Laserfiche WebLink
� ' � � � <br /> �`� <br /> `��� <br /> CITY OF ORONO �a <br /> BUILDING PERMIT APPLICATION �` <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> � <br /> O Mailing Address: Permit 2 D l 5�-C�b S � <br /> �- �O PO Box 66 <br /> Crystai Bay,MN 55323-0066 Date ve • G� � (< ` /S <br /> � <br /> Street Address:' Received : Z-l� <br /> .�, . _ - <br /> �` 2750 Kelle P kwa" � � 4� C' • c-' �'l $---_`_ <br /> y G� Y Y C k- �, Plan re w fee: ..� — <br /> `� Orono,MN 55�--�_._..�1.� ' _�`_�'. <br /> ��'rFSH��� To 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 info ation must be submitted. <br /> Incomplete applications will be returned. (P ase print) <br /> GENERAL INFORMATION: �� � � - <br /> Job Site Address: �� Z,.. �"� v�,� f`lo rp <br /> Will this be a Parade of Homes, Remodelers Showcase Home or er Display Home? Yes No <br /> lf yes,a special event permit is required with Police Department and Clty Council approv 60 days prlor to the event. Shutt/e bus service will be <br /> requtred unless applicant demonsfrates sufficlent on-site parking Is avallable. Non-per tted events wtll not be allowed. <br /> CONTRACTOR/A�LICANT INF RMATION: <br /> Name: -�p `, � <br /> State License# b( Expiration Date: / <br /> Phone: cell Z� office ( <br /> Mailing Address: Cit : h, ZIP: S�3 <br /> Contact Person: l k, Applicant is: ra / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMAT O : <br /> Name: v V�, <br /> Phone(day): d <br /> Address: r r'. Cit : (' ZIP: ,�,�cj <br /> Email and/or Fax � <br /> ARCHITECT/ENGINEER INFORMATIO : <br /> Name: � <br /> Phone (day): Z, Z <br /> Address: Cit : ZIP: <br /> Email and/or Fax: � ct a <br /> PROJECT INFORMATION: scri tion of ro'ect: <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 /> " 4ddition attached garage ❑ Garage/Accessory Bldg. �Public Sewer <br /> LJ Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑Office/Commercial ❑Private Sewer <br /> ❑Other:(specify) ���,�` ❑Multiple Family/Condo ❑Warehouse <br /> ❑Public ❑Storage '�'public Water <br /> **Any earth movement may also require ❑Commercial 0 Other(specify) <br /> MCWD revfew&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 />