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2015-00582-VOIDED
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Sussex Road
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3011 Sussex Road - 04-117-23-32-0018
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2015-00582-VOIDED
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Last modified
8/22/2023 5:12:10 PM
Creation date
4/10/2019 9:01:28 AM
Metadata
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Template:
x Address Old
House Number
3011
Street Name
Sussex
Street Type
Road
Address
3011 Sussex Rd
Document Type
Permits/Inspections
PIN
0411723320018
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CITY OF ORONO ' <br /> BUILDING PERMIT APPLICATION �� .�,�D <br /> FOR NEW STRUCTURES OR ADDITIONS �� �O ' <br /> A,. Mailing Address: <br /> �`�1 VO PO Box 66 Permit number. � • <br /> Crystal Bay, MN 55323-0066 Date received: '2,� � <br /> ,� Street Address:' �� <br /> ��, � 2750 Kelley Parkway ��CJ..��� plan review fee: �3� . $ <br /> L Orono, MN 55356 <br /> ��kEs Ho�� <br /> Total Fee: <br /> Main: 952-249-4600 Fax: 952-249�616 www.ci.orono.mn.us <br /> This application form musf be completed in full and all requirsd information must be submitted. <br /> Incompiete applications will be returned: (P/ease prinq <br /> GENERAL INFORMATION: 3 � � ' �SS��C ���D��/� �� �5-3-�� <br /> Job Site Address: <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No <br /> lf yes,a special event permit is requir�d with Police Department and City Council approval 60 days prior to the evenk Shuttle bus service will be <br /> required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: �-- • <br /> Name: �_( �,/A,� �lS l Ar� <br /> State License# Expiration Date: <br /> Phone: cell office <br /> Mailing Address: ,� �' Dh-' Ci : � ZIP: G <br /> Contact Person: A,✓ T A � Applicant is: Contractor / omeowne (Circle One) <br /> Email and/or Fax: �4„�l�i� fi A�✓jT�',-M/�/L, f�/►-1 <br /> PROPERTY OWNER INFORMATION: .�- <br /> Name: �J ✓'A� �/s //�,✓► <br /> Phone (day): p Z <br /> Address: � D�� Ci : D��J ZIP: S ��� <br /> Email and/or Fax �s vR� /S Tr A N� �'-f^/►1/-�/�. !�M <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: � L � R 1� IZG�1 �£ L V/Z � ��..�. � <br /> Phone(day): 6 3 <br /> Address: � vzt c� � LEP�qv[,.� ZiP: <br /> Email and/or Fax: ,2�L G D,42/f !Z�- , Go� <br /> PROJECT INFORMATION: Descri tion of ro'ect: �"t <br /> 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> ❑ New Construction Water Supply <br /> ❑Single Family with ❑ Residence <br /> Addition attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer <br /> Accessory Building ❑ Single Family with �Deck <br /> ❑ Relocation detached garage ❑Office/Commercial <br /> ❑Other:(specify) ❑Multi le Famil /Condo ❑ Private Sewer <br /> p y ❑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) $ ���Q, l�J <br />
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