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2009-00179 - siding
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1360 Vine Place - 07-117-23-42-0037
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2009-00179 - siding
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Last modified
8/22/2023 5:38:33 PM
Creation date
7/8/2019 11:35:19 AM
Metadata
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x Address Old
House Number
1360
Street Name
Vine
Street Type
Place
Address
1360 Vine Pl
Document Type
Permits/Inspections
PIN
0711723420037
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City of Orono <br /> Building Permit Application <br /> Mailing Address: <br /> O�O�O PO Box 66 Permit number: <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address: Received by: <br /> Gti`S 2750 Kelley Parkway Plan review fee: <br /> Hogue Orono,MN 55356 <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <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: 'ff <br /> Job Site Address: M 0 P 6.14 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Li Yes IgNo <br /> If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: / " <br /> State License# -Zte12_7 ZF?5_ Expiration Date: 3 3 i zv O <br /> Phone: Cf O--l" office ^ - c®II <br /> Mailing Address: Ci ZIP: <br /> Contact Person: Applicant is: on ractor / Homeowner (cird•one) <br /> Email and/or Fax: 1450Clod <br /> PROPERTY OWNER INFORMATION: <br /> Name: L4)L_)JaR_ <br /> Phone(day): <br /> Address: 13(„o l/(,(4- a4r. - CityAf(j" ZIP: <br /> Email and/or Fax <br /> PROJECT INFORMATION: <br /> Type of Project: Any earth movement may require <br /> MCWD review&permits <br /> ❑Door(s) El Remodel ❑Water Damage <br /> Minnehaha Creek Watershed District(MCWD) <br /> ❑Window(s) ❑Repair ❑Storm Damage 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Siding 8 Restoration ❑Other.(specify) Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> 8 Re-roof ❑Fire Damage www.minnehahacreek.org <br /> Overall Project Description: <br /> Estimated Constructkm Valuation-of Project(excluding land} $ ( -f Icon. CIO <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 <br /> are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative <br /> but to 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 public but can be given to the subject of the <br /> data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our <br /> purpose and intended use of this information is to annually update our records and records of other governmental agencies <br /> required by law. If you refuse to supply the information,the application may not be issued. <br /> Applicant's Signature: Date: <br /> Reset Form -7- / <br />
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