2014-00253 - adv plan review - Laserfiche WebLink

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� t. � • CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS Mailing Address: Pe�mit.num6er ' �� (SQZ' g-�� PO Box 66 � Crystal Bay, MN 55323-0066 Dafe received: Streef Address:' Received by` � y� ,�� 2750 Kelley Parkway Plan:review feet � ,�'ZO S!-DOZ� t :�� Orono, MN 55356 q'�FSf(O�' ':Total Fee: I Main: 952-249-4600 = Fax: 952-249 4616 www.ci.orono mn us ,: i Tfiis application:form must.be completed;in�full;and alh requiredtiriformation;:must"be{subrriitted: Incomplete applications wili'be returnetl (Please print) I GENER� INFORMATION: Job Site ddress: ',,5 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes ❑ No If yes,a specia/event permif is required with Police Department and Eity Council approval 60 days prior to the event. Shutt/e bus service will be required unless applicant demonsfrates suKcient on-site parking is availab/e. Non-permitted events will not be a/lowed. CONTRACTOR/APPLICAN R TION: Name: L1�C. State License# Expiration D te: Phone: cell • • office • • Mailing Address: Cit : ' P: I Contact Person: • i� pplicant is: ontrac o / Homeowner (Circle One) Email and/or Fax: � i PROPERTY OWNER INFORM�TI N: Name: Phone(day): • ' Address: Ci : iVJ�A ZIP: +� 3 Email andbr Fax • ARCHITECT/ENGINEER INFORMATION: Name: ,�5�1 NM 'E ip1 S CC w f WJ4 �_��. Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Descri tion of ro'ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ew Construction ❑ Single Family with esidence �� ❑Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation �etached garage ❑Office/Commercial ❑Private Sewer ❑Other. (specify) Multiple Family/Condo ❑Warehouse �,� ❑ Public ❑ Storage Public Water ' ""Any earih movement may also requi�e ❑ Commercial ❑ Other(specify) � MCWD review&permits. ❑ Industrial . ❑Private Well j Mlnnehaha Creek Watershed District(MCWD) ❑Other: (speCify) I 18202 Minnetonka Blvd I Deephaven,MN 55391 Phone: 952-471-0590 � Fax: 952-471-0682 www.mi nehaha r e or � Estimated C.onstruction Valuation (excluding land) $ ��J`�/ Q�v ^ I I � , i � . � i ;