Laserfiche WebLink
CITY OF ORONO � <br /> � , BUILDIIVG PERMIT APPLICATION ( �� � � <br /> . FOR NEW STRUCTURES OR ADDITIONS <br /> MailingAddress: Permitnumber: � �` y' ` <br /> ���� PO Box 66 ��' � C'�`_��`��� <br /> Crystal Bay, MN 55323-0066 Date received: -"/ �� <br /> RecelYedhy-:-- <br /> � �, Street Address' - - —--�-7 <br /> �'� � 2750 Kelley Pa �—�--- �lan review fee: � / ' <br /> ��kESH���G Orono, MN 553�-__,�_ � . �V 1,� 1 <br /> Main: 952-249-4600 Tot'Ta F-e`e:`�------`�����D�a <br /> Fax: 952-249-4616 �vv✓w.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: � <br /> Job Site Address: (� � i�cv. ������ ��,�1. , �(�t � �� �� �S 3�� I <br /> Will this be a Parade of Homes, Remodelers Showcase Home o other isplay 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 wrll be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> 0 <br /> Name: L�w.�Yv.r ati�a�.. �-r-kc�r�.. �:�c. . <br /> State License # . �„ C�� S4 ��xpiration Date: 3i f� A i <br /> Phone: cell 7 fo�j ' �.Z�i - t�� office <br /> Mailing Address: �p 3'7 G4� _ �� , � Cit : ��i v ZIP: �$3 Z <br /> Contact Person: �"'rovv. �Qw.�� r,•,ct,�. Applicant is: Contractor'. / Homeowner (CircleOne) <br /> Email and/or Fax: L�v�tic E3+ti ��C � r�v�� s��. (;a� <br /> PROPERTY OWNER INFORMATION�^ <br /> Name: S'�'k.v'� c�.� � �ta�(�. 'rJ �Y�-S <br /> Phone (day): '1�'3 - 3b� -- 3 <br /> Address: t-`U- �X � � Cit : �� �n� ZIP: rJ Jr� <br /> Email and/or Fax W� v�SS � c��� . <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZIP� <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: I�ZC K <br /> 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8� <br /> �New Construction Sin le Famil with Water Supply <br /> � g y ❑Accessory Bldg./Garage <br /> ❑Addition attached garage �Deck <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commercial ❑ Public Sewer <br /> ❑ Relocation detached garage ❑ Residence ❑ Private Sewer <br /> ❑ Other:(specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4-feet or greater ❑ Public Water <br /> "'"Any earth movement may also require ❑ Commercial ❑ Storage <br /> MCWD review 8 permits. ❑ Industrial ❑Warehouse <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: s eCi ❑ Private Well <br /> 15320 Minnetonka Blvd � p �� ❑ Other(SpeCify) <br /> Minnetonka, MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> $ �,h,�l J V <br /> Estimated Construction Valuation (excluding land) � <br /> CITY OF ORONO <br /> Last Updated: January 2015 <br />