HomeMy WebLinkAbout1998-010140 - window replacement PERMIT
_ CfTY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 Permit Number: �`{�;�-�'��"`_'
Crystal Bay, Minnesota 55323 �i�,t:;��.i:i
(612)473-7357 Date Issued:
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REMARKS:
FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE G{,
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, 3'otal Fee: $ Date Received:
Entered By: Permit#:
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 APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB STI'E ADDRESS: I� �1� L ��L:.,aa ��� C� ra�az�: S 3j �y
NAME OF OWNER: �1 r�'I • �S�e� b-t't� PHONE: (home) ��a ` �� 7�
` (work)
MAILING ADDRESS: � � 1.�,r+�4 L o e►d� fl v� CITY: d r G r d ZIP:�
CONTRACTOR: I..�e I.n ��� (,•.�:nc�c./ PHONE: CI�3' �03�
CONTACT PERSON: t MOBILE/PAGER:
MAILINGADDRESS: 3 C�eqrk� cm� . CI1'Y: S�.lo� t � ZIP: � _
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
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PROPOSED WORK(describe in detain: e..��c« �.,> .i�b�,�
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $_���7� �
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 Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: ��a`�I�
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[1B.TECTS OF DATA
Subd. 1. Type of data. 'Ihe righcs of individual on whom the dara is stored or to be stored shall be as set for[h in this secdon.
Subd.2. Information req�rired to be given individual. An individuai asked to supply private or confidenrial data concerning himself shall
be informed of: (a)the purpose and iatended use of the requesud data within the collecang State agency,polidca!subdivision,or statewide rysum;
(b)whecher he may refuse oY is legaliy required to supply the requested data;(c)any Irnown consequence arising from his supplying or refusing to supply
• private or confidenrial data;and(d)the ideadry of other persoas or endaes aa[horized by state or federal law to receive[he data. This requirement shall
not apply when an individual is asked to supply invesdeadve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. -
The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or prooertv raz refund
instrucaons ins[ead of on[hose forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whecher it is etassified as public, privace or confidencial. Upon his furcher request,an individual who is the subjecc
of stored privau or public data on individuals shall be shown rhe data wichout any charge to him and,-if he des'ues, shall be informed of the content
and meaning of that dara. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six monchs rhereafter unless a dispute or acdon pursuanc to chis secrion is pznding or addiaonal data on the individual has been collected or created.
The responsible authoriry shall provide copies of[he private or public data upon requesc by the individual subjecc of che data. The responsible authoriry
may require the requesdng person to pay the actual coscs of making,certifying,and compiling[he copies.
T1te responsible authoriry shall comply immedia[ely,if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesc
within[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,exciuding 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 concerning himsetf. To exercise[his right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipien[s named by the individual; or(b)noafy the individual that he believes rhe data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuanc to the provisions of[he administracive procedure act relaang 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 Ciry of Orono or any of its departments may require you to fumish 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 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 eztent 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.
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I understand my rights as stated above.
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