Laserfiche WebLink
.. ��'�Iq��� -� <br /> , � � 31.�75 <br /> City of Orono � � <br /> Building Permit Application <br /> for New Structures or Additions <br /> Mailing Address: Permit number: — ��0 <br /> ��,� PO Box 66 <br /> Q �\ Q Crystal Bay, MN 55323-0066 Date received: � 2Ul l <br /> `�`'�� <br /> � ���;��✓:;�. s, Street Address:' Received by: <br /> ������,� o'`� 2750 Kelley Parkway Plan review fee: � . O � B <br /> �t`�kESHo4'� Orono, MN 55356 p, ' <br /> _ !/ —p00 <br /> Total Fee: � ;; <br /> Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> C�NERAL INFORMATION: � � <br /> Job Site Address: � `} <br /> Will this be a Parade of Homes, Remodelers Showca ome or other Display Home? ❑ Yes ❑ No =a <br /> lf 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 sufficienf on-site parking is available. Npn-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION:C, /�,� / ,c� I J J <br /> Name: J J c- ��1( �V �! ��� <br /> � <br /> State License# Expiration Date: � — <br /> Phone: offic -� cell <br /> Mailing Address: � Cit : ' ZIP: <br /> Contact Person: : Applicant is: Contrac or / Homeowner (Circle One) <br /> Email and/or Fax: � r� �n ;v� f ' �� <br /> PROPERTY OWNER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: _ City: ZIP: <br /> Email and/or Fax <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> ;: <br /> � <br /> PROJECT INFORMATION: �,� <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 /> ddition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> A cessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial <br /> ❑ Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer <br /> p y ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> "*Any earth movement may 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 /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ <br /> Last Updated: 9/29/2009 <br /> - 17 - <br />