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� � r`� <br /> CITY OF ORONO ��� ; ,f ? <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> OA, Mailing Address: Permit number: �� "C��� <br /> � �VO PO Box 66 � _� <br /> Crystal Bay, MN 55323-Q(,�66 Date received: Z- `� <br /> �� � <br /> �-' ,. ft '�&d_by:---___ � '�- <br /> Street Address:� - �.� <br /> y�, � 2750 Kelley Parkway `� ���� {�1 review fee: �. • �J <br /> t�kESHO��G Orono, MN 55356 �'--��„_����. <br /> Main: 952-249-4600 Total F�e: <br /> 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 /> GENERAL INFORMATION: <br /> Job Site Address: J33� ��j��,���,• �,;,�; ��,�,, �•,�.� , <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No <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 sufficient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: _�rL�c�.v -L.o-, V'i,.�c:� /�vc- • <br /> State License# Expiration Date: <br /> Phone: (cell) ' � [. ��, �(o I Z (office) <br /> Mailing Address: L9 !� /tr-vrr ►�d Clt : /�5 t v���-£ ZIP: t ! <br /> Contact Person:� 2�, ,,M Applicant is: ntract�/ Homeowner (Circle One) <br /> Email and/or Fax: `_�j`s�U�,��N�„v��,� �� <br /> PROPERTY OWNER INFORMATION: <br /> Name: L c.• �• n tvo� -}-fo��..��S, i�c.- <br /> Phone(day): Gj.-rj'Z, y/�": ���Z_. <br /> Address: `1l/Gp ''"' � Cit : � i,�,o ZI P: ���2�f <br /> Email and/or Fax �, �,�,� �C�•�,r�y;�7 L�.�t , G�c H <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): � <br /> Address: • <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: . <br /> 1.Type of Project 2. Proposed Us "�j, `I e Disposal& <br /> b� W S�PP�Y <br /> ❑ New Construction ❑Single Family <br /> ❑Addition C�c��. attached gar, {.� (�a r��� >ewer <br /> ❑Accessory Building �1 � / ❑ Single Family -������ "�1 <br /> ❑Relocation detached gar; � u �ewer <br /> �Other:(specify)M�`'°'���� ❑ Multiple Family ���/� <br /> ❑ ublic ��. ater <br /> **Any earth movement may also require �ommercial <br /> MCWD review&permits. ❑ Industrial � ell <br /> Minnehaha Creek Watershed District(MCWD) ❑Other.(SpeCify) ��,l�i� <br /> 15320 Minnetonka Blvd �. <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ �� U�� f <br /> Last Updated: January 2016 <br />