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2011-00960 - roofing
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855 Partenwood Lane - 05-117-23-34-0012
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2011-00960 - roofing
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Last modified
8/22/2023 5:21:13 PM
Creation date
6/19/2018 11:39:05 AM
Metadata
Fields
Template:
x Address Old
House Number
855
Street Name
Partenwood
Street Type
Lane
Address
855 Partenwood La
Document Type
Permits/Inspections
PIN
0511723340012
Supplemental fields
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Updated
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, ' City of Orono <br /> Building Permit Appllcation for Internal Work <br /> windows, door�, siding, re-roof, etc. <br /> Mafling Adaroas: �p��:�umbe� �•,• o�?O//-��� <br /> O� �O PO Box 66 . . . . , . . ; . <br /> Crystal Bay,MN 55323-0086 pat�•�gpeived; • • <br /> SlreetAddress: �ce�t?Y� ' <br /> �� � 2750 Ksnsy Parkway � ,P.lan•n�wiew•tee: � .. . <br /> Orono,MN 55356 , , . . . <br /> 'Tptal•Fee: .• ' • '. . <br /> Main; 952-249�4800 Fex 952-2e{8�816 www.ci.arono_mn_ua � � ' . - ' <br /> This epplicc�ttion form must be completed in full�ttd all required informetion must be.submitted. ' <br /> Incompleie�pplications will be returned. (P/ease prfnt�� <br /> GENERAL INFORMATION: � • <br /> Job Site Address: • <br /> Will thts be a Parade aF Homes,Remalslets 8howcase Home o�other Display Home? Yes Nc <br /> If yes,a speaa/su�nt perm��requ�d u�'h PoOoe Dapartment end c�y t�ounpl aPP�I 80 d�ys p�fnr to the eve� she,dt�bus synricece wiN be <br /> 2quAed rs�bss app�cant demonstrates stdl�cieru on-sde parJcing ls avadrable. Non-permktsd events wr�/nct be sllo�red. <br /> CONTRACTOR/APP CANT INFORMATION: , <br /> Plame_ ' <br /> State License# E�iration Date: <br /> L�d Certif'�cation Number: �{(a—r��l.rt�S — � Expiration Date: � <br /> (�or w�orlc on homea btat wene constnu pHor to 19y8 ' <br /> Phone: `'� —! (��) lY� — L— q� (cell) <br /> Mailing Addr�ss: City. ' 21P: �j3 <br /> CoM�ct Person: I� � i pp icant is: ontr�cto / Homeowner �c�o�� <br /> Emeil and/or Fax: _ <br /> PROPERTY OWNER INFORMATIO : 1 <br /> Name: � � <br /> Phone(day): l <br /> Addr+ess: C1ty. 21P: ��j�jrj�p <br /> Email and/or Fax . <br /> PROJECT INFpRMAT10N: . <br /> � ���e�� Any eacth movament m�y requir� <br /> ❑DooKs) ❑Remodel ❑Waber Damage �ICWD revi�w 8l per�nlls: <br /> ❑1Mndcw(s) ���/�, ❑Repair ❑Sborm Demage Minnehahe 82�02 Min etonfca B�Ivd��M�� <br /> ❑Siding C„�J�" Q Restoration D Other. (spedfy) De�phaven,MN 55391 <br /> Re-roof ���� ❑Fire Demage Phone: 952�.71�0590 <br /> Fax: 952�71-0682 <br /> ' ne h . <br /> Overall P ect Descr� n: <br /> Estimated Construction Valuatfon of Pro mct(excludtn land) � <br /> APPLICANT ACKNOWLED6EMENT; � <br /> • Agrees b�provide all i�orm�ttion required or requesbed by tha Building pepartrnem; • <br /> � Certffies that the irrbrtnatlon supplied Is Vu�and correct to the best of hislher Imowledge. The applicaM rec;ognizes thet they <br /> are solsly t+esponsible fnr submktlng a complete applic�tion being aware tt�art upon fa(lure to do so,the staff has no alternative <br /> but to n�jecx it urrtil it is complete; <br /> • Some or all of the infortnatlon thet you aro asked to pruvide on this applicatlon is dassified by State law ss either private or <br /> conflde�rtial. Private data is informatlon wnlch generally, cannot be given{Q the public bu4 ca� be given to the subje�ct of the <br /> dats. Conflden�al data is infarmation whioh gen�ralq�cannot he given bo eit�er the public or the aubject of the data. Our <br /> purpcse and i��nded use of this iMermation is b annualry update our records and r�ords of o�er govemmer�tal agencies <br /> uired law. If ou to eu I infonnation the a Gcatiom m �ot be Issued, <br /> ApPlicarn's Signature: • �: 1 � <br /> �ast u�ea: oa.o�-�oi� <br />
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