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Home My WebLink About1999-011451 - tearoff/reroof � PERMIT . E �i�Y OF ORONO PERMIT TYPE: - .-. - .- 2750 Kelley Parkway- P.O. Box 66 =;:_`=-.-�-'��''�� Permit Number: .:; ; ��_ Crystal Bay, Minnesota 55323 - - _ _ _ (612)473-7357 Date Issued: _ _ _ SITE ADDRESS: . _ _s=;;'•�.��°�::a�;:;�:: {i�i° '. . . . . . i?'�—= # ,.=—s;:'—,.._—(_it3� i DESCRIPTION: �€��:E�i;-F:`�,;'=�-,;4.Ei_t� ��'•};�. 3�_a i?!`? i�?�l�Cil l.I.� I jr(-'?�'' .�,�.._.,";!..il 3,'i?,i�„�'{I_fi,;'ry"'_5,,,. -t � � ` � 1: `: �.._ �3+L :�#� ��=7�:� :,;f:��}`�., T e Ci F? �,,_ �i f_i�_t� _ _ . .:.- - _..__... ..._ ; ._ ..;.-. :, .�:: :, : ..�... _.. :-._: .. , •..: . : .:...:.. : { REMARKS: ��---�_�__.- - - FEE SUMMARY: :i��'`:�'��y - "°� . _ _ : � -.:;:,- _ :�,. ._ ,_., .�:.- ___' ' '' I _.. ::: �_ _ _ .�.. �.,_' ��'tr r 3 �=�Nf= ----- �,-,.�---t � CONTRACTOR: ��- ��_�i i r.�,-�t. - _:?' . .�v - .OWNER: ��{�°_:�i i:;f� ___�ira� ':?:t-`;-`�..'Y` j c:; 3 i'r:_;;_3� 'i li_i: :Si`i�:': . .n;#:;�:°�t�� i �� ',�+.5 tv �-:l�;�Y >>_'� � : _ ��'t1t`''��=�{�°r�:. �F+'. i _ i-`!_�`,.`:?I_d:3�;-�: �i°;(`J �L.`:�.f t�l�=:`. (t,ii I i.j,,� L_:_,L� '• - -i-{ �x.t' t —- -`-!'7' ''�.'' - ' �`;`'� -�.� �� { �,: �:��,i �`� �,; �=; ' �"�#l�'. :�� 'F`,�",,' - t_��s J x s �r"�� ' F' F:`F�- �- ;;1 �E , y _ . . .__ _C.�..�E�.� � , ��. %� �:�:�..'�"' ��.� ��'f_ F t�I _ ��. ; . t°t. .__ �_. .�. _. . . ._ . ._,_. : _. .,._ `t=_�LS !-1 �.�`: . t3'`.�� i ��l.�� . ;�;�_�.`"'..; ��'� ,_ #i�1•'•..� � _��_�'•.�`"'`�_i r��V=r� 4�f s i�"'? ��..� _ � . . '_3"t- � _ ,, : - - ^�� L a_�. ... �_� .. . ,,i .. :P• l�� tI� ��e�13�_:4#�¢-k �>'�$��:.��. ._. _. _tt%__ f.��::;_F;,i-�;�-„ .rF � I , APPUCANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� Total Fee: $ 'f��'� � �f Date Received: Entered By: �;�?. Permit#: �«-�/ CITY OF ORONO - BI.TII.DING PERNIIT APPLICATION All information must be submitted in full before plan review �-ill be started. (please print all information) -----------------_--------___--- :--__-- ---=- -------------------� THE APPLICA2r'T IS• (circle ane) OtiVNER OR ONTRACT01 JOB SITE ADDRESS: I � � �W�n�t��r�2t� �2 Z�= NAME OF OVYNER: �-�� t��,z�.t,J PFiONE: (home) �{? -��3 40 (work) I�IA.ILItii'G ADDF�FSS: [ � S U4��vt-�� 12-.CITY: 0�4N C ZIP: CONT'RACTOR: 11��=`xUe.� Ca��J+�2. ��P�y PHONE: S`� I -0 3�� C01�1'I'ACT PERSO�': t�� +��K�tiS NSOBILE/PAGER: MAILT\i'G ADDRESS: �7c`�S i�1. }-l-w`( I l�q CITY: ��(w�.os�-} ZIP: -F� L ( STATE LICE�'SE: # 2�( S J Si.e(o ARCHITECT/ENGII�TEER: PHOti'E: i�7AILLti'G ADDRESS: CIT"Y: ZIP: ��y�: REGISTRATION# TYPE OF tiVORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED tiYORK(describe in detai�: (� / ��o4t- �'°"� ,�"'' ��'°�`�� --� STORIES: SQ.F'EET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTJI��A.TED CONSTRUCTION VALUATION (excludi.ng land): $ �l, 7£3�_— - � 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 Build�n� Code; that I understand this is not a pernut and work is not to start without a permit; and th�c the work will b ' accordance with the approved plan. A.PPLICAi�'T'S SIGNATITRE: D�'TE: � � 2"s " `� � NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to tke event. Non permitted events will not be allowed. � , �. `� Sec.13.04 RIGHTS OF SUBJECTS OF DATA ' Subd. 1. Type ot data. Thc righcs of individual an whom[he data is stoced or oo be scccsd shall be u sec focsh ia this xcaon. Subd.2. IntormaGon reqirired to be pren indIv�dual. Art individuai uked w supply private or caafidendaI dara toccecaiag himself shall be informed of: (a)the purpose and iateaded use of the csquaced dan wichin the collecdag�tate