Laserfiche WebLink
Ci�r oF ORONo � r� 50� �'� <br /> BUILDING PERMIT APPLiCATION /� <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O� MailingAddress: Permit number: a� -��� <br /> O PO Box 66 <br /> Crystat Bay,MN 55323-0066 . Date received: 5/ � <br /> .� ,, Street Address:' <br /> Received by: � <br /> yF G 2750 Kelley Parkway Plan review fee: � �3 S. <br /> �q � ` Orono,MN 55356 /�� l��)� � rP <br /> k�s H o4 Main: 952-249-4600 �� 1�- �� �-o �� � <br /> Total'Fee: <br /> Fax: 952-249-4616 ��rv�nu.ci.orono.mn.us �J.r. �r-� ao,7-p ib „Q <br /> /}'��� <br /> This application form must be completed in fuii and ali required information must be submitted. u <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Dispiay Home? Yes No <br /> If yes, a special event permit is required with PoJice Department and City Council approval 60 days prior to the event. Shuttle bus service wil/be <br /> r�quired un/ess applicant demonstrates sufficient on-site parking is availabie. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> NBtlle: David Weekley Homes <br /> State License# BC697545 Expiration Date: <br /> Phone: �cell) s�2.�is.2s2� �off�� <br /> Mal�l�g Add�@SS: 12800 Whitewater Drive,Suite 20 Cj : Minnetonka ZIP; 55343 <br /> COtlteCt PGt'SOfI: Kevin Cummins Applicant is: ontractor / Homeowner (Clrcle One) <br /> EI1181�2nd/Of FBX: kcummins@dwhomes.com <br /> PROPERTY OWNER INFORMATION: <br /> IN81116: "5ame As Above" <br /> PhOne �(Jay�: Melissa Johnson 612.462.6932 <br /> Address _ �same As a,bo�e* Clty: ZIP' <br /> Email and/or Fax mjohnson@dwhomes.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Ne�fll@: Mulhern&Kulp <br /> Phone (day): Zis.ba6.sooi <br /> Add�@SS: 20 South Maple street,Suite 150 (�,Ity: Ambler PA Z�P' 19002 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Descri tion of ro'ect: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� <br /> � New Construction X Water Supply <br /> ❑ Single Family with ❑Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck Q Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commeraal <br /> ❑ Relocation detached garage � Residence ❑ Private Sewer <br /> ❑ Other: (specify) ❑Multiple Family!Condo ❑ Retaining Wall(s) <br /> ❑Public 4feet or greater 0 Public Water <br /> "`*Any earth movement may also require ❑Commercial ❑ Storage <br /> MCWD review 8 permits. ❑ Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 RE EIVED <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) a zso,000 S�p o 5�Q�� <br /> C�TY OF OR4NO <br /> Last Updated: January 2016 <br />