HomeMy WebLinkAbout1993-005663 - repair deck � PERMIT
` CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: `�''`-=�=�-``_'�`'
Orono, Minnesota 55356-0815 '•-'`-'�='�'r'�'
(612) 473-7357 Date Issued: •-� - -
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SITE ADDRESS:
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APPLICANTiPERMITEE GNATU ISSUED BY:SIGNATURE ��•
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, � ' • CITY OF ORONO - BUILDING PERMIT APPLICATION
Total Fee: $ � `J Date Received:
Date Approved:
Entered By: � � ,
Permit�:
Ar•T• INFOF�MATION MIIST BB SDBMITTED ZN FIILL BEFORE PLAN REVIEW WII.L B$ STARTED
(See Check-off List Enclosed)
-----------------------------------------------------
THE APPLICANT IS: (circle one) OWNER or CONTRACTOR
JOB SITE ADDR.$SS: �U�`�� �l i�/G�,� '�� /I � ZIP: �J����S`'
(work)
NAML OF OWNER: �� i �<<-'�'T- ��•� PHONE: (home)
MAILING ADDR.ESS: D �� � ,%'?�� CITY: ���)/"1�:/�� ZIP: �-����
CONTR�CTOR: - - �' �ct S L' -� PHONE: -�'�J� ` ��"� %�
MAILING ADDRESS: �� � ii�:i s r� /l GY _ CITY: �'/>Y��?� ZIP: ���6�
STATS LICENSE: ,� �
,�c�%�
ARCHITECT/ENGINEER: P$orrE:
MATZING ADDR$SS: CITY: ZIP:
p�: RBGISTRATION �
TYPE OF WORK: New Addition / Accessory Structure Move
Demo Remodel/Alteration �- Renovate Land Alteration
1�_t:f'c}�r'_ � , �
PROPOSF.D WORK (describe in detail) : - �- �
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STORI$S: SQ. FEST OF EACH FLOOR:
NO. OF BEDROOMS: GARAG$ STALLS: ATT. DET.
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ESTIMATED CONSTRIICTION VALIIATION (eacluding I.and) : $ ��iJ�'U L��
I hereby apply for a building permit and I acknowledge that the information
above is coinplete 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
snderstand this is not a permit and work is not to start without a permit; and
that the work wil 1 be in accordance with the approved plan.
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APPI�ICANT'S SIGNATDRE: � �'�_ � -C� �. DATE: �� '��' �
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� �� � CITY of ORONO
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Post Office Box 66•Cryatal Bay,Minnesota 55323•Municipal Offices
•
� - v � 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 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 supp].y data, but refusal may require that
the City deny the permit or Iicense.
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 �o review pri�a��
data on yourself.
6. Yaur full name is required to process this apglicatian or
permit.
/1 G% �7�i"��7 /� �c�c� /C���
First Middle Last
�_ � �� � 6-U-; , �t �
Address
.-e'� :� r � � �
City State Zip
7 ,?v
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Phone
I understand my rights as stated above.
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Sig ature _
BUILDING&ZOMNG—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS —473-7359
ASSESS[NG
---- -- �
573.04 RIGHTS OF SIIB.7ECTS OF DATA
Subdivision L Type of data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information re9uired t° be g��� ����� �'n.individual asked to
� supply private or confidentiel data concere d tamwitlhin the collect g state agency,
purpose and intended use of the request
political subdivision, or statewide system;
(b) whether he may refuse or is legally
required to supply the requested dat8; (c) any known consequence arising from his
supplying or refusing to supply private or confidentiel data; and (d) the identity of
other persons or entities authorized by stsau��e�kedlto supplyinvest 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 mg rolert tax re�und instructionsui steadhos
subdivision in the individual income tax •r
on those orms. . -- - -
Subd. 3.
Access to �ata by individusl- Upon request to a responsible �
authority, an individuel shall be informed whether h=�gteeor confident al.e Upon his
individuels, and whether it is classified as public, p
further request, an individuel who is the subject of Se to himrlande if he desires shall
individuals shall be shown the data witho o f an�y ��ta. �,f ter an individual hes been
�e informed of the content and meaning the data need not be �isclosed to
shown the private date and informed of its meaning,
him for six months thereafter unless a dispute ri� b en collected or etreatedtioT�e
, � pending or additional data on the individual
responsible authority shall provide copies of the private or public data up�reQu re tthe
the individual subje�et oft�e actual�cos h of mak ng,1�Qrt fYingye�'d compiling the
requesting person t pay -
copies. immediately, if possible, with any re9uest
The responsible authority shall comQly
made pursuant to this subdivision, or with lide e,�f Simmediateatcompliance ei9.su not
excluding Saturdays, Sundays and legel YS
possible. If he cannot comply with the re9fi et dat� withint hich toh omplynw�h the
individual, and may hsve sr► additional Y5
request, excluding Saturdays, SundaYS and legal holidays.
Subd. 4. Proced�e �►hen data is not accurate or comQlete. An individual may
contest the accuracy or completeness of Pnot f � inrlwriting tthe�responslb e au hor ty
exercise this right, an individuel shall Y
describing the nature of the disagreement. The responsible autholete and at pt to
days either: (a) correct the data found to be inaccurate or incomp
notify past recipients of inaccurate or iau�p�t he believesdthe datalto be correcty
the individusl; or (b) notify the indivi
Data in dispute shall be disclosed only if the individual's statement of disagreement is
• included with the �isclosed data. ealed pursug�►t to the
' The determination of the responsible authority may be aPP
provisions of the administrative procedure act relating to contested cases.