f�`.=�f'f�_t?J`L
F:I�1 �,i�i i=s� ;a,'z=�t'k:; �'y�::=Fa �t_—�;`i�li�EF-
4:�'ll:=f�E:� ;_��is�' ��� �1!� . {;���_�I i+�i`•�!�I t-��_
REMARKS:
FEE SUMMARY:
;%:-.'f_t;'-i�11_��.� �� . !_��_;{_1
_�'j�_�C_' �}�+Y� `�}ie�i . C�_�
:_�itl'���Ic+�'�:� _�y�a.
� i '-`-------;—t •�:..
Srii.L i �'F_Y .T�r+��. ��,
CONTRACTOR: OWNER: - r��=�:i ; ti_;�;t. -
fi1;�h:�:::�:�r��, �;�_�:::
_u#�� }-:�t;�; i �:;
;!�_tl:�l # t�i1ti� `_��:S+��
il 1 L_ 's'�{"..
i4��!1... ijt�',�F��:'j�!'.71S�ii tJL`+'ti{r�`� ;'��E;�iiYy`.=��('_; �'`{•`�•;�`-�`�:jE_i�`.( .#'�i E`;�E�:.� T;-�i �'i..��.... i.�•;i='`��;`�t� 4� � {_
}�,
!
�� i� }' :3 ri�.ik� F'tM •L� ' S i { �,{�! i`-[��,,, yti:_i�"t�,•� �ik! �� �s��.�. i __.�_f`�t"'�f t L-:�'��_.� �!?� � �'! �"�1._� t•t E .Y �^i�"'
•��„...•�1� .f.'_�.._ . ' ! '!!t'�4 _. #'•. "
! f:�'7_i��;a" [�-�; +i ly�i;idy:�`v; {�tv�s� ��..[i-i�� �_s� �"'1 EV+�E�`._�f i�=? �.�i_���L�'i(�si� i:s�fiw+� jz°���,'�;_:j�°�;�(i���i`_;
� _ _�..— - �
�%!����•1 -
PLI NT PERMITEE SIGNATURE ISSUED BY:SIGNATUR
.._.....--
Total`Fee: $ Date Received:
f Entered By: Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------------------------------------------------------------------------------------------------------
T'HE APPLICANT IS: (circle one) O`'VNER OR CONTRACTOR
JOB SITE ADDRESS: � ��� /C' �1 � � ZIP: �j- �js �j
NAME OF OWNER: ��c� ��'!'L t�'L--2(N(� PHO�IE: (home) �-F��' 2�,6 �,
(work) �(7�--�i�'3 � )
MAILING ADDRESS: 5�--�-�' CITY: ,� ZIP: S�.�S�
CONTRACTOR: PHOivE:
CONTACT PERSON: MOBILE/PAGER:
MAII�ING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PH0�1E:
MAILI�i 1G ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
,
PROPOSED WORK(describe in detain: o�� �/�P�z �� �.
vC7 -- ,.�v�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET.
ESTII�i IATED CONSTRUCTION VALUATION (excluding land): $ � ���' �
I hereby apply for a buildin�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 Buildin; Code; that I understansi- is not a pemut and work is not to start without a
pemut; and that the work will be in c,� ance�with the approved plan.
,/
,�_
APPLICANT'S SIG " DATE:
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
—...`..._...
,
Sec.13.04 RIGHTS OF SUB.TECTS OF DaT?,
Subd. 1. Type of data. The richrs of individual on whom[he data is stored or to be scored shall be as set fonh in this secdon.
Subd.2. Informaaon reqtrired to be given individual. An individual asked to supply privace or confidenaal dara coaceming himself shall
bt informed of: (a)the purpose and intended use of the request�daca wi[hin the collecang 3tate ageacy, polidcal subdivisioa,or sracewide rystem;
(b)whether he may refuse or is legally required to supply the requested dara:(c)any laiown coasequence arising from his supplying or refusing to supply
• private or confidenrial data;and(d)the idendcy of other persoas or enaaes authorized by state or federal law to receive the data. This requirement stiall
noc apply when an individual is asked to supply invesdeaave dara, pursuant to secdon 13.82, subdivision 5, co a law enforcement officer. -
Tha comrussioner of revenue r-iav place cha nodc� r�ouirPd und�r this subdivision in the individual income tax or prooem tax refund
instrucdons insczad of on those forms.
Subd. 3. Access to data by indi�-idual. lipon request to a responsible auchoriry,an individual shall be informed whether he is the subject
of stored data on individuals, and whether ic is classified as public, priva[e or confidenaal. Upon his further request, an individual who is the subjecc
of stored private or public dara on individuals shall be shown�he dara wi�hout any charge to him and,�if he desires, shall be informed of che content
and meaning of[hat data. Ahzr an individual has been shown[he private data and informed of its meaning, the data need not be disclosed to him for
six monrhs thereafter unless a dispute or acaon pursuant to this secaon is pending or addidonal data on the individual has bzen collected or creared.
The responsible authoriry shall provide copies of che privace or public data upon request by che individual subjecc of the data. The responsible auchoriry
may require rhe requesting person[o pay the accual coscs of making,cerrifying,and compiling the copies.
The responsible au[horiry shall comply immediately, if possible, wich any reques�made pursuant to this subdivision, or wirhin five days of
the date of the request,excluding Sa[urdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with[he mques[
within that time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,exctuding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest Ihe accuracy or completeness of public or pri�•ate
data concerning himself. To exercise this rieh:,an individual shall noa"ry in wriang[he responsible authoriry describing the nature of the disagreement.
The responsible au[horiry shall within 30 days either: (a)coe-rect the data found to be inaccurate or incomplete and attempt to noafy past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual tha[he believes thz data to be correct. Data
in dispute shall be disclosed only if[he individual's sra�emenc of disagreement is included with the disclosed data.
The decerminarion of che responsiblz authoriry may be appealed pursuanc to the provisions of the admirtiscrarive procedure act relaang to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Ri�[s of subjects of data", we would like 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 cercain 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.
Z. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, sta[e or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requires Council ac[ion to approve, some information may become
public.
5. You have certain riQhts under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required [o process this application or permi[.
Firs[ �fiddle Lasc
Address .
Ciry �
- ---� State Zip Phone
�";,-"'
I un stand y ri;hts as st�ted above.
�
' na re �