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2012-00916 - roofing
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North Shore Drive
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3324 North Shore Drive - 08-117-23-41-0012/21 and 44/0005
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2012-00916 - roofing
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Last modified
8/22/2023 5:47:07 PM
Creation date
11/15/2017 10:42:41 AM
Metadata
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x Address Old
House Number
3324
Street Name
North Shore
Street Type
Drive
Address
3324 North Shore Dr
Document Type
Permits/Inspections
PIN
0811723410021
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City of Orono <br /> . ,Building Permit Application for Maintenance / Renovation <br /> (windows, doors, siding, re-roof, etc.) <br /> Mailing Address: <br /> �,0,�. PO Box 66 Permit number: �D/�-DO / <br /> Q ,`\ � Crystal Bay, MN 55323-006 Date received: -/ �/� <br /> �� <br /> � �'��� s,l StreetAddress: m \�\� Received by: <br /> � ' �� <br /> ,�,L,�� �' �,� Gti 2750 Kelley Parkway �\ Plan review fee: <br /> 9gE�g/ Orono, MN 55356 <br /> ___"" Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �,�� � ��,�,p� 'rZ:Yi.�(. p,=-Ff N� <br /> This application form must be completed in full and all required information must be submitted. �--/Y-1 � <br /> Incomplete applications will be r turned. (Please print) <br /> GENERAL INFORMATION: '' � <br /> Job Site Address: ��3� � ,�Ci��T��l �C%`K�= ���j VC <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No <br /> If yes, a special event permit is required with Police Department and Ciry 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/APPLICAN�II�FORMATI�N: <br /> Name: �; � Fl����" �' �-�,�-'IL �" �oD ��.��� �1-��/���' <br /> State License# �'q f Cj Expiration Date: �� / � <br /> Lead Certification Number: Expiration Date: <br /> (for work on homes that were constructed prior to 1978 <br /> Phone: �l� 3 (� ��2 �Z �j3 (office) (cell) <br /> Mailing Address: Z/G� .�,��?���%¢L lZ City: � �,�d==�'i�� c? ZI P: � _5�3/ 2i <br /> Contact Person: � �� E� Applicant is: ontracto�� Homeowner (Circle One) <br /> Email and/or Fax: ��,� (� �Z �'.�"�Z v <br /> PROPERTY OWNER I FORMATION: <br /> Name: �R Z�>4 2"�.�2 r2 i r/� <br /> Phone (day): Z -�j'7�- vo0 <br /> Address: zj `7j�L� � C���� Si��:2,� �,� City:��%7�:?/L�O ZIP: `� 5 3�/ � <br /> Email and/or Fax <br /> PROJECT INFORMATION: <br /> Type of Project: Any earth movement may require <br /> ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: <br /> Minnehaha Creek Watershed District(MCWD) <br /> ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd <br /> ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 <br /> Phone: 952-471-0590 <br /> [�Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 <br /> �T 5 rl �� ❑ Window(s) www.minnehahacreek.orq <br /> Overall Project Description: <br /> _Estimated Construction Valuation of Project(excluding land) $ � JG� O <br /> � <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 su I the information,the a lication ma not be issued. <br /> Applicant's Signature: / � �1/J/�"L i�l���f,� �6�F�{2 Date: ,` ��" �Z <br /> Last Updated: 08-09-2011 <br />
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