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2010-00813 - siding
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2285 Blaine Avenue - PID: 17-117-23-34-0025
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2010-00813 - siding
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Last modified
8/22/2023 3:37:24 PM
Creation date
4/18/2016 2:18:30 PM
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x Address Old
House Number
2285
Street Name
Blaine
Street Type
Avenue
Address
2285 Blaine Avenue
Document Type
Permits/Inspections
PIN
1711723340025
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Updated
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u <br /> � � City of Orono <br /> Building Permit Application for Internal Work <br /> (windows, doors, siding, re-roof, etc.) <br /> Mailing Address: Permit number: <br /> �,�. PO Box 66 <br /> 0 ,�\ O Crystal Bay, MN 55323-0066 Date received: <br /> � �'� Received by: <br /> �ia t�✓���_�� �, StreetAddress: <br /> �',E, �t � ���' 2750 Kelley Parkway Plan review fee: <br /> 1.��'���'ri��¢,sv Orono, MN 55356 <br /> kESHO <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: � �) <br /> Job Site Address: -� ��S � �� ��� ,�-� �( �/cr <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o <br /> lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to fhe event. Shuttle bus service will e <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFOR ATION: <br /> Name: �'"1.� �w�>t e-o�;� <br /> State License# a c�i C)��-7'7 Expiration Date: 3 �i �� <br /> Phone: ��3- ��� ._���� (office) (cell) <br /> Mailing Address: �S s< <� U,, �. N Cit : Mu f.e �',- � ZIP: —S � •- <br /> Contact Person: ��,,��,,,,, S{-z; � Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: ;,,�.�� @ �,..�,�Q,,��s f Q (�S _ ��,-� <br /> PROPERTY OWNER INFORMATION: <br /> Name: /"L�v� Sc_I�o-�(r��.C��✓ <br /> Phone (day): (�i �- -��'� -`�;�3S" <br /> Address: ��,,,,�z as �-6�.� City: ZIP: <br /> Email and/or Fax <br /> PROJECT INFORMATION: <br /> Type of Project: Any earth movement may require <br /> MCWD review 8�permits <br /> ❑ Door(s) ❑ Remodel ❑Water Damage <br /> Minnehaha Creek Watershed District(MCWD) <br /> ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd <br /> Deephaven, MN 55391 <br /> �iding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> e-roof ❑ Fire Damage www.minnehahacreek.orq <br /> Overall Project Description: . � �,�,�,�1 r e _ 5 ; ` � � �� . � <br /> Estimated Construction Valuation of Project (excluding land) $ ���ZSU <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 /> " re uired b law. If ou refuse to su I the information, the a lication ma not be issued. <br /> ApplicanYs Signature: Date: �/��1 U <br /> LastUpdated: 05-04-2009 <br />
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