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Home My WebLink About1998-010462 - land alteration PERMIT � �ZTY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 i;'";�� =;��` ' �:'`�-� Crystal Bay, Minnesota 55323 Permit Number: i:;�,i"i%��:�; (612) 473-7357 Date Issued: s,��:i�'i;�`�;;; SITE ADDRESS: .�=,i=.=� �y�_E`s-i t�-� ��-4�rl�;r l.,'��'. � _�..� �'. I . �'d . . i),�_� � -,_.•y;_�_�,_tiili:�:f DESCRIPTION: tl•��=;' �`r't'3l11�. �V��r� �r;��.� h��C.�`.i��i i_i�,� REMARKS: :;r��{±��,Y°� F'i�i I�=t �at�{.�� '}_�;_:� `' F�;r;I��I i��.—� ��==a+L i t� :_3—��,' :=i�T�;�i�_r�:: G�;�� FEE SUMMARY: F-;;��= �M� `'�','Lyti , t){Y p , . -�:. .�.�l�41}�5��.�.s��I�•I.i�yl� ....__.. '��Y� E:1� __— i s s.a.a...a. jl t�.�{j �-;?r� �t t_1t_"1 ,t_!i i CONTRACTOR: OWNER: — ��s� i�=�{#� — 1�'ii-i�? I 3.l��F-3+_' .�'�� :L.�.�. t;31_iF;�:'� `�:-#I_iF;� �.j�'. ;_��;s�j��,�j-{ i,''1E�j :_r�:r�`�l «�_ -.L. �ij•�{a - �ti� .._ 3 t'i� _ � �_� �``�`.�'11:„;:=:i;_l=+.� i�s�i �•Ef-i'�-.�". € fl` "�:`i�-i1... i�"�`'`�`:�_}'„sj��!;`_!'•;.�_,,� T�'"!i= y j��_� �I�L,' �'lFs�-:'t {�i!?F:-, a _ - - - . r e , �.� � 7 —;L; - r_ '* u.I "."f �.� .�3_ii`i�`I :��:�i{%!. �;}-� �;�__ t,_ � , i_1�.. `r:�-°;��:��1�?�i i;yrli 3 i=ie;�-.. ': I�,i I)ir3 ��i�__ �+%i i�;`::; ?;� . . `�:`= ' -- L, ;�fl`I��"v;_I tl�`.�.1l��-��+� � �11`•;:' W; � ,;:�` f�i== �''.ls°#.�l�`��#.ti-� _�_��:..i�#,i'.�t� {_!_�s+� '."..��a'�_�.t':z`.�'t�._�.5�`� . � J � /'} 0,�;�Z��Jn f�LICA T/PE MITEE SIGNATURE � ISSUED BY:SIGNATURE � • T.�tal Fee: $ � � Date Received: Entered By: � Permit#: i'�' "1 , i 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) Oti�NER OR CONTR.ACTOR JOB SI7'E ADDRESS: ��j�,C- � �. ��;�� /l/�_ ZLP: � `��,� �-� �--� �-- � '� ��.y^Y�l V NAME OF OWNER: {='f� /�/,'1�? �� PHOivE: (ho � l� _ _ �(work) ��c�1 � k 7 C� �_ ,� MAILING ADDRESS: Z�� ,��, ��CITY: ' Z � ZIP: " � � �� C0�ITRACTOR: ,� ' � ,Si ��` PHONE: �7�� /�O C0�ITACT PERSON: �".!�'�2 r� �N'��=MOBILE/PAGER: MAILTNG ADDRESS: CITY: ZIP: STATE LICENSE: # AP.CHIT`ECT/ENGINEER: ,�U�'', � PHOiVE: ;VIAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF tiVOR�i: New Addition Accessory Structure Move Remodel/Alteration ✓ Land Alteration PROPOSED`VO (describ in detai : j J �� 4�� O � `v�` Gt .� — � t4Ctd� C��tva STORIES: SQ. FEET OF EACH F'LOOR: � NO. OF BEDROOiVIS: GARAGE STALLS: ATT. DET. ESTII�i IATED CONSTRUCTION VALUATION (excluding land): $ I (� �bb� "�� I hereby apply for a buildin�pernut 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 Ciry and with the State Buildin� Code; that I understand this is not a pe 't and work is not to start without a pemut; and that the work will be in accordance wi app ved plan. APPLICANT'S SIGNATLTRE: — DATE: � �Z ' ; NOTE! Parade o Homes events requ epa t � it approval by Police Department and City Counci160 days prior to the event. Non permitted vents wi11 not be allowed. � ` � �� Sec.13.0A RIGHTS OF SUB.TECTS OF DaT?, Subd. 1. Type of data. The riehcs of individual on whom che data is stored or to bz stored shail be as set for[h in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply priva[e or confideadal dara concerning himself shall be informed of: (a) the purpose and incended use of the requested data wi�hin[he collecdng�tatz ageacy, polirical subdivision,or satewide rystem; (b)whe�her he may refuse or is legally required to supply the tequested data;(c)any Imown coasequence arising from his supplying or refusing to supply privat�or confidendal dara;and(d)the ideadry