2011-00234 - attached deck - Laserfiche WebLink

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t City of Orono ,I`�a �� Buiidin Permit A lication �1 g pp for New Structures or Additions Mailing Address: Permit number: o?D//— O��y ��,�. PO Box 66 Z,_ / / �� Q Crystal Bay, MN 55323-0066 Date received: `�" j�t a �"'�''�t�-:` �,�, Street Address:� Received by: d ��`�' � � ti� 2750 Kelle Parkwa x�,a, Y Y Plan re�iew fe : \'�'Esi�io4�/ Orono, MN 55356 I --`f Total Fee: G �Z, � 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 �- �- �L,� ��_ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No lf yes,a specia/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,oermitted events will not be allowed. CONTRACTOR I APPLICANT IIV�ORMATION: ` r - Name: ��,,� J'''.k.a,�sL ��K l��\ State License# 'Z�,37,5 3 G Expiration Date: 3 - 3 i - �Z Phone: Z - 7�52 - J� Z office cell Mailing Address: -t City: _i �-� ZIP: �S 3'1 Contact Person: ��,� �,�Q Applicant is: Contract / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION Name: i/V�� (y,� Phone(day): Address: Cit : ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: Cit : ZIP: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction �ingle Family with ❑ Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. � Public Sewer ❑Accessory Building ❑ Single Family with � Deck �Relocation , detached garage ❑ Office/Commercial ❑ Private Sewer Other. (specify) " ��'� ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water "'"`Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial �Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ 3,� _ � , . x \ ;