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. From:ALLSTAR CONSTRUCTION 19529427464 07/30l2013 14:05 #219 P.001/011 CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �I � �� ?�" �OA TO Mailing Address: Permit number: ..o <V PO Box 66 Crystal Bay,MN 55323-0066 Date received: �`3 �� Street Add�ss:' Received by: y � 2750 Keiley Parkway Pian review fee: `�t � Orono,MN 55356 JI ^� ��FSH�� TOtal Fe@: /�/ / •� Mein: 952-249�600 Fax: 952-249-4616 www.ci.orono.mn.us / !' 7'hi�"applic�tian form anus;k�e cpmp�ted tn#�,�11 arid all requ�r�1 irifam�atiii�must'�s�br�itted;` In�ompl+�t�appMis:�kiQris wlll.#�e re�urr�i�d: (Please print) GENERAL INFORMATION: Job Site Address: 3�f�Z? SHoe�z.,�� .��r✓£ �Ro�a Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No !f yes,a spec/a/e�nt permit is required with Police Department and City Couna7 apprcva/60 days prlor to the event. Shutt/e bus servke wlll be required unkss applka»t demonsdates suNkierM on-site parking!s ava!lab/e. IVon-permMled events wllf not be allowed. CONTRACTOR!APPLICANT INFORM TION: ` ' 1 t ,. �1 Name: l411,5�-�4R-- �S-�L-1-ic�+ I'hRnR�CG►v►er►7` " � rrT /'T�fGmG�-✓I State License# 8 3/575 Expiration Date: 3/ Zai�/ Phone: cell Ce�Z- 2 i— 9 office S2 - 9f�z� 75/ Mailing Address: $ry5 f h f �f*t- ^ ii-e ?a3 Ci : A� IL 1.4i ZIP: 5 3S , Contact Person: ��rn A- Applicant is: / Homeowner rc��one� Email and/or Fax: "y„ ai�S ar�� 9st �9 y�.- 7 y(o�{ ', �— ' PROPERTY OWNER INFORMATION: Name: J A.+'•c s B IoG�- ' Phone(day): [e�2 - 7 2�^ 7 9 y3 Address: 3y7Z Sh�RGLinG ��✓C City: Qr�G►JD ZIP: s,�.�q/ Email and/or Fax ' t4RCHITECT I ENGINEER INFORMAjlON: Name: /V/A Phone(day): Address: City: _ ZIP: , Email and/or Fax: PROJEC7 INFORMATiON: Descri tion of ro'ect: 1.Type of ProJect 2.Proposed Use 3.Structure Type 4.Sewage Disposal& ' Water Supply ❑New Consttuction ❑Single Family with ❑Residence ❑Additfon attached garage ❑Garage/Accessory Bldg. ❑Public Sewer ❑Accessory Building �Single Family with Deck ❑Relocation �K detached garage �Office/Commercial ❑Private Sewer �Other:(speafy) ❑MulUple Famify/Condo ❑Warehouse ❑Public ❑Storage ❑Public Water "*My earth movement may also require ❑Commercial ❑Other(specify) MCWD revtew&peRnits, ❑Industrial ❑Private Well Minnehaha Creek Watershed District(MCWD) ❑Other:(speCify) 18202 Mlnneionka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehah eek.or Estimated Construction Valuation(excluding land) 5 Z� 7dCJ ^