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2014-00522 - roofing
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1390 Railroad Avenue - 10-117-23-31-0005
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2014-00522 - roofing
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Last modified
8/22/2023 3:22:27 PM
Creation date
7/12/2018 1:19:03 PM
Metadata
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x Address Old
House Number
1390
Street Name
Railroad
Street Type
Avenue
Address
1390 Railroad Avenue
Document Type
Permits/Inspections
PIN
1011723310005
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Updated
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� � City of Orono <br /> Building Permit Application for Maintenance / Replacement / Renovation <br /> (No structural expansion. Only windows, doors, siding, re-roof, etc.) <br /> �^'�\ Mailing Address: <br /> j ��'V PO Box 66 Permit number: <br /> r' ', Crystal Bay, MN 55323-Ofl66 Date received: <br /> � ; <br /> � : , ,� 5treet Address: Received by: <br /> �'F ,�/ 2750 Kelley Parkway Plan review fee: <br /> l�kFSH��/� Orono, MN 55356 <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 v�rww ci.arono.mn.us <br /> This application form must be completed in full and all required information must be submitted_ <br /> Incomplete appl�lcations will be returned. (Please print) <br /> GENERAL INFORMATION: , � ,��f�� �� ,,� <br /> Job Site Address: ;�/�, <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes <br /> H yes,a special event permit is required with Police Dapartment and City Council approval 60 days prior to the event. Shuttle bus senrice will be <br /> required unless applicant demonstrates sufficient on-site parking is availa6le. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION:�� <br /> Name: S� ` r' <br /> State License# (� Expiration Date: <br /> Lead Certification Number: p � � Expiration Date: <br /> (for work on homes that were construcfed prior to 1978 <br /> Phone: (cell) (office) <br /> Mailing Address: � . <br /> u S City� ' (� ZIP: � <br /> Contact Person: ,/ Applicant is: Contractor Homeowner (Clrcle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: <br /> Name: 1 " �� <br /> Phone (day): - Z �� S <br /> Address: City: Xc�J� ZIP: SS�� <br /> Email and/or Fax: F <br /> PROJECT INFORMATION: Overall ro'ect descri tion: <br /> Type of Project: Any earth movement may also require <br /> ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8 permits: <br /> �roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) <br /> ❑Re-roof, cedar ❑Restoration ❑Water Dama e 18202 Minnetonka Blvd <br /> 9 Deephaven, MN 55391 <br /> ❑Re-roof, other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590 <br /> ❑Window(s) Fax: 952-471-0682 <br /> www.minnehahacreek orq <br /> Estimated Construction Valuation of Project(excluding land) $ J �� <br /> APPLICANT ACKNOWLEDGEMENT: <br /> • Agrees to provide all information required or requested by the Building Department; <br /> • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are <br /> sole�y responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to <br /> reject it until it is complete; <br /> • Some or all of the information that you are asked to provide on this application is classified by State law as either private or <br /> confidential. Private data is information which generally cannot be given to the pubfic but can be given to the subject of the data. <br /> Confldential data is information wh' h genera y cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this inform is II pdat our records and records of other govemmental agencies required by law. If <br /> ou refuse to su 'the i atio h I tio not be issued. <br /> ApplicanYs Signature: Date: " Z � <br /> Owner's Signature: Date: <br /> Last Updated:03/06/2013 <br />
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