Laserfiche WebLink
CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O A, Mailing Address: Permit number: p�l'l J�—� <br /> f vO Cry sal Bay, MN 55323-0066 Date received: ��( � � 'r7 <br /> a Street Address:' Received by: V <br /> ��, G� 2750 Kelley Parkway Plan review f : <br /> �qkFSHO�@. Orono, MN 55356 <br /> Main: 952-249-4600 Total Fee: �� 5� <br /> Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application fam must be completed in futl and all required information must be�ubmitted. <br /> Incomplete applicatians will be returned. (P/ease print) <br /> GENERAL INFORMATION: <br /> JobSiteAddress: zazr ��,,,��� �o�t c,,, o �-o�e M� .C',f"'.PS"6 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes No <br /> If yes,a special e�nt permit is required with Police Department and City Council approval 60 days pnor to the evenk Shuttle bus senrice will be <br /> required unless applicant derrrons6ates suflkient on-site parking is availab/e. Non per►nitted events will not be allo►n�d. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: <br /> State License# Expiration Date: <br /> Phone: (cell) (office) <br /> Mailing Address: City: ZIP: <br /> Contact Person: Applicant is: Contractor / Homeowner �c��ie o�� <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION: <br /> Name: c ,e�.c, � Hoc,r�� <br /> Phone(day): _ ,�Lv - z� z - z r T 4 <br /> Address: 2 ,� t,r �i�� �c�i{ c o�� c,ti City: o„ o ., o ZIP: r r.t rb <br /> Email and/or Fax c �o�a.._ r v � y Q a o o. c o ...�. <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone(day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of pro"ect: �c � t � � h , � wa. �1 <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction ❑Single Family with ❑Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑Office/Commercial <br /> ❑ Relocation . detached garage ❑ Residence ❑ Private Sewer <br /> �Other:(specify) �� F Q.,,,,,.�o ❑ Multiple Family/Condo ,�Retaining Wall(s) <br /> w�t� ❑ Public 4-fieet or greater ❑ Public Water <br /> *"Any earth movement may also require ❑Commercial ❑Storage <br /> MCWD review�permits. ❑ Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) �+Other: (specify� ❑Other(specify) <br /> 15320 Minnetonka Blvd R,,� �.�, , r,. . n s u��, I <br /> Minnetonka,MN 55345 � <br /> Phone: 952-471-0590 <br /> Fax: 952�71-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation(excluding land) a i ���, � <br /> Last Updated: January 2015 <br />