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� ' , � ,/ <br /> CITY OF �RONO 5l/ ��` <br /> , �j <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> ,/ Mailing Address: Permit number: aC�/ —�� l � <br /> � �0�0 CrysBtal Bay, MN 55323-0066 Date received: f a ���— <br /> � StreetAddress:' y� Received by: <br /> y � 2750 Kelley Parkway 5��-ss�' Plan review fee: 'Y � l J`—oF �!' <br /> `�tq �,� Orono, MN 55356 � cf����-7 <br /> k�SHOR Total Fee: <br /> Main: 952-249-4600 Fax: 952-249-4616 ����vw c�cas,�r , �,,� <br /> This appiication form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: ��-/� <br /> Job Site Address: �Cs S 1�C L' {�� p � S J J� <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display ome? ❑ Yes o <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 su�cient 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-ss�3os Expiration Date: 3i2o�s <br /> Phone: (cell) 612-363-4304 (office) �63-479-6926 <br /> Malllllg AC1Clf@SS: 14870 BROCKTON LN Cjt ; DAYTON ZIP: 55327 <br /> Contact Person: TOM osFa,R Applicant is: o ractor / Homeowner (Circle One) <br /> Email and/or Fax: tomo@stonebaymn.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: STONEBAY BUILDERS LLC <br /> Phone (day): �ss-a�s-ss2s <br /> ACldf@SS: 14870 BROCKTON LN Clty: DAYTON ZIP: 55327 <br /> Email and/or Fax tomno@stonebaymn.com <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: TOM osFAR <br /> PhOf12 (C18y�: 612-363-4304 <br /> ACICIf@SS: 14870 BROCKTON LN Clty: DAYTON Z�P: 55327 <br /> Emall 8nd/Of Fax: tomo@stonebaymn.com <br /> PROJECT INFORMATION: DeSC�lptlOfl Of pfO�eCt: New Single Family Dwelling <br /> 1. Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <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 /> ❑ Public ❑ Storage X❑ Public Water <br /> **Any earth movement may also require ❑ Commercial ❑ Other(specify) <br /> MCWD review&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 /> � "��� ��I��ar�eFK orq <br /> Estimated Construction Valuation (excluding land) $ 2�9,000 <br />