Laserfiche WebLink
CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �O A ,O Mailing Address: Permit number: "� P� - Q/Q <br /> ��� PO Box 66 '- c� <br /> � Crystal Bay, MN 55323-0066 Date received: a ����' lJ <br /> � <br /> Street Address:� Received by: f <br /> yF �� 2750 Kelley Parkway �� Plan review fee: �I 33�� 7� <br /> �qkfs ri��� � Orono, MN 55356 fl,�� �0��--�-p j� � <br /> Main: 952-249-4600 �1� Total Fee: ��. ^ <br /> Fax: 952-249-4616 www.ci.orono.mn.us p� <br /> This application form must be completed in full and all required information must be bmitted. <br /> Incomplete applications will be returned. (Please print) ' <br /> GENERAL INFORMATION: <br /> Job Site Address: SR��a��h;,,,,�,�P <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No <br /> /f yes,a specia/event permit is required with Po/ice Department and City Council approva/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/APPLICANT INFORMATION: <br /> N8171e: David Weekley Homes <br /> State License# ac69�sns Expiration Date: <br /> Phone: (cell) siz.��s.2s2� (office) <br /> Mailing Address: 12800 Whitewater Drive. Suite 20 Clt : Minnetonka ZIP: 55343 <br /> COntBCt PersOn: Kevin Cummins Applicant is: Contractor / Homeowner (Circle One) <br /> EfTl81� aCld�Of F2X: kcummins@dwhomes com <br /> PROPERTY OWNER INFORMATION: <br /> Name: *same as aeo�e* <br /> PhOne �day�: Melissa Johnson 612.462 6932 <br /> Address: *same As Abo�e* City: ZIP: <br /> EfTl81� 81lCj�Of F8X mjohnson@dwhomes.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: mUmern&KUip <br /> Phone (day): zis.6a6.aooi <br /> Add�eSS: zo South�naple StreeL suite�so Clty:Ambler,PA Z�P: 19002 <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of pro�ect: <br /> 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& <br /> Water Supply <br /> 0 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) ❑ 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 ❑ 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.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ zso,000 ���'���� <br /> �EB 2 3 2018 <br /> Last Updated: January 2016 (`,�T1(OF ORONO <br />