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CITY OF ORONO � <br /> BUILDING PERMIT APPLICATION �� �`� � �� <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> Q�� Mailing Address: Permit number: �� -(���' <br /> � PO Box 66 <br /> �� � `.� Crystal Bay, MN 55323-0066 Date received: <br /> � <br /> ; Received by: <br /> �, , Street Address:' <br /> yF �� 2750 Kelley Parkway Plan review fee: .�b <br /> �q�.Fs�,���. Orono, MN 55356 ap� _������ <br /> _ Main: 952-249-4600 Total Fee: <br /> Fax: 952-249-4616 www.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) LSc r-�;L� ��. <br /> GENERAL INFORMATION: <br /> Job Site Address: s,s sa��h,,,,,�,yP <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display 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 will be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR I APPLICANT INFORMATION: <br /> N8111@: David Weekley Homes <br /> State License# gc69�sas Expiration Date: <br /> Phone: (cell) 612.716.2627 (office) <br /> Mailing Address: 12800 Whitewater Drive,Suite 2o Clt : Minnetonka ZIP: 55343 <br /> Contact Person: Kevin Cummins Applicant is: Contractor / Homeowner (Circle One) <br /> EfTlal� afld�Of FaX: kcumm�ns@dwhomes.com <br /> PROPERTY OWNER INFORMATION: <br /> Nal'Tle: "Same As Above' <br /> PhOng �day�: Melissa Johnson 612.462.6932 <br /> AddfeSS: *Same As Above* Clty: ZIP: <br /> Email and/or Fax mjohnson@dwhomes.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Nal'pg: Mulhern&Kulp <br /> Phone (day): us.646.sooi <br /> Addf@SS: 20 South Maple Street,Suite 150 Clty: Ambler,PA ZIP: 19002 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & <br /> Water Supply <br /> 0 New Construction 0 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) ❑ 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&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 <br /> www.m innehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ zso,000 <br /> Last Updated: January 2016 <br />