HomeMy WebLinkAbout1998-010888 - remodel,side,windows PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 h"f��--'':��'s=
Crystal Bay, Minnesota 55323 Permit Number: :;�.:i;=;=��=; _
(612) 473-7357 Date Issued: s i i;���::�=_;
SITE ADDRESS:
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FEE SUMMARY:
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CONTRACTOR: OWNER: -' F;�'�_� i r���t. r��
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PP ICA i FMITE�SIGNATURE ISSUED BY:SIGNATURE ���� a
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�� Total Fee: $ �q •?S Date Received:
Entered By: �( Permit#: /(� }��' ?�
CITY OF ORONO - BIJII.DING PERNIIT 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 SITE ADDRESS: �S�� �, ��11a'LC. ct7�/!J� Z�: s�c1 �
NAME OF OWNER:-J�� ����'� 0,�4� . PHONE: ome) �{7�--�v�
(wor ) —�Z
MAILING ADDRESS: 7��� ��� �h a-ie- CITY:� 7� ZIP: L '�''J �
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CONTRACTOR: ��y�t, 1v S �Ig�t� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CIT'Y: ZIP:
STATE LICENSE: # '
ARCHITECT/ENGINEER: �� ��1 S�_PIiONE: �b I' ��C Z`�
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED ORK(describe in detai�: �� ��1��r�.(�+A�< �1 i�..�'jG+�'�l1'�c�YYi.t,�1
� P� �1 Z Q��i,s
STORIES: � SQ.FEET OF EACH FLOOR: Z C7 0 d
NO. OF BEDR OMS: �_ GARAGE STALLS: ATT. Z DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �D�Da O
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
pernut; and that the work will be in accordance wi approved plan.
APPLICANT'S SIGNATURE: DATE: �� � � � d
NOTE! Parade of Homes events r uare sep e permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF S�JBJECTS OF DATA
Subd. 1. Type of data. The righrs of iadividual on whom the data is stored or to be stored shall be as sec focth ia this secaon.
Subd.2. Informaaon reqirired to be givm individual. An individual uked to supply private or coafidendal data concerning himself shall
be informed of: (a)the purpose and inrcaded use of the teques�ed data within the callecdng state agency,poliacal subdivisioa,or sratewide rystem;
(b)whether he may refuse oY is kgaily requited co supply the requesud data:(c)any Imown coauquence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idendty of o[her persoas or earides autharized by state or federal law to receive the data. Tbis requirement s6a11
not apply when an individual is asked to supply invesrigadve daa,pursuanc to secaon 13.82,subdivision S,to a law enforcement officer.
The commissioner of revenue mav elace che nodce mwired under d►is subdivision in the individual income rax or orooem taz refund
instrucdons instead of on chose focros.
Subd.3. Accas to data by individual. Upon requesc co a msponsible authoriry,an individual shall be infocmed whethec he is the subject
of smred data on individuals,and whaher it is class�ed as public,private or confidential. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown rhe dara without any charge W him aad:if he desires,shall be informed of the content
and meaning of that data. After an individual has been shown che private daa and informed of ics meaning,the data need not be disclosed to him for
six monrhs thereafur unless a dispute or acdon punuanc to�his secdon is pending or addidooal data on the individual has been collecud or cnared.
The responsible authoriry shall provide copies of[he privace or public data upon rcquest by the individual subject of the data. The responsible authoriry
may requin the requadng person W pay the actual costt of making,cerdfying,and compiling the copies.
The responsible audioricy shall comply immediately,if possible,wi[h aay request made pursuant to this subdivision,or within five days of
the date of the reques4 excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
wi[hin chat dme,he shall so inform rhe individual,and may have an addiriooal five days wirhin which to compiy with the request,ezcluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data i�not accurate or complete. An individual may contest the accuracy or completeness of public or private
data conceming himself. To exercise this right,an individua!shall noafy in wriciag rhe responsible authoriry describing the naare of dte disagreement.
The responsible authority shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and atumpt to nodfy past recipienu of
inaccurate or incomplete data,including recipieaa named by the individual;or(b)nodfy the individuai thac he believes ehe data to be cormt 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 pursuant to the provisions of the adminisaadve procedure act relaang to
contested cases.
DATA PRIVACY ADVISORY
In accordaace with M.S. 13.04, Subd.2, "Righu 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 fumish certain private or
coafidential 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, but refusal may require that the Ciry deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent 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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