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Home My WebLink About1999-011352 - tear off reroof PERMIT CITY OF ORONO PERMIT TYPE: 2750 KellEy Parkway- P.O. Box 66 �:'_��_.:?��•��z Permit Number: Cr�stal Bay, Minnesota 55323 Date Issued: '��' � '�'`� (612) 473-7357 _ ', __- . _. _ SITE ADDRESS: .�_ _:_ ��::L�=_', ;;4'� t�,3 . ' . . . . . ��is—�; 1. ! _ —j,�:i.—ii'_i.:?�=, DESCRIPTION: I �i��i i;: f_„-� !�:`�� E_I�_i�- J'4 I�^E l. r ; ''iE j�:;��•I—S'—.�`—� 's�=..�1 Z t.'� i'i i'��j,; . f�=:`= `.��1——H? .� �{_�_�._i_ _, _�i :;:11;`�_� �:;�:=s;'1:. i, �.',�, �;;t�_:;°l��i_€h {_��ll'.�L�i'= ___��:_ [1.::.�%!� il{_i . t?�`��"�y�Fj-i�_ REMARKS: FEE SUMMARY: �:::.: -�; - � a ��r�:��_� � :��:�,� . ; c-,; :_,��:. --•-- s`�� ;�?�. . :?.�, -:_�;�:t•�_�s��_��:-� ______ �•�: ��. i�_��t.��i ��•� ��f?`� �;i i CONTRACTOR: ._ ;��,P,�:i ; ,_.�;;�,:. .— M;, , s_;;_: .OWNER: _ — r.— _ . ._ �_z i�t�h;=��.tf:°'�� i;�i`i)V-��:A s- -:)i_i:_:_`'i- _ .. . . �::�i`�V•,�, .. .i <<_I (,�Y J-�� - ".tS�i i �» f�.�.`•.`_�i_• _ . . . .. ..... � I'•.L.�.�� i"��l�� (`i;':{`��_.._W i"`_„-:T�'. �4V _. . " '_� ..'!�.� '. .'�'� <ii;� i.��•." "+i t.��1.�_. _:'''`_�—'.''�. . .� _. _ _. �._ _ _ _ _ _ _ _ sc.� } �� t-,f: � !_;i��-: 3 ;-.r--::-� . �.i".tt ___. . - �"'�t".i'.='1_ _ .=i _ f'a �i�_ ?-.�._. ! i� ".�_. .� Yr. .1_ . _.. ._.. *' t �� . . . ._ _ -•— -.- '•�-� _ t� ! t 3 (1 ;- t '-,-: ;�(�� E ti�i - -f'�;�'- i: _. I '� _.f �!i=;€ - �., 5::: �.�E�'i.j �:< ! -�:}: , � , r , •..: __._, , . ._ . ._. ..___.: � _ ''r-`,�._E._ iv�_.; .. . .�. `. : �:`•.••._ �_�'i-- �.�•a . i-i:.._.._ _ _ . _.. �.��s»,i�i�� iy��S?ti�?s:ii'.r-�� _ ' _ _ i 3 ' "' _ s_:».�;j-_ .. i i _ ._ -.�^'r�{ i ' a':�i . �j�s'v f i` � � ±vF^.��. .�`._r r�ii'r�Tj .». ! . . i^. �•.'S.. °_�� . _. L _.. ._. ._ _ . ._ _ . _. . _�_. _ _ __.. . _ _ _ _ _ . .__ . _.. .._ ._.. . . _ . � l ,�a.. � APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� d� �. ,F. �. Total Fe�: $ t�' Date Receive�l: /t ,' � ��-.�..._. Eritered By: � � ��,�`� Permit#: �'�`--.:;- -._..,__v - -� s, CITY OF ORONO - BUII�DING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ----------------------------------- ---------------------- , --------_�--------------------- THE A.PPLICANT IS: (circle one) O R O CONTRACTO - JOB SIT'E ADDRESS: � � � l , � r ZIP: , me �I� �� C' � T 'ER: .sL� � ��' PHONE: (ho ) I�AAI�iE OF �`Vi� , (work) 1�IAILL\'G ADDRESS: �c'-�,�,� CITY: ZIP: , CONTRACTOR: t t .� � ��'lv��' PHONE: � �?0 -21 �` � CONTACT PERSON: � MOBILE/PAGER: � � MA.II.,ING ADDRESS: - � � CITY: �� t l'i. (U��, ZIP: �, 3 � ? STATE LICENSE: #� G ? 6 ARCHITECT/ENGItii'EER: PHO�iE: �IATI.Pi 1G ADDRESS: CITY: ZIP: ��: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration �-- � 1 _ �, P$OPOS�D WORK(describe in tain: � U "� � , 2--_ .L,C'.� �' l,v�; � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIi�IATED CONSTRUCTION VALUATION (excluding land): $ ��, � �� C�� b I hereby apply for a buildina 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 understand this is not a permit and work is not to start without a pernut; and that the work will be in accordance with the approved plan. � � DAT'E: c � �b �� ( , , . ,�-: y ��-- APPLICA�tiT S SIGNATURE. (� i NOTE! Parade of Homes events require separate permit approval by Police Department and Ciry Counci160 days prior to the event. Non permitted events will not be allowed. . Sec.13.04 RIGHTS OF S[JB.TECTS OF DaTA ' Subd. 1. Type of data. The righcs of iadividual on whom che data is srorcd or to be sco�sd shall be as set forth ia this section. Subd.2. Information reqtrired to be given individual. �1n individua!asked to supply privatt at confidenrial data concerniag himself shall be informed of: (a)[he purpose and incended use of the rzquured dam wi[hin the collecang state ageacy,polidcal subdivision,or staccwide rystem; (b)wh:�k:er he may refuse or is.legally requir.d to supply che r:quesud data;{c)aay Iatown coasequence arising from his supplying or refusing to supply private or conndenaal data;and(d)che ideadry of ocher persoas or enddes authorizcd by sc�[e or federal law to rcceive tfie data. 