Laserfiche WebLink
. <br /> . <br /> CITY OF ORONO <br /> BUILDING PERMIT APPLICATION <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> O Mailing Address: Permit number: <br /> �- �TO PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: <br /> Street Address:' Received by: <br /> y� � 2750 Kelley Parkway Plan review fee: <br /> � �� Orono, MN 55356 <br /> �KFSH�� 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 /> GENERAL INFORMATION: <br /> Job Site Address: �� � �'� �� ��I �1{� ����- LG�l1ol � �� �' �/� <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 1 APPLICANT INFORMATION: I <br /> Name: 1l�ic�Jcen�'-� U�s��c�✓� Y i�; d�l l n�t <br /> State License# ��Z�j Z�� Expiration Date: Z��� /s���1�z< <-�- <br /> Phone: (cell)�17_�c�� �;u:t� S (office) <br /> Mailing Address: �p �;>x I�S City: �,y�rf�r,-:,,�,v ZIP: c�3r�,� <br /> Contact Person: " � � Applicant is: Co�tr2�r / Homeowner (Circle One) <br /> Email and/or Fax: ���J�� �,,..�cv�c,� ' - )� �51 C, i v; �r� a�Z -Z�S= `�%"�y Z. <br /> PROPERTY OWNER INFORMATION: ,�/fT lI 7=3C� 7- I ��7f� � �-1�-T� <br /> Name: L��'k-r'� C�cJ�la��;��j .�,��.� <br /> Phone (day): lrr%�- ,�;�LI - l��/T_ <br /> Address: ���' a ����r s'�J�r..�,�"� �v;�s'.�rr•�- City��,�;; L�`1� ZIP: S�3S � <br /> Email and/or Fax <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): � <br /> Address: City: ZIP: <br /> Email and/or Fax: <br /> PROJECT INFORMATION: Description of project: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal & � <br /> Water Supply <br /> ❑ New Construction �Single Family with [$F�esidence ' <br /> ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> �$Other: (specify) �1�7��av+� ��i;�./�;ln.'_ ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> ""Any earth movement may also require ❑ Commercial ❑ Other(specify) <br /> MCWD review 8�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) $ �-'� �P� <br /> , � <br /> , {a <br />