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Home My WebLink About1996-007732 - land alteration PERMIT CITY OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 UsER DEFINED Permit Number: 007732 Crystal Bay, Minnesota 55323 (612)473-7357 Date Issued: 02/21/q6 SITE ADDRESS: 1565 ORONO OAKS DR LSV P. I .N. ; 35-118-23-33-0008 DESCRIPTION: R0-100 CU YDS FILL User Permit Type LAND ALTERATION REMARKS: FEE SUMMARY: Base Fee ISO 00 Total Fee $50. 00 CONTRACTOR: I OWNER: - Applicant - DALBEC JOHN 1565 ORONO OAKS DR ORONO MN 55356 (612)472-2082 THE UNDERSIGNED HEREBY REQUESTS PERMISSION,TOM MAKE THE REAL IMPROVEMENTS I WORK INCOMPLIANCE WITH ALL CITY'`,, SPECIFIED AND AGREES TO DaSTRICT t ALL • OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. 467 (9.„4-7-1 APPLICANT/PERMrTEE SIGNATURE ISSUED BY:SIGNATURE w • • , ' Total Fee: S DateReceived: Date Approved: Entered By: Permit#: i l 3 z- CITY OF ORONO - BUILDLNG PERMIT APPLICATION ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED THE APPLICANTT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 1 5 0 5 o Pan o O .9/(S ZIP: S 3 f 6 NAME OF OWNER: ...C-0 41w 041 ' e c PHONE: (home) (0 j—)o s (work) MAILING ADDRESS: CITY: ZIP: CONTRACTO2: PHONE: MOBILE PHONE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # I ARCHITECT/EGINEER: PHONE: MAILING ADD SS: CITY: ZIP: NAME: ' REGISTRATION # TYPE OF WORIK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration X PROPOSED WORK(describe indetail): S v 1 io y05 A-` 1 STORIES: T SQ. FEET OF EACH FLOOR: NO. OF BEDR OMS: GARAGE STALLS: ATT. DET. ESTIMATED 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 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; nd that the work will be in accordance with the approved plan. APPLICANT'S S GNATURE: --4 -- DATE: -- l9'- ,6 NOTE! Parade or Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. a .t • O _ CITY of ORONO .� _. >„ Municipal Offices !` _ . H Post Office Box 66 � , C) Crystal Bay,Minnesota 55323.0066 �kESH. 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 (see following paQe) to review private data on yourself. 6. Your full name is required to process this application or permit. PLEASE PRLNT First Middle Last 6 v 40o a c) s►l�S ,o S' S Address 5"5- 3c6 42 j- City State Zip Phone I understand my rights as stated above. ignature TELEPHONE-473-7357• FAX-473-0510 a I S13.04 RIGHTS OF SUBJECTS OF DATA Subdivision 1. Type of data. The rights of dividuals on whom the data is stored or to be stored shall be as set forth in this section. Subd. 2. Information required An.individual asked to to be given individual • himself shall be informed of: (a) the • supply private or confidential data concerning state agency, purpose and intended use of the requested data within the coetoris legally political subdivision, or statewide system; (b) whether he may from his required to supply the requested data; (c) any known consequence arising supplyingor refusing to supply private or confidential federal data;aw to rnded (de the) the identity of f. state or other persons or entities authorized by1 investigative data, requirement shall not apply when an individual is enforcemented to uofficer. pursuant to section 13.82, subdivision 5, The commissioner of revenue ma .lace the re notice unm re•uired un under his subdivision in the individual income tax or •ro•ert on those orms. — Subd.an. - Access to data by individual Upon request to a responsible authorit , individual shall be informed whetherlhe VBteeor bject of stored Upon his Ya confidential. data on individuals; and whether it is classified as � P data without any charge to him and, if he desires, shall further request, an individual who is the subject of stored private or public has individuals shall be shown theof that data. After an individual Se been informed of the content and meaning the data need not be disclosed to shown the private data and informed of its meaning, pursuant to this section is him for six months thereafter unless aP upon request by din or additional data on the individual has steeor public datarreated. The rpen g copies of the p the thehponsible authority subj t of provideThe responsible authority may requirern the individual subject the data- certifying, and compiling the actual costs of making, yi g� requesting person to pay - copies. if possible, with any request The responsible authority shall comply immediately, made pursuant to this subdivision, or within five days of the date of the request,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that which to comply so inform h the have an additional five days withinindividual, and may Sundays and legal holidays. request, excluding when data is not accurate or complete. An individual may Subd. 4. Procedure public or private data concealing himself. To contest the accuracy or completeness of in writing the responsible authority exercise this right, an individual shall notify authority shall within 30 describing the nature of the disagreement. The responsible dayseither: (a) correct the data found to be inaccurate ror incomplete peec and anamedttempt to by notify past recipients of inaccurate or incompletedisagreement is the individual; or (b) notify the individual individual's he believes evesstatement the data to b correct. Data in dispute shall be disclosed only if the• included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases.