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2017-01005 - windows
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2560 Old Beach Road - 21-117-23-22-0010
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2017-01005 - windows
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Last modified
8/22/2023 4:02:37 PM
Creation date
3/1/2018 1:14:24 PM
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x Address Old
House Number
2560
Street Name
Old Beach
Street Type
Road
Address
2560 Old Beach Road
Document Type
Permits/Inspections
PIN
2111723220010
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City of Orono <br /> Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY <br /> (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) <br /> �Ol VO Mailing Address: Permit number: <br /> PO Box 66 <br /> Crystal Bay, MN 55323-00A6I6' Date received: <br /> Street Address: <br /> AUG 2 S Z01_1 Received by: <br /> ti 2750 Kelley Parkway Plan review fee: <br /> elt L Orono, MN 55356 CITY OF ORON <br /> 'fkes►io�� 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: �S�D� ��� ���� �� • <br /> Job Site Address: <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 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 /> CONTP•..�..., , ..,... .,...•r ,.,�,.�...T,.. . <br /> Name: Pella Northland <br /> State L 1530025 1h Ave N Ste.100 Expiration Date: <br /> Lead C Plymouth MN 55447 1S 17 g 2' 1 Expiration Date: cf-7—a-p <br /> (for i 763-745-1400 1978 <br /> Phone: BC645090 expires 3/31/19 (office) <br /> Mailing Address: City: ZIP: <br /> Contact Person: 2 3'(S_(d017 Applicant is: ontractor Homeowner (circle one) <br /> Email and/or Fax:�O <br /> PROPERTY OWNER INFORMATION: <br /> Name: -3GmtES kl/w <br /> Phone (day): 01S2,g771 473._ <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Overall project description: <br /> Type of Project: Any earth movement may also require <br /> ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: <br /> ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) <br /> 15320 Minnetonka Blvd <br /> ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 <br /> ❑ Re-roof,other(specify) ❑Siding ❑ Other:(specify) Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> Window(s) www.minnehahacreek.org <br /> Estimated Construction Valuation of Project(excluding land) $ '— <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 are <br /> solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to <br /> 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 data. <br /> Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and <br /> intended use of this information is to annually update our records and records of other governmental agencies required by law. If <br /> you refuse to supply t information,the application may not be issued. —7 <br /> Applicant's Signature/X-- y Date: <br /> Owner's Signature: Date: <br /> Last Updated:January 2016 <br />
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