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City of Orono <br /> Building Permit Applica�cion <br /> for New Str�ucture� or Additions <br /> Mailing Address: Permit number: p��S <br /> ..�o A,O PO Box 66 — <br /> �V Crystal Bay, MN 55323-0066 Date received: <br /> Street Address:� Received by: __ . _. <br /> y ; 2750 Kelley Parkway --�� �j/ � ��, Plan review fee: � . 7� <br /> �q ��� Orono, MN 55356 L' � ��� �p/�-p�3� � <br /> kFsxo Main: 952-259-4600 — --- - �-��fe�� __ <br /> __ <br /> Fax: 952-249-4616 wk�-,-�v.ci.orono.mn.us � <br /> This application form must be completed in full and all required information mu„�t,be submitted. �°1 �'� <br /> Incomplete applications will be returned. (Please print)�� � R I ����. , � <br /> GEIVERAL INFORMA,TION: _% <br /> Job Slte Addres�: 3880 shoreline Dr orono, z�1n 55391 ��it ��2i�1 5 <br /> Will this be a Parade of Homes, Remodelers Showcase Flome or other Display Home? ❑ Yes x0 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-permrtted events will not be allowed. <br /> COIdTI2ACTOR/APPLICANT INFORMATION: <br /> Name: RJ Marco Construction Inc <br /> State License# �A Expiration Date: N/A <br /> Phone: (cell) 612-685-6594 (office) 651-484-5635 <br /> Mailing Address: 75 W Viking Dr #104 , City: Litt.Ze Canada Z�p: 551I7 <br /> Contact Person: Jesse 1z xill Applicant is: ( Contractor )/ Homeowner (Circle One) <br /> Email and/or Fax: jesse@rjmarco.com <br /> 651-484-5701 <br /> PROPERTY OWNER INFORMATION: <br /> Name: Hennepin County <br /> Phone (day): j'� 612-596-7830 <br /> Address: A2208 Government Ctr-300 So Sixth St City:Minneapolis Z�p; 55487-0175 <br /> Email and/or Fax greg.moore@hennepin.us <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: Oertel Architects <br /> Phone (day): 651-696-5I86 <br /> Address: 1795 St. Clair Ave City:St. Paul ZIP: 55105 <br /> Email and/or Fax: �oertel@oertelarchitects.com OR ewerner@oertelarchitects.com <br /> � Orono maintenance facility <br /> PROJECT IIVFOIZMATION: Description of project: Expansion & renovation project <br /> 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage <br /> � Addition attached garage ❑ Deck [� Public Sewer <br /> ❑ Accessory Building ❑ Single Family with �] Office/Commercial <br /> ❑ Relocation detached garage ❑ Residence ❑ Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s) <br /> ❑ Public 4-feet or greater ❑ Public Water <br /> **Any earth movement may require ❑ Commercial ❑ Storage <br /> MCWD review 8�permits. [� Industrial �Warehouse ❑ Private Well <br /> Minnehaha Creek Watershed District(MCWD) r] Other:(specify) ❑ Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka, MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.m innehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ 1,509,211,00 <br /> Packet Last Updated: January 2015 <br /> Page 20 <br />