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2017-01180 - minor alteration
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3180 Ridgewood Circle - 04-117-23-23-0021
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2017-01180 - minor alteration
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Last modified
8/22/2023 5:10:21 PM
Creation date
7/25/2018 10:56:36 AM
Metadata
Fields
Template:
x Address Old
House Number
3180
Street Name
Ridgewood
Street Type
Circle
Address
3180 Ridgewood Cir
Document Type
Permits/Inspections
PIN
0411723230021
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Updated
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. '09121l2017 08:19 Dercon Construction �A�}7639513019 R.0011001 <br /> � <br /> , <br /> City.of Orono <br /> Building Permit Application for Maintenance/RepEacement/ Remodel—���,,.�'_'' .�� <br /> (i.e.windows, doors, siding,re�oof,etc.—NO S71�UGTURAL EXPANSION) <br /> �a�V ��O Box BB� P�rmit number. �7"�l�gD <br /> 0 Crystal eay,MN 55323-0066 Date reoeived: � � <br /> StreerAddress: Reoeived by: <br /> 5 i �` O�����Y Plan review fea: <br /> �K�SHo�� � g�,3� <br /> Tot�l Fee: <br /> Msin: 952-249-4600 Fs�t 952-249�816 www_ci_orono n_us <br /> This application form must be compieted in full and aN r'equired infnrmafion must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> Job S' Ad`dressRMAT10N: �� l�V 1R \l� �.��0� � <br /> ic, <br /> YYill th' be a F�arade of Homes,Rempdslsrs Sh cas�Home or other Display Home? Yes No <br /> Jf a special ev�enf pemrit is requ6ed wiEh Pafks Department and CHy Caen�approv�l 80 dtda privr tv tfie event Shuk►e bus seivi�wd!be <br /> required un�ess e�Yica►�t aemarsbates suAtiaent orr�ite paddng!s avaUable. nlar�pan�f�d avenLs witl not be auowea. <br /> CdN71�ACTOR/APPLICqNT iNFORMATION: <br /> Name: �Q,�O� (py�5�(�(1]G51'I� �\C�,S �L�L . <br /> State License# Y�G�i�q l�v Exp+ra�on Date: 0'3'31�1�I <br /> Lead CerE"rFcation Number. (.����� Expiration Date: _k 4 �1`7 <br /> (for work on hanes that were cansbuct�d p�ior tn f978 ' <br /> Phone: (ce[I) {p�2��.'j(p�(��Q� (e�rCe) <br /> Mailing Address: �d'�. '10 �—A�(1C W G�'hr pV�.V" ZIP: �"�D"� <br /> Contact Persort: �(� ���,���,�� AppliCant is: nb'2 / Homeowner �ci�o�.� <br /> Email and/or Fax: �i�aV���,� �L�4�l <br /> PROPERTY OWNER INFORMATION: <br /> IVame: �'�,\Sr w l�`?u� <br /> Phone(day): - � a ���"3'� ' <br /> Address: "yl`�� 1/�•�,WCwc� 1V'���` CitY; L�v1��,t�..�R� ZIP: ��3�<a <br /> Email and/ar Fax: 1�2:��r f�C..C�.�wil`�✓�.�A►M <br /> PRdJEC71NFORMATION: overaU ro ect descrf on: 1�-C U. � Vw�' <br /> Type of Projeck My earth movement may also require <br /> �Doar(s) ❑Remodel ❑Fre Darr�age <br /> AACWI7 review&permits: <br /> Minn�haha Creak Watershed Disb�id(MCW R) <br /> ❑R�-nr f,asphalt ❑Repair ❑����� 15320 Minnatonka Blvd <br /> ❑Re-r f,o�i$r ❑Reatoratlon ❑Water Darnage Minnetonka,MN 55345 ' <br /> �Other.(speafy) Phone: 952-471�0590 <br /> ❑Re-roof,other(spaeNy� �Siding , Fa�c 952-471-0682 <br /> Q NV�mdoW(S) www.minnehahacrsek.ora <br /> Estimated Construction V�luation of Project(excluding fan� $�?►ti�l � <br /> APPI.ICANT ACKNOWLEDG�Np�N7: <br /> • Agr�s to provide$II infoRnation required or requested by U�e�uildir�g Department; <br /> • Ce�dfes that the information suppied is true and corred to the best af hfs/her knowledge. The appl�ant recognlaes�et they ere <br /> solety responsible for submitting a canplete epplicetion being awsre tttst upon failure bo do so,the s�ff has no alhemative 6ut to <br /> rejert it urrtil it is complete, <br /> • Some or af!of the irrfortnation tF�at you are aslaed to provide on th� appYcatlon Is dassified by State taw as either private or <br /> corifidermal. Private data is informason which generady cannoi be given to the pubtic but can be given to the subject of the dsta. <br /> Confidential d�ts i�informstion wFtich generally cannat be given 6o either the public or the subjed af the data. Our p�upose and <br /> intended use of lhis infomiation is to ennuaYy update nur reoords and reoords of other govemmer�mi agendes required by law. If <br /> ou refiise to su the infortnation the ication ma not be issued. <br /> Applican#'s Signature. 1����uii � Date: ��'� I��� <br /> Owner's Signature: Date: <br /> L�t Updated:Jarluary 2016 <br /> � <br />
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