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2014-00903 (siding)
Orono
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Bayside Rd - (AKA: Co. Rd. 84)
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3510 Bayside Rd - 05-117-23-13-0016
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2014-00903 (siding)
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Last modified
8/22/2023 5:16:39 PM
Creation date
1/15/2016 1:45:04 PM
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Address
House Number
3510
Street Name
Bayside
Street Type
Road
Address
3510 Bayside Rd
Document Type
Permits/Inspections
PIN
0511723130016
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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 /> �O�O Mailing Address: Permit number: <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address: Received by: <br /> � � 2750 Kelle Parkwa <br /> y�. G Y Y Plan review fee: <br /> Orono, MN 55356 <br /> `qkFSH04� 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: <br /> Job Site Address: 3��� s�'� �oae(. O�n�' <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o <br /> If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus se i e 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# Expiration Date: <br /> Lead Certification Number: Expiration Date: <br /> (for work on homes that were constructed prior to 1978 <br /> Phone: (cell) (�/? _—7�q_ �.(�(�7 (office) <br /> Mailing Address: Z�S�o ��5�� � City: j�y�y� � ZIP:�'�� <br /> Contact Person: � � Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: <br /> Name: ��� (���� <br /> Phone (day): ��Z_-��9 �-(`-��1 <br /> Address: 3.�/.� �c.�s,�z.G� ,�.�.t._ City: �yV� ZIP:���(� <br /> Email and/or Fax: �.��-��� c� t��r�. c�,,� <br /> PROJECT INFORMATION: Overall pro�ect description: S:r.l-� G� ��� -L <br /> Type of Project: Any earth movement may al require <br /> ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: <br /> ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) <br /> 18202 Minnetonka Blvd <br /> ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 <br /> ❑ Re-roof, other(specify) �Siding ❑ Other: (specify) Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> ❑Window(s) www.minnehahacreek.orq <br /> Estimated Construction Valuation of Project(excluding land) $ <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 /> solely 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 public but can be given to the subject of the data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this infor tion is to annually update our records and records of other governmental agencies required by law. If <br /> ou refuse to su I t tion,the a lication ma not be issued. <br /> Applicant's Signature: Date: � /-� <br /> Owner's Signature: - Date: � ��l � � <br /> Last Updated:03/O6/2013 <br />
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