2013-00767 - pool in ground - Laserfiche WebLink

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', ,. '� , (�.�2'� � Ci of Orono � 3 . � . . � �� Build�ng Permit Appl�catio for a Swimming Pool �O • O Mailing Address: Permit number: 0 '�7(p ��T PO Box 66 Crystal Bay,MN 55323-0066 Date received: ^ � Street Address: Received by: � � ��" 2750 Kelle Parkwa P �70�•.S� 9�, G� Y Y Plan review fee: t�XESHO�� Orono, MN 55356 ��_ 7� Total Fe : Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � ,Q� - -� This application form must be completed in full and all required information must be submi . Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: �/QD? S�Gyf��.-G�/�� /�`'L� CONTRACTOR/AP LICANT INFOR ION: Name: � d�1 �DL � C State License# C Expirati n Date: / /�- Phone: `� .S� Fax: �Sa �J 3� �Z�SS __ Address: O L ��2 C d,� Cit : -� �(` ZIP: y Contact Person: Contact's phone number /Q/� p'LS /S' �3 Email: � ' u • << A licant is: Contractor Homeowner �c��ie o�e� PROPERTY OWNER I ORMATION: Name: .�2 � � ,r/,� �-f�-- Phone (day): Mailing Address: O S� .�.0�� ZIP: Email and/or Fax: . ENGINEER INFORMATION: Name: Phone: Address: City: ZIP: Email: Fax: PROJECT INFORMATION: 1. Pool Dimensions: 4.Accessory to: 5. Pool Type: 7. Retaining Walls? % v'�� X�feet ❑Above ground �yes ❑ no Height_�" �(Single Family 2. Heated? ❑ Multiple Family/Condo �In-ground *A building permit is required �yes ❑ na � public for any wall over 4 feet in ❑Other(specify) height measured from the 3. Excavated materials will be: ❑ Commercial bottom of the footing to the top ❑ Industrial of the wall, even if it replaces ,�,removed from site 6.Sewage Disposal 8 an existing wall. �used on site ❑ Other: (specify) Water Supply Tiered walls are considered ❑Other: (specify) �Public Sewer one wall unless they are separated by twice the height �D ❑ Private Sewer of the higher wall. Total Cubic Yards �Public Water ❑ Private Well „y Estimated Construction Value $ � Packet Last Updated: 0329/13 Page 19 of 21