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CITY OF ORONO • <br /> BUILDING PERMIT APPLICATION ". ` ' <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> �0 Mailing Address: Permit number: /7-11V <br /> PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: —k'? <br /> Street Address:' Received by: <br /> tiF C� 2750 Kelley Parkway Plan review fee: <br /> ��K£sHo�� Orono, MN 55356 Ov 733 <br /> Main: 952-249-4600 Total Fee: 7` <br /> 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: 1020 Tonkawa Road, Orono <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ® Yes ❑ No <br /> H 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/APPLICANT INFORMATION: <br /> Name: Stonewood, LLC <br /> State License# BC 594315 Expiration Date: 3/18 <br /> Phone: (cell)612-267-2670 (office) 612-462-4000 <br /> Mailing Address: 153 Lake St. East City:Wa zata ZIP: 55391 <br /> Contact Person: Sven Gustafson Applicant is: <C2jatac1iR> / Homeowner (Circle One) <br /> Email and/or Fax: Sven stonewood.com �. `e C 0 <br /> PROPERTY OWNER INFORMATION: <br /> �jL Z-q 2 - (p(�p� <br /> Name: Forrest & Renee Burke <br /> Phone (day): 612-961-5291 <br /> Address: 1020 Tonkawa Road Orono City: Orono ZIP: <br /> Email and/or Fax Forreot burke(@uhaxom i °err eS f- <e CU C, 1n <br /> ARCHITECT/ENGINEER INFORMATION <br /> Name: Eskuche Design, Peter Eskuche <br /> Phone (day): 612-296-7575 <br /> Address: 18318 Minnetonka Blvd, Deephaven 55391 City: ZIP: <br /> Email and/or Fax: Peter(a)eskuche.com <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 ❑Accessory Bldg./Garage <br /> ❑Addition attached garage ❑ Deck ® Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Office/Commercial <br /> ❑ Relocation detached garage X 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 also(require ❑ Commercial ❑ Storage <br /> MCWD review&permits. ❑ Industrial ❑Warehouse ® Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify) <br /> 15320 Minnetonka Blvd <br /> Minnetonka,MN 55345 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> www.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) <br /> 1,525,000.00 RECEIVED <br /> JUN 2 9 Z017 <br /> Last Updated: January 2016 CITY OF ORONO <br />