ageary.polirical subdivisioc,or sracewide rys�em; (b)whechec he may refuse oti is.legatiy requ'a:d co suppiy the requesc:d data:(cj any lasowa eoauquecce uising fram his supplying or refusing w suppty privsce or coafidenaal data;and(d)c6,e id,endry of ocher pecsoa;or eadaes auc�ocized by snce oc fede�al taw to Kceive che daa. This requiremect s6a11 not apply when an iadividual is uked to supply invudgadve daa,pursuaa�to secaoa 13.82,subdivision S.tn a law eatoccemenc officer. . '[he_cec�rnissioner of rcvenua mav otace the nocce r.auired under chis subdivision in the individua! income rax or orooectv taz refund insauedons insuad of on those fornu. Subd.3. Aecess to data by individuaI. Upon tequesc to a responsible au�horiry,an individual shall be informed whtther he is the subject o[swred daa on individuats,and whechec ic is c[assifted u pubGc,privau-,or confidenaal. Upon his further reques�an iadividual who is the subje:c of scorai private or public dam on iadividuais shall be shown�he da�a wichout any charge oo hua and;if he desires,shall be informed of the coacenc and meaning ot diat dara. Aher an individual has been showa the private dan and iaforaied of ics meaning,the daa nerd noc be d'uclosed oo him for six monehs theceafur unless a dispute or acaon pursuanc to �his secdon is pending or addidonal dara on che individual has beea collecced or erea�ed. 'Ihe tespantible auchoriry shall'provide copies of che privace or public data upon request by the individual subject o[the daa. The responsible auchoriry may require�he requesring person m pay�he acncal coses of making,cecdfying,and comp'iling the copia. The responsible auehoriry shaIl comply immediacely,if possible,with aay request made pursuant w this subdivision,or withitt five days of the dare of che tequesc.ezcluding Saturdays,Sundays and legal holidays,if imcaediace compliance is not possible. If he eannoc compty wirh the requesc wirhin chac ame,he shall so inform the'individuat,and may have an addidonal five days wirhin which to comply wi�h the request,ezcIudin'g Sacurdays, Sundays and legal holidays. Subd.4. Proeedure when data Ls not aecurate or eomplete. M individual may contest the accuracy or completeness of public or private data coneeming himself. To exereise�his right,an individual shall nodfy in wridag the respoosible auchoriry describing the nature o!the disagreemeac The respoasible authoriry shall within 30 days either: (a)correct rha data found to be inaccurate or incomplete and atumpt to nodfy past recipien�s of inaccucace or incamp[e�e data,including recipienes named by the individual;or(b)naafy the individual thac he believes che dara to be correeG Data in dispu�e shall be disclosed only if the individual's statemenc of disagreement is induded wirh the d'uclosed daa. The decerminaaon of the responsible auchoriry may be appealed pursuant w the provisions of the adminisaadve pcocedure act reladng W contemd casts. • DATA PRIVACY ADYISORY In accordance with M.S. 13.04,Subd.2, "Rights of subjects of data",we would Iike 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 certain private or confidential information. You aze notified thar. 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 Ciry deny the permit or license. 3. The information may be shared with ocher local.sca[e or federal agencies to the excenc 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 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 permic. ��",zv�� C�� S��P�.7 ' Fitst �fiddle Lut �S �. (�y 1 CQ `� Addceu PL'�rn�,� � n�„� 5�44 c .�4 c-c,3 rit) . Ciry Sace Zip Phone I und d my rights as stated above. Sigru