2017-00113 (Adv. plan review) - Laserfiche WebLink

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Building Permit Appiication for MaC ety of �rono (�.e. windows, doors, siding, re-a ofe tRept�p �RUCTURAL EXPANS p ential ONLY � a �Q A r Marling Add�ess: N� � �/a� l VQ PO Box 66 Permit number: p��/7 Crystal Bay, MN 55323-0066 Date received: o{'7—/ y � Street Address: 'ved by: �� Y d � �` 2750 Kelley Parkway — q"�FSHo��` Orono, MN 55356 � Plan review fee: i Main: 952-249-4600 Fax: 952-249-4616 °a a�� 7— D"��—> www.ci.orono.mn.us This application form must be completed in ful(and all required information must be submitted. incomplete applications wili be returned. (Please print) GENERAL INFORMATION: Job Site Address: 2408 Casco Paint Road, Orono, MN Will this be a Paracte of Homes, Remodelers Showcase Home or other Display Home? If yes,a special event permrt is required wrth Police Department and Crty Counci!a ❑ Yes required unless applicant demonstrates sufficient on-srte parking is avai ableafNor�permrtted events w!ltnot be aelowed.eN�No be CONTRACTOR/APPLICANT INFORMATlON: Name: The Legacy Building Co Inc State License# Lead Certification Number: 431870 Expiration Date: 3/31/2018 (for work on homes that were co sfruc ed prior to 1978 Expiration Date: Oct 6,2021 Phone: (cell) Mailing Address: (of€ice) 94848 Kral Rd Contact Person: Craig,lansma �'t � � tonka ZIP: 55345 Emai►and/or Fax: �ra� Applicant is: ontract r / Homeowner (Circle One) gj@thelegacybuildingco.com PROPERTY OWNER INFORMATION: Name: James Gasch Phone (day}: 612-834-1984 Address: 2408 Casco Point Road, Email and/or Fax: jamesgasch ��tY� orono ZIP:55391 @gmail.com PROJECT INFORMATION: �verall project description: remadel existing kitchen, replace 2 windows and i ext door Type of Project: ❑ Door(s} �Remodel j Any earth movement may also require ❑ Fire Damage ' MCWp review&permits: ❑Re-roof,asphalt ❑ Repair ! Minnehaha Creek Watershed District(MCWD) ❑ Storm Damage � ❑Re-roof,cedar ❑ Restoration � 15320 Minnetonka Blvd ❑Water Damage � ❑Re-roof,other(specify) ❑ Siding ' Minnetonka, MN 55345 ❑Other: (specify} � Phone: 952-471-0590 ' [�W in dow(s) � Fax: 952-471-0682 Estimated Construction Valuation of Project(excludin land �'""""e�'ahacreek.or APPLICANT ACKNOWLEDGEMENT: � � $ 41,234.00 • Agrees to provide all information required or requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are ; �olely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to � reject it until it is complete; ; • Some or ali of the information that you are asked to provide on this application is classified by State law confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. � Confidential data is information which generally cannot be given to either the public or the subject af the dataas either private or �i intended use of this information is to annually update our records and records of other governmental agencies required b la ou refuse to sup I the information, the application ma not be issued. • Our purpose and y w. If Ap�licanYs Signature: � — Date: 2l7/2017 Owner's Signature: �ast Updated:January 2016 Date: