Laserfiche WebLink
� city of Orono ,� �� � 9� <br /> Building Permit Applicatio � <br /> for New Structures or Additions � <br /> Mailing Address: Permit number: ��l��c�� <br /> ���� PO Box 66 <br /> � Crystal Bay, MN 55323-0066 Date received� —3�— � �o <br /> ( O —�----- <br /> � � Street Address: Received by: � <br /> �� ' � 2750 Kelley Parkway Plan review fee: J��Ss <br /> ��.',q ���! Orono, MN 55356 a ��_�� <br /> kFSH� Main: 952-249-4600 Total Fee: <br /> Fax: 952-249-4616 vR;v°�4>�t:� �,�c;;,c� ;�,s� �is <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please prrnt) <br /> GENERAL INFORMATIO : � ' T/ <br /> Job Site Address: �-�,? 5_ � .�C���S�U�c� � !��/ . � � � � � �3� 'C <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other U��splay Home? ❑ Yes ■0 No <br /> lf yes, a special evenf permit is required with Police Department and City Counci!approva160 days prior to the event. Shuttle bus servrce will be <br /> required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be altowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> �JBI'p8: Stonebay BuildersLLC <br /> State License# acss�sos Expiration Date: <br /> Phone: (cell) (office) /� <br /> Mailing Address: 148702 Brockton LN N Cit : Da ton zIP: 55327 <br /> COIItaCt P@fSOfl: Tom Osfar Applicant is: ontracto / Homeowner (Circle One) <br /> E11181� alld/OI' FaX: tomo@stonebaymn.com <br /> PROPERTY OWNER INFORMATION: <br /> �farpg: Essay Holdings <br /> Phone (day): s�z-��o-3ooa <br /> Address: 2110 Lvndale Ave. S City: Mpls ziP:55405 <br /> Email and/or Fax aggarwal@yahoo.com <br /> ARCHITECT/ ENGINEER INFORMATION: - r <br /> Name: Tom osra� <br /> Phone (day}: s�2-sss-asoa <br /> Address: 14�370 Broc:kton LN City:Dayton ZIp: 55327 <br /> E11181� 811d/Of FaX: tomoCa�stonebaymn.com <br /> PROJECT INFORMATION: Description of I'02Ct: newresidentialtownhome <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) ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4-feet or greater ❑■ Public Water <br /> "`�Any earth movement may require ❑ Commercial ❑ Storage <br /> MCWD review 8�permits. ❑ Industrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watersned 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) � � <br /> � � 1 U16 <br /> Packet Last Updated: August 2015 CITY OF ORONO <br /> Page 21 <br />