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Home My WebLink About1998-010492 - land alteration PERMIT CITY OF ORONO PERMIT TYPE: 27;� Kelley Parkway- P.O. Box 66 �":=:�� -'�'��'�`'' �Crystal Bay, Minnesota 55323 PermitNumber: i;�;;�,��,� (612)473-7357 Date Issued: �;;�# ;��-;;; SITE ADDRESS: ;�i;�� +=��1t� �IF��:t� �t'y� .I1� +�-`+ . �4 . i b,=�—i ; F—'.,�:=�—�'::.—i):iC's?� DESCRIPTION: ta��' �'F,�'f�iit. TrF�t E ►::hsC.y Ht_l�;;�'1T�t�+t� REMARKS: ._ "" �►,� i_�r::� �:.�.' E�:I Ct�? �td�+ �°� �+�ia�i-i�_�t�i �!i ?'r�i t� i:{' ;,�� .�-;�i;;__�; _ �;�_!i�� _��"��i�d� '-:._i r�I F=� �_:t�{t�ft��T?i ��=;�:::�:=,�i i��.� — t�f�� i�i._ FEE SUMMARY: +=i�=�' `'�� _____.---��is�.'� �,_zf..a�. �L'�' �.�tl , iiij CONTRACTOR: — �k,�� i��t-�t. — OWNER: t'it-�� ?!��[4%S_ .� . i . i.'_��;`W��.`i i ;-is si i:i li 3�� i!i 1�i�� I�`. '�} . �;i_�k f=Yi: i i i�:F�, 1 i�;t�i� L T�Si i::� :��y`� l.En,� c�=:e� #iys:ifv€� tij(�I .5`=�t;`, ��C�z� L�?P�:;E . _ _ _ _ _ �, �-� �.?�-,—t�.;''s f i i i:r.i'=i '37'=—_.�._�s -- - - _ ::.,-- — — . .,--.—.�—.:. — — — _ _ t — , � - � � �. _ =`�:.t�?�?,; ��', !-:S="t'�';�`-�: •;f�S�4 t �i..;�t _�"'fi- �;;Y'�-�: i t '-'i!`:f`til !'7E-�Y..' : ��. �_��IE..f��'�:��i�.3�v`�' i��I'-:�`=�'l . . _ '_ _ . .. .�: - :-��'�,i.2 I� 1�f 7 i-t4i:l{ Nt�iF:`��;,'-. I t_f E:�_1 F-:4_4_ .. _4 t:, _�'a = j�`�t s i.1_�T t`.`�„ I�, { t-`-. , i t:". . .=.5_ _i. ! � . _. i�ij=�i�t��i�! l�iii!_}�i�((-1��i_r�'.=� ��,f1� '._�!�€;�i y i_,ii- ;'.s��{E ..'_ _�_ _'� _y i.�i ��`t}t.:, t,_l�st<!s�„ ?-°;vtz'�!l,'•°!�s';:Y=V ' � . L ,. _ . . � x C� �� . APPLICANT/PERMITEE SIGNAT R ISSUED BY:SIGNATURE - . ':�w�. Total Fee: $ Date Received: �ntered By: � Permit#: C� �1� . - CITY OF ORONO - BUIL,DING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) . THE A.PPLICANT IS: (circle one) OWNER OR CONTR.ACTOR� � � � . JOB SITE ADDRESS: 10 5�,� ��,a L:.� ,-,�o.. {�v e ZIP: 'S5 3 r7 � � , � NAME OF Oti'YNER: �o�� 41�4,,,, �,e PHO�TE: (home) ��- �q c�� o (work) MAII�ING ADDRFSS: �o=,r,�.e � CITY: Q ro�-.o ZIP: CONTRACTOR: e g� r � : 1._.. 1 . PHOi�TE: �'11 Z- 8\�n . CONTACTPERSON: r� s �-1� e MOBILE/PAGER: b\q - a�l �O MAII..ING ADDRESS: _ p o �o,c � o CITY: 1Lon �ZIP: �3�b STATE LICENSE: # . AI'.CHITECTlENGINEER: PHOi�1E: � MAII.ING ADDRESS: CIT'Y: ZIP: NAME: REGISTRATION# TYPE OF tii�ORK: New Addition Accessory Structure Move � � Remodel/Alteration Land Alteration P OP SED tiV0 (describe ' d ai�: t,c,i�d �1� � �,� l� �,� �\W a.� � � c D�o ��Q° — 8 0�° STORIES: SQ.FEET OF EACH FLOOR: • - NO. OF BEDROOMS: GARACYE STALLS: ATT. DET. ., ESTII�i IA.TED CONSTRUCTION VALUATION(excluding land): $ I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in confornaance with the ordinances and codes of the iCity and with the State Buildin� 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. APPLICAN�'S SIGNATURE:�� -� DATE: �1�3 � NOTE! Parade Q H'omes events require separate permit approval by Police Department and � City Council 60 days prior to the event. Non p rmi�ted events wi11 ot be Ilowed. 21 � � � �� . _ri`. . � • � Sec.13.04 RIGHTS OF SUBJECTS OF D:�TA Subd. i. Type of data. The righes of individual ou whom ehe data is stored o�to be scared shatl be as set focn4 in this secrion. - Subd.2. Informatioa reqtrired to be givea tadividual. An individual asked to supply privare or conFdenaal dara concerning himsetf shall be iaformed of: (a)[he parpose and inmaded use of the tequest�dara wiehin tfie collecaag Stace agency,polidcal subdivision,or statewide rystem; (b)whe�her he may refuse or is legally requir:d co supply the requesud dac�:(e)any Imown coasequence arisiag from his supplying or refusing to supply privac:or eonndendal data;and(d)the idendry of o�her pecsons or enrides aachocized by sc�te oc federal law ro receive the dara. 