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� <br /> �� 1�� <br /> City of Orono <br /> Building Permit Application <br /> for New Structures or Additions <br /> �-_=-�_,,, MailingAddress: �l� -�3 <br /> ��,0,� PO Box 66 Permit number. <br /> �i0 , Q Crystal Bay, MN 55323-0066 Date received: / /I� <br /> �� �3�'�`�` Received b <br /> �I a �t �-�" �, � Street Address:' y� <br /> �,s, ' "��� �ti`� 2750 Kelley Parkway Plan review fee: <br /> � � <br /> L9AESH0¢� Orono, MN 55356 <br /> �-_ __- �� ��� �� <br /> 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 /> tncomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 48o Sussex�ane <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 wifh Police Depanment and City Council approva!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 /> N8►71@: Water Street Homes,LLC <br /> State License# 2o3sosos Expiration Date: sis��zo�� <br /> Phone: ��z - �:�a- Y��� (office) �,i 2 � f��a :�(e�o Z- (cell) <br /> Mailing Address: 3c�� Ihr�u,�t 1`�.�ka � � 5� Cit : Gw�i-- ��,�=�,,q- ZIP: 3 5-�`� / <br /> COIltBCt P@fSOfl: Rick Carlson Applicant is: Contrac or � �{6A�AAaAFRAf (Circle One) <br /> Efll81� 8f1d�01'FBX: Rick@WaterStreetHomes.com <br /> PROPERTY OWNER INFORMATION: <br /> Na�pQ: William and Mary McMillan <br /> Phone (day): 1��2 � ��/7. ��t�y <br /> Address: �Fc s4Ss E�- Lnr City: c,�o;vc� ZIP: �3 �J�. <br /> Email and/or Fax iu,'4 <br /> ARCHITECT/ENGINEER INFORMATION: <br /> N81'pg: Water Street Homes,LLC <br /> Phone (day): ts�2�aso-aooz <br /> Address: 3�� ����.� F,�:.,��.�r "�L� 5_ City: u,��--rc�H�'r ZIP: .�'S3i/ <br /> Ef1181� 2fld/Of FaX: rick@waterstreethomes.com <br /> PROJECT INFORMATION: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> ❑ New Construction �❑ Single Family with ❑ Residence <br /> �❑Addition attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer <br /> ❑Accessory Building ❑ Single Family with QQ Deck <br /> ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer <br /> ❑ Other: (specify) ❑Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may 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.minn hahacreek.or <br /> Estimated Construction Valuation (excluding land) $ �,000 <br /> Last Updated: 9l29/2009 <br /> - 17- <br />