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Home My WebLink About1997-009367 - tear-off/re-roof � - � PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 Permit Number: �=`"=�`�'�t` Crystal Bay, Minnesota 55323 -'` ''�'-��-��' (612) 473-7357 Date Issued: ;^.,:�,;;�..,:, ;,�i-, SITE ADDRESS: ; :.:�., __.., r -_ - _- _;��;�;:,-; DESCRIPTION: -��,-� -.�:-.J��::�.- :;,_.t-,r: ...,�..,,: _.. r �i iti �-� =�? � _ �i=—�=i�,�1'i,.�,`.`,•�#ws�''�i_ ..._. .,{i 1"i•.� yi�'�':... �(C€:I�.� a Y i,=' .'_�1 �i_i Z 1 i� 13Fi„i i''F:; � t'�:�;,s L.t'L—i1:_��_E:` �-'.°t"=.•�;,,��; (w i,z}j;�x �'.f,.:=�:1 {-}'I . `'.`'�_��'`�V€.t�'3? REMARKS: , - - -, - - - - ��.�: � r. _. tY � ; :: � � — ... _. _. . ... _. . . ,. . . _ . , • r , �: �. : ' % s� � �' 'd. . : u.. ,, . � � ,, ; . :, _ _ �� ; _. __ � _�_ _ . — r.—., � ,— —• — . ..-- . — 1_:� i i':W! . ;L t_I"E h.;—t��t}T i�..__ _'_!_. . . .. , .._. .. . t:+ . . , .. .. .._..� ... . . � t j�. FEE SUMMARY: -�,;��i�.�_��.��:^;�:� �_ . s:_:::: ,��.a=�� s=��:� ��?' �F . _ ':��3t':.'!'i_{!'�� . '�:�i �ll'•:''�� 3!�.=FT.;;i}� ______ _sr�M.�` �;t�t�:a� �—._.a ��_�•3. . �_•3"_� CONTRACTOR: -- . ,- ,- = ; �_;.�i t. -- - _.�; OWNER: :,., - � ,:_:, :� � - . ..� _ .., . 4`f' • ._ _.... .. .. �. ._ . , . _. _ . _ .. . . . _ ._ . .�::`f'.L_ i',t{'•:;i�-;f��{'� i_i.; _ _:,f'f: }"',:_si:' i �. w��'ii_lil't„ f.ii: •. � .: �.:,_—.: � �,� — _,I� ._ . �*{:_:;.' � . " _ _. .+'.(`Yf i _. _ _. ._ - - - ...�.f�a�'j _.W ;:t,�, -� . . .;;::,,,,_-� - � � ;W;:,; - : �' , -. . , #'��r`�.r=��t u�..�f . ...�.._, � ` "' _ _ _ ._ _ . .. .. .__ . . .._. .. _ . . __ ._ '. `� . . .... _ .,_ . ._. . __ .: � ;s s }`.� :• _�..; � ..._ — _;.. �; , r. _y!'t r . ` : { . :..:..'�_ �` ' ..,_ . . . . ._ .�.:_. e ____ ., ._ �. .. ry '- ... • a •_. .. � . ��_. . _._. . _ _.. '.'• r �=- �r . _, i _ .. ..,—.r � ci, t� 'f � ie";"14 �� .. ._�' ��s � . , � ._ _. ,i _... . .. _ .-dA.€.._»3�.`ti�� ,.._... .__ , .r . _ . . . � � .r ,... .... ...... .,.f ,. . �� `� . APPLICANT/PEFiMITEE SIGNATURE ISSUED BY:SIGNATURE ' r . � Total Fee: $ Date Received: '`. Entered By: � Permit#: - CITY OF ORONO - BUII�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 O CONTRACTO JOB SITE ADDRESS: ��7 D �(I o,�T�-( S f tG2 E �� ZIP: NAME OF OWNER: S��l� �� PHONE: (home) �� ` �l(� (work) MAILING ADDRESS: ��?� /�- Sh c<< ��— CITY: C�r v r i � ZIP: CONTRACTOR: iti�.l��wc,�-k `� CL�r�S`}-- PHONE: ��4— 7 � �7 7 CONTACT PERSON: C��k pJ��`c ,r MOBILE/PAGER: �(� G� � 7 � � 5 _ MAILING ADDRESS: 02`7 oZ S N�t��.n 1- �. . CITY:�� ., i.,,.ov�-L� ZIP:�` STATE LICENSE: #a � 6�.�. 7 > ARCHITECT/ENGINEER: PHONE: MAII.ING ADDRESS: CITY: ZIP: NAIVIE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration X Land Alteration PROPOSED WORK(describe in detain: ��e v�c� ��-� �-- ��'� c�b� .� l C G� ..3�r t� � �L �vi`��.1� �{-v p-�' STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �i �� 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 SIGNATLTRE: ��/�� DATE: �� l�] NOTE! Parade of Flomes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � � . Sec.13.04 RIGATS OF SCTBJECTS OF DATA Subd. 1. Type o[data. 