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Home My WebLink About1992-004552 - re-roof PERMIT CITY OF ORONO PERMIT TYPE: �} 1335 Brown Rd. South • PO. Box 66 '{ `_ Permit Number: Crystal Bay, Minnesota 55323 Date Issued: t3;-;; Lt;: (612) 473-7357 SITE ADDRESS: OLD C JB E_ . i . N . , DESCRIPTION: Building Work Type RE-ROC-117 i�i f•v fig r'rit_sjrefr3 L•I f 1 Ul Vl1TV f .11 T171TL•L V! 1 J.4•L 717 t r!f if if l!{ I JI JI VVVVV r=•- V1 6L71 74'T �r�V fulAAA TY REMARKS: " `.J.V( 11L 4L1f 1 1111'll sl' I L=LI i7 i.-T.1!L• L•VVI I VI ivJ:VJ FEE SUMMARY: ``•q•�• if11-1L_t_jF: 1 I i_:N - - -har-g 1,: . , 4ifT CONTRACTOR: - Applicant - OWNER: M :1 S R i%-;F I NG 1 7's-DO .5 ORANCI =:i:I•-!00L D I'_T #278 -99TH LA CiLD CRY:'z"TAL BAY RD N BLAINE M,N EC:$ :;A L0Nt1 L :::E MN HE UNDER_.T GNED HEREBY REQ(JE,::;"_' E,E R'M i:v;:_:T!it'd 11_! MAKE THE REAL I t'1E'R�_:VEt°cN I SPEC I i=I ED AND AGREE:__., TF_' Df3 ALL 140M%*.' T N _TR I �:iA T PL I ANC= I.J I TH ALL_ I T`v' 1-1C __ _ ET 1 ; 1 1 G "� 4 3-;Et�;N%i ;1E;;:I �; t�Et:E:_; t:;twD :,! ;TE i:ii M I NNE:_; . ,A R1:T L T' � f_i:.L � :E:,.i.I i�:Et iEt T'_ . I PPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATdFW i CITY of ORONO Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices • - On the North Shore of Lake Minnetonka 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 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 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 to review private data on yourself. 6. Your full name is required to process this application or permit. ,Jc�zo✓rFp 5ILl�/f First Middle Last II1 ' 601-0t; N G I<t�- L4,Vt Address C12c -e )01,ves, /Vf City State Zip -79J -3Sz Phone I understand my rights ,as stated above. Signat e BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359 ASSESSING r^ 5I3.04 BIGHTS OF SU=CTS OF DATA Subdivision L Type of data. The rights of individuals on whom the data is stored or to be stored shall be as set forth in this section. Subd. 2. Information required to be given individual. An.individual asked to supply private or confidential data eonc ea data within• collelf shall be ecoting state gee purpose and intended use of the request political subdivision, or statewide system; (b) whether he may refuse or is legally lrnown consequence arising from his required to supply the requested data; (c) any fidertiel data; and (d) the identity of supplying or refusing to supply private or conive the other persons or entities authorized by state'0 feis edeeral lto to re einvestigative data requirement shall not apply when an individual pursuant to section 13.821 subdivision 59 to a law enforcement officer. der The commissioner of revenue ma lace the notice req o uinsteadhos subdivision in the individual income tax or ropert tax refand on those 7orms. -- -- Subd. 3. Access to data by. individusL Upon request to a responsible authority, an individual shall be informed whether ublic, �r'vateesubject of or eonfidential.ed data on Pon his individuals; and whether it is classified P uL data on further request, an individual who is the subject of storedto him and, if he desires, shah individuals shall be shown the data without that�ta.a. After an individual has been 6e informed of the content and mell aning ingi the data need not be disclosed to shown the private data and informed of its utaaction pursuant to this section is J him for six months thereafter unless a dispute pending or additional data on the individual the has r vateeor public data n collected rupon arequest by responsible authority shall provide copies The responsible authority may require the the individual subject of the data. p certif and compiling the requesting` person to pay the actual costs of making, certifying, copies. immediately, if possible, with any request The responsible authority shall comply • the date of the request, made pursuant to this subdivision, or within five days of of tmmehe to compliance is not excluding Saturdays, Sundays and legal holidays, he possible. If he cannot comply with the requesttwhin ithitnwhich to comply mply�with the individual, and may have an additional days request, excluding Saturdays, Sundays and legal holiciays. Subd. 4. Procedure when data is not accurate or complete. An individual may himself. To contest the accuracy or completeness of public or private data concerninge authority t an individual shall notify in writing the resp exercise this right, describing the nature of the disagreement. The responsible authority shall within 30 days either. (a) correct the data found to be inaccurate or incomplete ids attempt by notify past recipients of inaccurate or individual that hte e the recipients be correct. the individual; or (b) notify the mrre is Data in dispute shall be disclosed only if the individual's statement of disagree • included with the disclosed data. appealed pursuant to the The determination of the responsible authority may oneed cases. provisions of the administrative procedure act relatingto CITY OF ORONO - BUILDING PERMIT APPLICATION Total Fee: $ �3 � ' ��C Date Received: Date Approved: v Entered By: -// Permittt: J .53�' ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED (See Check-off List Enclosed) --------------------------------------------------• ----------------------- THE APPLICANT IS: (circle one) OWNER or CONTRACTOR JOB SITE ADDRESS: - b ) `� C�y57�'� 1�1g y �y14/,I ZIP: 5- 3-5 nn (work) `f 7 3 - 7 31 3 NAME OF OWNER: rZG ( � f SL' Z 7 PHONE: (home) MAILING ADDRESS: �i &-V U�Y574L T3V9`f T C CITY: L oIV& 14K-(- ZIP: J 3 S 6 CONTRACTOR: M �' 5 F-00 FI r"&, PHONE: 7 g 0 -g5 Z- MAILING ADDRESS: IVIS 1� A/ CITY: 13 L,gI'� 'L ZIP: J L!3 STATE LICENSE: # /V/4 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION - TYPE OF WORK: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORK (describe in detail) : L�OV�`' Z 5e Cy rzoo r X7 opuoNa /11 /dDL-e- .56�jo0LL STORIES: SQ. FEET OF EACH FLOOR: . NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land) : $ 5 U, Uuy 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: / �L � DATE: