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2011-00500 - roofing
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4320 Sixth Ave N - 31-118-23-12-0009
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2011-00500 - roofing
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Last modified
8/22/2023 4:28:44 PM
Creation date
2/14/2019 12:43:09 PM
Metadata
Fields
Template:
x Address Old
House Number
4320
Street Name
6th
Street Type
Avenue
Street Direction
North
Address
4320 6th Avenue North
Document Type
Permits/Inspections
PIN
3111823120009
Supplemental fields
ProcessedPID
Updated
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NEW EXTERIORS, INC Fax:763-315-8908 Jun 21 2011 12:OOpm P001/001 <br /> . + <br /> City of Orono <br /> Building Permit Application for Int�rnal Work <br /> (windows, doors, siding, re-roof, etc.) <br /> Meiling Add►gss:, Permit rnunber. <br /> Og,O�O PO BoX 66 � <br /> Crystal Bay,MN 55323-0068 Date�ceived: •S <br /> � a� �, I St►�et Address: Received ny: <br /> � ` �d�' 2750 Kelley Parkway Plan revi6w fee: <br /> Orono,MN 55356 /� <br /> Total Fse: �f/ /83� � . <br /> Main: 952-249�600 Fax 952-249�616 www.ci.ororto,mn.4�s /� <br /> This applicativn form must be completed in full and all required information must be submitted. <br /> Incomplete applicatiens will be retumed. (Please print) <br /> GENERAL INFORMATION• .3� � �� �� <br /> Job Site Address: �-/6 <br /> �11 this be a Parade of Homes, Remodelers Showcase Home or other�isplay Home? Yes o � <br /> !!ye�a special ever#perm�is reqWr�d w�th Palice peparbnent and Cdy Counal approwel 60 days prio�ro bhe event ShuMe bus servlae wiq be <br /> rsquned unless spplics/K demo,u�es suA�iclent or►�lts parki�is evar7able. Nw►�elmfl�ed events w�71 not be aAowed. <br /> CONTRAC70R/APPUCA�I FORMATIO : <br /> Name_ � ' j ,� S,NC. <br /> � SYate License# 02 '3� � Expiration Date: Z <br /> Lead Certification Number. E�iration Date: <br /> (�or work oa homes that were eo doi to 1978 <br /> Phone: - — � (office) (cell) <br /> Maittng Address: � � � ; � ciry: � g z�p: SS36 � <br /> Contad Pe�son_ � � qpplicant is: o rac o � / Homeovmer (Clrcle One) <br /> Email and/or Fax; 'j(o - ^_ �8 <br /> PROPERTY OWNER INFORMATIQN� . <br /> Name: D �qµ <br /> Phone(day); 3- _ �� <br /> Address: �h _ City: • ��� ZIP: . S�S.3S �o <br /> Email andlor Fax <br /> PROJECT INFORMATION: <br /> Ty�of ProjeM: Any ealth movement may require <br /> ❑Doo�(s) ❑ Remodel ❑Water Damage �C�����`���' <br /> Minnehaha Creek WaterShed Distrid(MCVYQ) <br /> ❑wndow(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd <br /> ❑3iding ❑ Restoration ❑Othe� (specc:ify) Deephaven,MN 5b391 <br /> Phone: 962-471�0590 <br /> Re-roof ❑ Fire Oamage Fax 952�71-0682 <br /> www.m i n n eh ah acre e k.o ra <br /> Overall Pro"ect D�scription: <br /> Estlmatad Construction Valuation f Pro'ect(exc udin land $ <br /> APPLICANT ACKNOWLEDC3EMENT: <br /> • Agrees tp provide all iMortnation required or raquested by the Building Departnterit; <br /> • Certifies that the information supplied is true and correet to the best of his/her knowledge. The applicaM recognizes tttat they <br /> are solely r�sponsible for submitting a complete appliCation being aware tltat upon failure to do so,the staFF has no altemative <br /> but tp rejecx it until it is complere; <br /> • Some or all of the infoRnation that you are asked to provide on this application is classiRed by State law as either ptlV�te or <br /> confideMial. Private data is informadon whieh generdlly cannot be glven to the public but can be given to the subjed of the <br /> dats. Confiderrtiel data is informaflon which nerally qnnot be given to either the pubfic or the subject of the da1�. Our <br /> putpose and intended use of i tio11 ' to annually update our reconds and records of othnr govemmental agencies <br /> uir�ed b law, If ou refuse s in rmation,the licaiion ma not be i�sued. <br /> Applica�Ys Signature: ' ' Date: ' � <br /> � <br /> Lsst Updated: 03-01 2011 <br />
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