'Ihis requirement shall not apply when an individual is asked to supply iavesd¢arive dam,pursuanc to secdon 13.82,subdivision 5, w a law enfoczemenc o�cer. 'I�e cemmissioner of revenue mav olace the nodc- rauired und:r�his subdivision in the individual income tax or oropem az refund inscrucuons inscezd of on chose forms. Subd. 3. Access to data by individual. Upon rcquesc to a responsible authoriry,an individual shall be informed whather he is che subjecc of stored daca on individuals,and whecher it is classifi:d as public, priva[e or confidenrial. Upon his funher requesc,aa individual who is the subjecc of stottd private or public data on individuals shall be shown[he dara wi[hout any charge to him and,-if he desires, shall be informed of the contenc and meaning of chat data. After an individual has been shown[he privace dara and informed of ics meaning,the dara need not ba disclosed ro him for siz monciu thereafrer unless a dispute or acaon pursuanc to this secdon is pending or addiriooal dara on the individual has been colleccPd or crea�ed. 'Ihe cesponsible au�t:oriry shall provide copies of the privace or public data upon request by the individua!subject of the data. The responsible authoriry may require the requesdng person to pay the actual costt o[makinz,cerdEying,and compiling the copies. The responsible authoriry shall comply immediately, if possible, wi[h aay request made pursuant to chis subdivision,or within five days of the dace of the request,exctuding 5an►rdays,Sundays and leg�l holidays,if immediate compliance is not possible. If he cannot comply with the requesc wichin that ame,he shall so inform the individuai,and may have an addidonal five days wi[hin wtuch to comply wich the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data i�not accurate or complete. An individual may concest the accuracy or completeness of public or priva[e dara conceming himself. To exercise�his right,an individual shall noafy in wriang the responsible au[horiry describing the nature of the disagceemeot. The responsible authoriry shalt within 30 days eitt:cr: (a)correct the data found to be inaccurdte or incomptece and attempt to nodfy Qast recipiencs of inaccurate or incomple�e data, including recipiena named by che individual; or(b)no[ify the individual that he believes the dam to be correcG Data in dispuce shalt be disclosed only if the individual's statemenc of disagreement is inc(uded with[he disclosed data. The decerminadon of thc responsibiz au�horiry may be appealed pursuant to the provisions of the administrarive procedure act relacing to contested 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 tha[your request for a permit or license from the Ciry 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 detemune your qualification for the permit or license requested. 2. You may refuse to suppty data, but refusal may require that the City deny the permit or license. 3. The information may be shared with o�her local, state or federal a�encies to the ettent necessary to process the pernut or license. 4. If your reques[ed perm.it or license requires Council action to approve, some information may become public. 5. You have certain ri�hts 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. ,�� l(i �4`l� 1 �l'"~ / 1 /L �� yv Fir�t�� o �% j� /�1 � �fiddle Last 1 t��d'�C Addresi /( /(C�. �/� 2 � � y 1 { �J b '/ . � t��( 7 � � j � �l �iry Sa�e Zip Phone I unders d my ri s. ted above. ��- ` ' �z z � __ s�g�N«