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, <br /> CITY OF ORONO ���, . <br /> BUILDING PERMIT APPLICATION � -S �!J <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> MailingAddress: Permitnumber: _-��•�.�'t_�c'',�;', <br /> ���^IO PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address:� Received by: <br /> ,'�%y � 2750 Kelley Parkway Plan review fee: �' 1� �d�• J <br /> �`�� ����� Orono, MN 55356 ��,-,�S_/>�_ <br /> �ES��� Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 www ci orono n;n us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will e returned. (Please print) <br /> Job SiRe Add eOS MATION: / �' � �� � , � �� � `� �� � (���)� <br /> / <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No <br /> If yes,a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shutt/e 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 /> Narpe: STONEBAY BUILDERS LLC <br /> State License# BC-681308 Expiration Date: 3i2o�s <br /> Phone: (cell) 612-363-4304 (office) 763-479-6926 <br /> M81IIt1g Addf@SS: �4870 BROCKTON LN Clty: DAYTON Z�P; 55327 <br /> Contact Person: roM osFAR Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/o�Fax: tomo@stonebaymn.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: STONEBAY BUILDERS LLC <br /> Phone (day): �ss-a�s-ss2s <br /> Addf2SS: 14870 BROCKTON LN Clty: DAYTON Z�P: 55327 <br /> Email andlor Fax tomno@stonebaymn.com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: roM osFAR <br /> Phone(day): s�2-sss-asoa <br /> Addf@SS: 14870 BROCKTON LN Clty: DAYTON ZIP: 55327 <br /> Email and/or Fax: tomo@stonebaymn.com <br /> PROJECT INFORMATION: Descri tion of f0�2Ct: New Single Family Dwelling <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� <br /> Water Supply <br /> � New Construction ❑ Single Family with � Residence <br /> ❑Addition attached garage ❑ Garage/Accessory Bldg. � Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Pubfic ❑ Storage X❑ Public Water <br /> **Any earth movement may also require ❑ Commercial ❑ Other(specify) <br /> MCWD review 8�permits. ❑ Industrial ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) <br /> 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> ��i3r �k c��r <br /> Estimated Construction Valuation (excluding land) $ 2�9,000 <br />