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From: 04/19/2018 16:38 #398 P.002/002 City of Orono Building Permit Application for Maintenance / Replacement/ Remodel - Residential ONLY (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) Mailing Address: Permit number: p� 0/ 1 'V POBox 66 Crystal Bay, MN 55323-0066 Date received: 41"2D' Street Address: Received by: —ply, 2750 Kelley Parkway r Plan review fe Orono, MN 55356 fktsHo�� Total Fee. 7U Main: 952-249-4600 Fax: 952-249-4616 www ci.orono.mn us / This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 3227 CASCO CIRCLE-ORONO.MN Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes ® No 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 required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ALLSTAR CONSTRUCTION COMMERCIAL State License# BC706473 Expiration Date: 3-31-2020 Lead Certification Number: NA Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) 612-865-8262 (office) 763-479-8700 Mailing Address: 5145 INDUSTRIAL STREET, SUITE 103 C. " •• • PLAIN ZIP: 55359 Contact Person: BRADEN LARSON Applicant is' Contractor Homeowner (Circle One) Email and/or Fax: BRADEN(a.ALLSTARTODAY.COM PROPERTY OWNER INFORMATION: Name: CHRISTIANE O'ROURKE Phone(day): 763-412-0170 Address: 3227 CASCO CIRCLE City: ORONO ZIP: 55391 Email and/or Fax: CJOURKEQGMAIL.COM PROJECT INFORMATION: Overall project description: ASPHALT ROOF TEAR OFF REROOF Type of Project: Any earth movement may also require ❑ Door(s) ❑Remodel ❑Fire Damage MCWD review&permits: [JK Re-roof,asphalt ❑Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd 0 Re roof,cedar ❑Restoration ❑Water Damage Minnetonka,MN 55345 1:11 Re-roof,other(specify) ❑Siding ❑Other (specify) Phone 952-471-0590 Fax' 952-471-0682 0 Window(s) www.minnehahacreek org Estimated Construction Valuation of Project(excluding land) $ 54574.95 APPLICANT ACKNOWLEDGEMENT: • 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 solely 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 all of the information that you are asked to provide on this application is classified by State law as either private or 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 of the data. Our purpose and intended use of this informati is to annuaHy update our records and records of other governmental agencies required by law. If you refuse to supply the i o an,the application may not be issued. Applicant's Signature: '' Date: / 9"/ Owner's Signature: Date: Last Updated-January 2016