HomeMy WebLinkAbout1996-008434 - 2 windows � PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 ����_��.�.�.?�.t�?��
Crystal Bay, Minnesota 55323 Permit Number. t_;��;;,�__,�.
(612) 473-7357 Date Issued: �,��,:�V;� ;:,_r�,
,ITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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A PUCAN %PE SIGNA E ISSUEDBY:SIGNATUR
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all inforniation)
----------------------------------------------------------- ----- -----------------------------------------------
THE APPLICANT IS: (circle one) WNER R CONTRACTOR
JOB SITE ADDRESS: 3.�s0 ��}�� (����� z�: SS�.�i �
` 0 �/
NAME OF OWNER: , � � r1 f-} ; PHONE: (home)��
(work) �7 4�/L�f
MAILING ADDRESS: 3 S� ,Zv i/ ��K'�CITY: Ct�A-Y2fl FR ZIP: S53`3 t
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
rJAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED WORK(describe in detain: �p!�� I �i n.f��> /�l i� � W_+���c.0
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STORIES: I �Z S FEET OF EACH FLOOR:
NO. OF BEDROOMS: �� GARAGE STALLS: ATT. DET.
00
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ v51 —
I hereby apply for a building permi I ac o edge that the information above is complete and
accurate; that the work will be ' c ce w th the ordinances and codes of the City and with
the State Building Code; that I nd ' �i not permit and work is not to start without a
permit; and that the work will �or e 'th e approved plan.
APPLICANT'S SIGNATURE , � DATE: t (��P
NOTE! ParadeQf Homes events require separate ermit approval by Police Deparlment and
City Council 60 days prior to the event. Non permi ed events will not be allowed.
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Sec.13.04 RIGFTTS OF SCJBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidendal data concerning himself shail
be informed of: (a)the purpose and in[ended use of the requesied dara within the collecang'state agency, poliacal subdivision,or sratewide system;
(b)whether he may refuse o'r is legally required to supply the requested dara;(c)any laiown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idendry of other persons or endaes aurhorized by state or federel law to receive[he data. This requirement shall
not apply when an individual is asked to supply invesrieadve data,punuanc to secdon 13.82, subdivision 5, to a law enforcement ofFicer.
The commissioner of revenuc mav place the nodce required under this subdivision in the individual income tax or properry raz refund
instrucdons instead of on those forms.
Subd.3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject
of stared data on individuais,and whether it is c(assified as public,private or confidenoal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown che dara wiehout any charge to him and,�if he desires, shall be informed of the contenc
and meaning of chat data. Aher an individual has been shown[he private data and informed of its meaning,the dara need not be disclosed to him for
six months thereafter unless a dispute or acaon pursuant w this secdon is pending or additiona(data on the individual has been collected or created.
The responsible authoriry shall provide copies of the private or public data upon request by the individual subjecc of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately, if possible,with any requesc made pursuant to this subdivision,or within five days of
the date of the request,exctuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data conceming himself. To exercise this right,an individual shall nodfy in wridng the responsible authoriry describing the nature of the disagreement.
The responsible au�horiry shall within 30 days either: (a)correct the data found[o be inaccurate or incompiece and attempt to nodfy past recipients of
inaccunte or incomplete data, including recipients named by ehe individual;or(b)notify the individual thac he believes the data to be correc[. Data
in dispuce shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data.
The determinaaon of the responsible auchority may be appealed pursuanc to the provisions of[he adminisaadve procedure act reladng to
contested cases.
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 pemut or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You aze 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 supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent 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 rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�,a�, `�� R.�, �Co�f �n�p�£2.
First M�ddle Last
3s�o � P��c�
Ad res � �, � r
�( . r � /�iU � co
Ci ° State � Zip Phone
;
' I u � t �ny ri hts s ated above. �
� ��
Signa r �� �\
DATE TIME
CITY OF ORONO CALLED IN �—
INSPECTION NOTICE SCHEDULED 0 � �..��
PERMIT N0. COMPLETED
ADDRESS ��� O �-Ltlu �g[�l.�°
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTINO 11 MECHANICALRI 18IXCAV/ORADIN(�/FlWNO
�Q �RAMIN(i 13 MECHANICAL FlNAL 19 LAI�SHOREIWETIJWDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL
Z 04 WALL Bp. 12 WA7ER HOOK-UP 17 SITE INSPECTION
� p5 FlNAL 14 SEWER HOOK-UO O6 PROORESS
2
� 07 DEM�SITE 27 SEP11C MAIM. 21 COMPLAINT
v
� 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FpLLpyy-Up
= 09 PLUMBINO RI 23 SEP'TiC FlNAL 35 HARD COVER REMOVAL
v 10 PLUMBINQ FlNAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
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d �RKSATISFACTORY:PROCEED G PROJECTCOMPLETE
W
� O CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WIIL REfURN
O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in tion 24 hours in advance.473-7357
OwnedCont site:
Inspector: --
YVhite CopyAnspecta's Fib Csnary Copp/Site Notic