of o�her persoas or enddes auchorized by scate or federal law to receive[he data. This requiremenc shall not appty when an individu�l is asked to supply invesdgadve data,pursuant to secaon 13.82,subdivision 5, to a law enforcement ofricer. - The commissioner of revenue mav place [he noace r_ouired under this subdivision in [he individual ir.come tax or prooem tax refund L�scrucdons instead of on chose forms. Subd. 3. Access to data by indi�idual. tipon requesc to a responsib(e au�horiry,an individual shall be informed whed:er he is the subject of scored dara on individuals,and whethzr it is class�ed as pubiic, private or confedenrial. Upon his further request,an individual who is the subjecc of scored privace or public daca on individuals shall be shown che data wi�tsout any charge to him and;if he desires, shall be infocmed of the con[enc and meaning of cha�dara. Aher an individua!h�s been shown che priva�e data and informed of its meaning, [he data need not be disclosed to him for six monchs chereaiter unless a dispute or acaon pursuanc co [his secdon is ptnding or addidooal data on the individuai has been coflecced or creared. The responsibte authoriry shall provide copies of the priva[e or public data upon request by the individual subject of che dara. The responsible authoriry may require[he requesring person to pay the actual coscs of making,cerafying,and compiling the copies. The responsible au[horiry shall comply immedia�e(y,if possible,with any request made pursuant to chis subdivision, or wi�hin five days of the dace of che request,exciuding Sanirdays,Sundays and legal hoiidays,if immediate compliance is noc possible. If he canno�comply with the request within chat dme,he shall so inform the individual,and may have an addidonal five days within which to comply with the requesc,exc[uding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may concest che accuracy or compleceness oFpubiic orprivate dac�concerning himself. To exercise chis ri¢hc,an individual shall nodfy in wridng the responsible authoriry describing the nacure of the disagreemeac. The responsible authoriry shall within 30 days either: (a)correcc the dara found to be inaccurate or incomplete and attempt to nodfy pasc recipienrs of inaccun�e or incomple�e data, including recipiencs named by the individual; or(b)noafy the individual thac he believes [hz data to be correcc. Data in dispu�e shali be disctosed only if the individual's sraczmenc of disagreement is included wich the disclosed data. The determinarion of the responsible auchoriry may be appea(zd pursuanc to the provisions of the administracive procedure act reladng to contesced cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd.2, "Ri�hts 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 determine your qualification for the permit or license requested. 2. You may refuse to supply data, buc refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal a�encies to the extent necessary to process the permit or license. 4. If your requested permi[ or license requires Council action to approve, some information may become public. 5. You have cenain ri�hts under M.S. 13.04 (available upon request) to review private data onyouurself. 6. Your full name is required to process this application or permit. - -�� L ��j �'% �. � First,� t � ,fiddle � Lasc �6� ,� �� , ��_ Addres �/� � � � i�-,� —� i `� � Y n� � �- �:_ �-- (_��_�i Ciry State Zip Phone I understand my '„ s stated a ove. � � � . , % Sig mr � /