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6/29/11 12 : 09PM PDT Villamil Construction Co. —> Orono Bu�lding/Permit App. 95224946
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<br /> ~ City of Orono $1�/4�
<br /> � Buildin� Permit Application for Maintenance I Renovatian
<br /> windows, doors, sidin , re-roof, etc.
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<br /> � 2750 Kelley Parkwey :�;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,;,,,,,,,,,,,,,,,,,,
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<br /> Orono MN 55356 ,...��.....:............::..::.:.:::.....
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<br /> Main• OSZ-14A-4600 Fax� 952.249.4618 w�nnN.ci.orono.mn.us� ••.�:::�:::::::::::::::�::::::::::;:;;:::::::;:::::�:�::;:�i�'�•::i;�:::::;:::::::,;:::::::::::::::
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<br /> This applicaticn form muat be completed in full and all requir�d information must be$ubmitted.
<br /> Ineomplete applleatlons wlll bs returned. (P/eese prinf) ��3
<br /> GENERAL INFORMATION:
<br /> Job Slte Addres$: 3160 Nort S ore Drive
<br /> wll this be a Parade of Homes, Remodelers 3howcasa Home or other Display Home? Yes No
<br /> I/yss,a specia/eNent parm�t ie required w�h Police Depaitment and City CounciJ approw/60 days pior to the avent. 3hutf/e buc sevvrce will be
<br /> r.aupyd unNsa epAl�en�dsmonaaratsa 8ufllclsnt on-alts perK/np l�s avellabN, Non-permrasd ownts wlll not bs elbwsd,
<br /> CONTRACTOF!/APPLICANT INFORMATION:
<br /> Name: Villamil Construction Co.
<br /> 8tate License# 20633780 Expiration Date: �p/�
<br /> Lead Certification Number: Expiretion Date:
<br /> (for work on homes rha�were oon�[ructed pr/or�o l878
<br /> Phcne: 612-221-7511 (office) 612-221-7511 (cell)
<br /> Mailing Address; 5535 County R�d 151 Ci :Mianotrista ZIP:55364
<br /> Corrtact Person: Ian Villamil Applicant is: orrtra r / Homeowner (Cbde One)
<br /> Email and/vr Fax; ianvillamilCulamail.com.866-546-8583
<br /> PROPBRTY OWNPR INFORMATION:
<br /> Name: Michsel Wsllace
<br /> Phvne(day): 612-325-4173
<br /> Addr�ss: 3160 North Shoro Drive City:Orono ZIP: 55391
<br /> Email and/or FaX mike.wsllace(a,�mchai.com
<br /> O CT FO O :
<br /> Type of Project: Any earth movement may require
<br /> ❑ Door(s) ❑ Rgmodsl ❑Firs DamagB MCWD revlew 8�peRnits:
<br /> p Re•roor, as nait Minnehaha Creek Watershed District(MCWD)
<br /> p ❑ Rapair ❑Storm Damage 18202 Minn�tonka Blvd
<br /> ❑ Re-roof, cedsr ❑ Restoretion ❑Water Damege D88phaven, MN 55381
<br /> Phone: 652•471-0580
<br /> ❑ Re-roof, other(spooli�r) ❑ 8iding ❑Othar, (apecify) Fax: 952-471-0682
<br /> ❑Window(s) wuvw.minnehahacreek.oro
<br /> Overall Project Deseription: Removs existing shingles&underlaymeat.Replace with ics 8t water,tu pape�r,and asphalt shingles.
<br /> E�timated Constru�tion Valuation of Projact(excluding land) S ffi10,000.00
<br /> APPLICANT ACKNOWLEDOEMENT:
<br /> . Ag�es bo provide all infor►nation required or requested by the Building Department;
<br /> . Cnrtffies that the information suppli�d is true and correc!to thQ best of his/her knowladge. The applicant recognixes thmt they
<br /> are solely responsible for submitrina a complete application beina awdre that upon failuro to do so,the sqff has no alternative
<br /> but to reject it until it is complete;
<br /> • Some or all ot the intormation tha�t you are asked m provida on thls application is classified by Stats law as enher private or
<br /> oonfidentiel. Private data is information which generally cannot be given to the publio but can be given to the subject of the
<br /> data. Confidential data is information which gansrslly cannot b� �ivmn to aithsr tha publio or ths subjgct of ths data. Our
<br /> purpoco and intendod use of this information is to annually update r racordc and rawrdc of other governmontal a�enciea
<br /> le ul�d b I w. If ou r@fuse su I h InfOrlTt I p II I nOL b�ISSued.
<br /> Appncant�s signature: oate: _OS/26/2011
<br /> Last Updatsd: 0&09-2a11
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