'I�is requ'uement sbatl not apply when an individual is asked.to suppiy invesdgadve dan,pursuant to secdon 13.82,subdivision S, to a law enforcement o�cec. � The commission�r of revenue mav olace �}ie noace r-auird und-r this subdivision in the individual income rdx ot oropectv ax refuad insaucaans inscead of on chou forms. Subd.3. Accas to data by indirldual. Upon request to a responsible au�horiry,an individual shall be informed whaher he is the subject � of seord dac�on individuals,and wheehec ie is elassified as pubiic,privac�or eo�denaal. Upon his furiher tequese,an individual who is the subjeec of stored private or public data on individuals shall be shown ehe dara wichout any charge w him and;if he desires,shall be infotmed of the contenc and meaning of chat data. Aher an individua!has been shown ehe priva�e dara and informed of its meaning,the data need not be disctosed to him for siz monchs thereafser uniess a dispute or acdon pursuanc to chis secaon is pending or addidoaal dara on the individual has been collecced or creared. The responsible authoriry shall provide copies of the privace o�public da�a upon request by the iadividuat subjecc of[he data. The responsible authoriry may cequire the requesring pe�son to pay the actual coscs of making,cetafying,and compiling the copies. The responsible auchoriry shall eomply immedia�ely,if possible,wich any reques[made putsuant W this subdivision,or wirhin five days of the date of che requesc,exduding Satur+days,Sundays and legal holidays,if immediate compliance is not possible. If he canaoc comply with the request wichin rhat titne,he shall so inform[he individuai,and may have an addidoaal five days wichin which to comply wi�h the requesc,exc[uding Satutdays, Sundays and legal holidays. Subd.4. Procedure whea data L�not accurate or complete. An individual may contest the accurdcy or eompletentss oE public ar private data conceming tiunself. To exercise chis righc,an individuai shail noafy in wridng[he responsibte au�horiry describing the naeure of rhe disagreemeac. '!he responsible au�horiry shail wiehin 30 days either: (a)correcc the data found to be inaccurate or incomplete and atumpt to nodfy past recipieacs of inaccunte or incomplete daca, including recipients named by the individual;or(b)aotify ehe individual that he believes the data to be correcG Data in dispute shall be disc(osed oniy if the individual's se�em�nt of disagreement is included wirh the d'uclosed da[a. Tht decerminadon of the responsible auchoriry may be appealed pursuant to the provisions of the adminis�adve procedure act retaang to contestad eases. DATA PRIVACY ADVISORY In accordance wich M.S. 13.04, Subd.2, "Ri�ts of subjects of data",we would like 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 informacion. You aze nocified thac:• 1. The information you furnish will be used to determine your qualification for the permit or licease requested. 2. You may refuse to supply.data, but.refusal m�y require that the Ciry deny the permit or license. 3. The information may be shazed wich other local, state or federal agencies to the excent necessary to process ' the permit or license. 4. If your requested permit or license requires Council actlbn to approve� some information maq 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 permi[. �e� ��o n� . Firsc �fiddle _ Lasc Addreu , Ciry Scacc Zip Phaae I understand my ri�hts as stated above. . ,� , Signacure .