HomeMy WebLinkAbout1999-011717 - siding, soffitf, fascia PERMIT
CITY OF ORONO PERMIT TYPE:
� 2750 keiley Parkway- P.O. Box 66 - _ - .- '
Crystal Bay, Minnesota 55323 Permit Number:
Date Issued:
(612)473-7357 .. - . - =`f'--'-
SITE ADDRESS:
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DESCRIPTION: I
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REMARKS:
FEE SUMMARY:
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APPLICA RMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ ,,�. � :� 7� Date Received: :�� �-���
Entered By: �. '� Permit#: %' �,��_
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CITY OF ORONO - BULLDING PERMIT APPLICATION � �
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All inf�rmation must be submitted in full before plan re�vie�v �-ill be started. . �
(please print all information) . :
THE APPLICAI�"T IS: (circle one) O�VNER OR CONTRACTOR
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JOB SITE ADDRESS: .S� l� � �Z�: `� �
NA.1�� OF O'4�TER: ���-� �c�Di.�a4�.�c�/� PHONE: (home) _ �
(work) �
NIATLIPIG ADDF•E.SS:3.39� C� S �_��CTI'Y: O�d�6 _ZIP: S.ss3�
, � �
CO�RACTOR:��i " o r -c S ��G PHOI �s� �$`�� � �
CO��'ACTPERSON: ,9� � ,� _ MOBILE/PAGER:
MALLTtii'G ADDRESS:/� o/� CITY:,iN o .��-� � ZTP: .�`5 6%�
STATE LTCE�TSE: #
ARCHITECT/EI\TGII�TEER: . PHOti�: �
�7AILItii'G ADDRESS: CTTY: ZIF':
�TAME: REGISTRA.TIO�T#
TYPE OF tiVORK: New Addition Accessory S�ucture
Move Remodel/Alteration Land Alteration
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?�O?OSED'SVORK(�escri8e in detai�: �,tJ-�,�: �' � ' �`
y7
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STORIES: SQ.�EET OF EACH FLOOR:
�'O. OF BEDROOiVIS: GARAGE STALLS: ATT. DET. � .
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EST .Tl�i IA.TED CONSTRUCTION VALUATION (excludi.ng land): $ %�� 6 r — �
I hereby apply for a building permit and I acirnowledge that the information above is complete and
accurate; that the work will be in conformance wi[h the ordinances and codes of the City and with
the State Buildi.n� Code; that I understand this is not a permit and work is not to start without a
pernut; and thac the work will be in accordance with the approved plan.
�TT'S SIGNAT'URE: / DATE: �� l��
APPLICAi ° � ��
NOTE! Parade o,�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.
Sec.13.Q4 RIGFiTS OF SLJB.7ECTS OF DATA •
Subd. 1. Type o[data. The righct of individual on whom[he data is scoced ar ro be sroced shalI be as sec forch in chis secrioa
Subd.2. Iatormation reqirirrd to he given indiridual. An individual uked w suppty privac:or coafideadal dam cancerning hi�self shalI
be iaforu:ed o`: (a)[he purpose and incended use of the requesred dara withia che calIecdng�tate ageary,goliacal subdivisioc,or samwide rysc:m;
(b}whecf:ec he rcay refuse oi is_(egalIy requir.d co suppty che r_quesud daa;(c)any lmown caastqucnce arising from his supplying or reCusing w svpply
privac:or co;�;dcr.�ii�ta;and(d)the ideadry of ocherpersaas oreaddes auchorized by sta�e orfedecal law co teuive�e da�. This r_quiremenc s�all
not apply when an ir.dividual is asked ta supPly invesagarive daa,pursuanc to secdon 13.8?,subdivision S,co a law eaforcement ofncu. . . -
'f�e cer.lmiszioner of revenue mav Dtac- the nodr r�uird und-r this subdivision in [he individual incorne tix or orooem t�z refund
inscsucrions�nsuad of on those fomu.
Subd.3. ?.ccess to data by indiriduaI. Upon requcsc to a respansibie authoriry,an individual shall be informed whether he is che subjecc
of stnr:d dao on individuals,and whecher it is elassiFied as public,private or conFdendal. Upoa his furcher rquest,an individual who is ehe subje:c
of scor.d priva:e or public data on individuals shall be shown[he daa wichout any charge to him and;if ha desira, shalI be infocmed of rhe contanc
and m:aning of that dara. Aher an individual has been showa�he private dat�and iafocmed of ics meaniag,the dara nerd not be d'uclosed to him for
siz monchs�heceaftec uriless a dispu�e or acaon pucsuanc co �his secaon is pending oc addidoaal daa on the individuaI has been eollecmd or creamd.
The responsible au�horiry shallprovida eopies of the priva`or public daca upon request by the individual subjccc of che dara. Tha responsible auchoriry �
may requir_ the nquesdng person to pay tha accual coses oi making,eerdfying,and eompiling the copies.
The responsible auchoriry shall eomply imzr.edia[ely, if possibie,wich aay request made pucsuant co�his subdivision,oc wictun five days of
the date of the request,ezctuding Satucdays,Sundays and legal hatidays,if immediate compliaace is notpossible. If he canaot compty with[he requesc
wichin chac ame,ho shall so inform che individual,and may have an addidoaal five days within which to comply wich the�equest,ezcluding Saturdays, �
Sundays and legal holidays. . . �
�
Subd.4. Procedure whea data is not accurate or eomplete. An icdividual may conc:sc[he accucacy or eompleceness of pubiic o�privace
dara conceming himself. To ezeccise chis right,an individual shal!nodfy in wridng the respoasibie auchoriry describing�he nacure of che disagreemeac �
The respoasibie au[horiry shail wichin 30 days ei�:ec: (a)correcc che data found to be inaccurate or incompie�e and arc:mp�co norify pasc recipiencs of i
inaccurate or incomplece daia, inciuding recipiea�s named by che individu�l;or(b)nodfy the individual thac he believes the dara to be correcc Daci
in dispute shall be disclosed onIy if the individual's statertstnt of disagreement is included wi�h the disclosed data.
T�e de�erminadon of the responsibla auchoriry may be appealed pursuant to the provisions of the adminisaarive proceduro act relaang ro ''
eontesmd cases. .
DATA PRTVACY ADYISORY
. i
In accordance wich M.S. 13.04, Subd.2, "Ri�hts of subjeccs of data", we would like to inform you that your request !
for a pemut or license from the Ciry of Orono or any of its departments may require you to furnish certain private or ;
confidencial information. �
You aze notified thar.
1. The information you furnish will be used to determine your qualification for the permit or license requested. I
2. You may refuse to suppty data, but refusal may require that the City deny the permit or license. �
3. The information may be shazed wich o�her local, stace or federal a�encies to the etcent necessary to process
the permit or license.
4. If your requested perm.it or license requires Council action to approve, some information may become
public. �
5. You have certain ri�hts under M.S. I3.04 (available upon request) to review privace data on yourself. '
6. Your full name is required to process this application or pe 't.
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�9��-� P o n �rl�'� /t?s?�Y�/�✓" ,
Firsc �fid I.asc
� %o� .7 � ' -�.�'�� r���
Address
Ciry iP�•,�I �___.. Sace !� _ Zip /7-�3),., Phaae �C'�— ��
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I understand my ri�hts as stat above.
Sigcucure
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