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2011-00655 - water intrusion repair/partial stucco
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1510 Green Trees Road - 11-117-23-23-0015/32-16
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2011-00655 - water intrusion repair/partial stucco
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Last modified
8/22/2023 3:29:25 PM
Creation date
1/18/2017 11:54:08 AM
Metadata
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x Address Old
House Number
1510
Street Name
Green Trees
Street Type
Road
Address
1510 Green Trees Road
Document Type
Permits/Inspections
PIN
1111723230015
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� City of Orono <br /> ` Building Permit Application for Internal Work <br /> (windows, doors, siding, re-roof, etc.) <br /> ----� Mailing Address: Permit number: <br /> j:¢,0,1� PO Box 66 <br /> ;ii� y ��, Crystal Bay, MN 55323-0066 Date received: <br /> �I �"'`�''�" ��'' Received by: <br /> ,a ?'�`;� �,1 Street Address: <br /> ''�s{,..-> F�/ <br /> 'S',E, ' ��� t'� �ti�� 2750 Kelley Parkway Plan review fee: <br /> l9gE$H�gF'� 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: <br /> Job Site Address: i5(u Gr�Cn Tr-e�5 �cad <br /> Will this be a Parade of Homes, Remodelers S owcase Home or other Display Home? ❑Yes � No <br /> lf 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: l�lurtcrher� L�nStru�ri�n �'�mp.�nu <br /> State License# ;��q3 � Expiration Date: ��j.ji�ac�;L <br /> Lead Certification Number: Expiration Date: <br /> (for work on homes that were constructed prior to 1978 <br /> Phone: 74 3-ti4��.�oyu (office) ��z-�iz-9�o� (cell) <br /> Mailing Address: /�jo,� s�1,rn !}vcnuz �Y�rFt� City: a �c C�ro�� Z�P� y53�:y <br /> Contact Person: �j�f�. �ph�„�n Applicant is: ontracto / Homeowner (Circle One) <br /> Email and/or Fax: ac}}� C h�n�rh�r��.ecm <br /> �� <br /> PROPERTY OWNER INFORMATION: <br /> Name: Lecrqe n"1 ��nd h`=�na� �. �D�nK� <br /> Phone(day): <br /> Address: l�It� Grezn irec� �,�ad City: IN�uz3ta ZIP: 553��, <br /> Email and/or Fax <br /> PROJECT INFORMATION: <br /> Type of Project: Any earth movement may require <br /> ❑ Door(s) ❑ Remodel �Water Damage MCWD review 8�permits: <br /> Minnehaha Creek Watershed District(MCWD) <br /> ❑Window(s) � Repair ❑ Storm Damage 18202 Minnetonka Blvd <br /> ❑Siding ❑ Restoration ❑ Other:(specify) Deephaven, MN 55391 <br /> Phone: 952-471-0590 <br /> ❑ Re-roof ❑ Fire Damage Fax: 952-471-0682 <br /> www.minnehahacreek.orq <br /> Overall Project Description: Wa)cr Infru�rcn�'}�patrs k.~ �n�rh��1 �'I����� <br /> Estimated Construction Valuation of Project(excluding land) $ �, Y SJ `'" <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 afl 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 I the inf ation; e a lication ma not be issued. <br /> ApplicanYs Signature: Date: �f y✓ l l <br /> Last Updated: 03-01-2011 <br />
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