o: MonlCe Fodneca Pogt9 3 uf'19 20'13-0�-'1Z 0�:00:40(a:Ml-) '1952856506'1 From: Joo Bronnen
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<br /> �uilding Permit Appli�ation for Maintenance / Renovation .7D�1
<br /> (windows, doors, siding, re-roof, etc.)
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<br /> � \;. y. Crystal Bay, M N 55323-0066 ,�`ate.�t8c�'I��d:;�:;;:::<:::<:`::;;':: ...::: �..: >,.:;:>��:::=a�<;
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<br /> Main: 952-249-4600 Fax: 952-249 4616 www.ci.orono.mn.us
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<br /> This application form must be completed in full and all required information must be submitted.
<br /> Incomplete applications will be returned. (Please print)
<br /> GENERAL INFORMATION:
<br /> Job Site Address:p 145 Sm i th Avenue
<br /> Will this be a Pa�ade of Homes, Remodelers Showcase Home or other Display Home? Yes No
<br /> !f yes, a special eve►rt permif is required w'rfh Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be
<br /> required unless applicanf demonstrates s�cient on-sife parking is availab/e. Non-permifted evenEs wiU not be allowed.
<br /> �,•GAidgRA6��R l AR�P-LJ�/kNT INFORMATION: z�„ ,;_�2_-������:40 <<;M,-> -�45���.�,ofs, �,-�.n . �;.P..,.,�.,
<br /> Name: Brennan Pro erties LLC
<br /> State License# BG381410 Expiration Date: 03 31/2013
<br /> Lead Certification Number: NAT-119015-1 ',,,r� `1�/ IQ� , r��"�� Expiration Date: 11 24 2016
<br /> (fa work ho s that r�e const�uc,�ed prfor fo�1�878 6,�y, , ,,_ :9.,.� , r , r ,
<br /> Phone: �t,���C��1�6�5°=���� ,,, ,. .����6u�fi�:►l�of�ic+e) �il��?�1�����1ti , a�.��Gi � ��Il�,)�'�.�I+w�a'1 (cell)
<br /> Mailing Address: 15 i s V' »il'd�'1t . �:it�C'S, :���:, 9�1�, !'�-P : CCf ake ZIP: 55 72
<br /> Gontact��rson: oe rennen M.�;,�,; � ,es� pp icant is: ontrac or omeowner �crc�i.or�aj
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<br /> PROPL�'E�Y OWNER INFORM�ITION;, ,= E G �y
<br /> Na�ie:� � F ;. � Lor i Gherard i'�r,, ss ___ _____ - - ,
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<br /> Pho[��,��a��o-`'�� 612-670-4228 . ,�in� :� ,
<br /> Address: 2985 WatertoM[n Road City: �.a�o�o ZIP:
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<br /> ���,eg�f��r��#ess: 145 r�r�i? ,�. ���tt� Any earth movement may requlre
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<br /> �Re-roof, cedar Restoration ❑Water Damage Dee haven, MN 53 1
<br /> �1'FR�I�TOR ' �F'�a .F�'f INI��.'a°''�.s Phone: 952-:471-0590
<br /> �roof, other(spe�r� ���Si��p�� 4,i__ �� Q Other: (specify) Fax: 952-471-0682
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<br /> �ie�aEE-�p�et�%De���ion:�t4iftcti��f` remode l<:; bath remode l�; add f i-re��l�ce i%�dd/r �I a' =4.Z��w i ndows
<br /> Esftftf�t'�d6r�#t��t�'t��1��bf'Proj�ct'(�Stclo'dingland) $ 15,000
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<br /> �_cr ac ��eo providL��tl i � tirf�t�iFi required or re�uested by the B�rpiii�ig�Se�artmerit;
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