'Ihe righa of iadividual on whom rhe data is scored or to be smred shall be as set fonh in this section. Subd.2. Information req�rired to be pvw individual. An individual as�ed W supply private or coafidential dara conceming himself shall be informed of: (a)the purpose and inteaded use of the requesud data within the collecdng State agency,polidcal subdivision,or statewide rystem; (b)wheeher he may cefuse oti is legally nequired to supply�he:equesud data;(c�any kaown consequence arising from 6is supplying or refusing w supply priva[e or confidendai data;and(d)the idenary of o[her persons or enddes authorized by sate or federal law m meive rhe data. This requiremenc shall not apply when an individual is asked to Supp(y investigaave dara,punvant W secdon 13.82,subdivision 5,to a law enfoceement offiCec. The commissioner of revecrue mav olace the noace teauiied under this subdivision in the individual income tax or orooem raz refund instcucdons insuad of on those forms. Subd.3. Accas to data by individual. Upon request to a responsible authoriry,an individuai shall be informed whether he is the subject of stored data on individuals,and whether it is classified as pubtic,private or confidenoal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and;if he desires,shall be informed of the content aud meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be discloud oo hicn for siz months thereafter unlesa a dispute or acdon pursuanc to[his secrion is pending or addi6onal data on the individual has been coUected or created. The responsible authoriry shail provide copies of the private or public data upon nquest by the imdividual subject of the data. The responsible authority way m�uire the requesting person to pay the actual costs of making,catifying,and compiling the copies. The responsible authoriry shall comply immediately,if possible,with any nquest made pursuant to this subdivision,or within five days of the date of the nquest,exeiuding Saturdays,Sundays and legal holidays,if immediace compliance is noc possible. If he cannot comply with the request within that dme,he shall so inform the iadividual,and may have an addidoaal five days withia which to wmply with the nquest,excluding Sahudays, Sundays and legal ho(idays. Subd.4. Procedure whea data is not accurate or complete. An individuat may contest the accuracy or completeness of public or pmate data conceming himself. To exercise this right,an individual shall nodfy in wricing the tesponsible authority describiag the nature of die disagteement The responsible authority shall widiin 30 days either: (a)correct the data found ro be inaccurace or incomplete and aaempt to noafy past recipientc of inaccutate or incomplete data,inc(uding t+ecipients nazned by the individual;or(b)nodfy the individual that he believes the data w be correcc Data in dispute shall be disclosed oaly if the u►dividual's statement of disagreement is inciuded with the discloud dara. The determinaaon of the responsible authoriry may be appealed punvant to the provisions of the administcaave procedure act relating to contesoed aases. 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 permit or license from the City of Orono or any of its departments may require you to furnish 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, 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 liconse requires Council action to approve, some informatioa may become public. 5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself. 6. Your fu11 name is required to process this application or permit. �e� `� �"x.G..��Z First / I Middle r Last �(P � ('�l � �O �a— I� 4� Add r _ �Gl k� /�� 7� i7 �i ��" D�� 1�C� `n Ciry Staoe Zip Phone I understand my rights as stated above. �� Signamro -