Laserfiche WebLink
* . � i <br /> r 1 �/""� <br /> � <br /> CITY OF ORONO �a�� <br /> BUILDINiG PERMIT APPLICATION <br /> FOR NEW S�'TRUCTURES OR ADDITIONS <br /> ,�O A,O Mailing Address: Permit number: � —� <br /> �V PO Bo�t 66 � <br /> CrystaliBay, MN 55323-0066 Date received: J�-�7 <br /> � Street Addr�ess:' ��(� �� Received by: 2T � <br /> y�, G'� 2750 K�elley Parkway ���"�,1,� Plan review fee: � � <br /> �,�k�SHo��, Orono,MN 55356 d�/7 �7�3 <br /> Main: 952-249-4600 Total Fee: <br /> Fax: 952-2149-4616 www.ci.orono.mn.us <br /> This appNcatlon fom�must be pleted in fuil and ail required informallon must be submitted. <br /> Incomple�ap Ifcations wiii be returned. (P/ease print) � <br /> GENERAL INFORMATION: <br /> Job Site Address: r SO� S �� <br /> Will this be a Parade of Homes, Remodele s Showcase Home or other Display Home? ❑ Yes �No <br /> If yes,a specia/event permit is required with Police Depa ent and City Council approval 60 days prior to the event. ShutHe bus service will be <br /> required unless applicant demonstrates s�cient on-site pdrking is available. Non Permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: l�c nc��s Sa9R L .�..L-- <br /> State License# �— � Expiration Date: <br /> Phone: cell office <br /> Mailing Address: o ��{'- u . Cit : � i ZIP: SS3�F3 <br /> Contact Person: Applicant is: ac Homeowner �ci►�i•o�� <br /> Email and/or Fax: �,�ex _ rv;►�j���sc . c�n. • <br /> PROPERTY OWNER INFORMATION: <br /> Name: U�nrQ.�-S f L.L.C_ <br /> Phone(day): L�1 0 -3��-_��a 1 , <br /> Address: y �t, 1��'- pk,� . .�a . City: �}�ak;�� ZIP: SS343 <br /> Email and/or Fax o�,l�x e n�i��.1un�.c I�cs . car� <br /> 0 <br /> ARCHITECT/ENGINEER INFORMATION: ' <br /> Name: C�.�► � �-}-e,��s <br /> Phone(day): S - 1 - <br /> Address: 1 Ni � Cit : o �, � z�P: ,55343 <br /> Email and/or Fax: d C,.,; c,o <br /> PROJECT INFORMATION: Descri tion o ro'ect: <br /> 1.Type of Project 2.Pr posed Use 3.Structure Type 4.Sewage Dlsposal 8� <br /> Water Supply <br /> ❑New Construction ❑S ngle Family with ❑Accessory Bldg./Garage <br /> ❑Addition ched garage ❑Deck �Public Sewer <br /> ❑Accessory Building ❑ ingle Family with �Office/Commercial <br /> ❑Relocation etached garage ❑Residence ❑Private Sewer <br /> �Other:(specify) I'�mc�d�\ ❑ ultiple Family/Condo ❑Retaining Wall(s) <br /> ❑ blic 4-feet or greater �Public Water <br /> **Any earth movement may also require mmercial ❑Storage <br /> MCWD review 8 permits. I dustrial ❑Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ ther: (specify) ❑Other(speCify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952�71-0682 <br /> www.m in nehahacreek.or <br /> Estimated Construction Valuation (excluding and) � ,�_��• �� <br /> Last Updated: January 2016 � <br />