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CITY OF ORONO <br /> BUILDING PERMIT APPLICATION /0 <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> OMailing Address: Permit number: <br /> �TO PO Box 66 <br /> Crystal Bay, MN 55323-006 Date received: <br /> Street Address:' 1►� Received by: /- <br /> yF 2750 Kelley Parkway �� Plan review fee: <br /> 11 �G Orono, MN 55356 <br /> KESH�� 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 12nnt) <br /> GENERAL INFORMATION: <br /> Job Site Address: N n Itt <br /> Will this be a Parade ofHomes, Remo eters Showcase Home or other Display Home? ❑ Yes RrNo <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/AP t (CANT INFORI,I4rION: <br /> Name: n �/lel 1 ;1 <br /> State License# vExpiration Date: <br /> Phone: cell � - - 31' office - <br /> Mailing Address I r ' - City: f <br /> Contact Person: VL _ Applicant is: Contractor / omeowner , (circle One) <br /> Email and/or Fax: , 1'-V1 -� <br /> PROPERTY OWN R INFORMATIO <br /> �W <br /> Name: S <br /> Phone (day): 44 <br /> Address: city: ZIP: <br /> Email and/or Fax <br /> c <br /> ARCHITECT/ ENGINEER INFORMAT ON: <br /> Name: L S <br /> Phone (day): <br /> Address: City:///;4 IP: <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 ❑ Residence <br /> 1-7 Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer <br /> Accessory Building ❑ Single Family with ❑ DeckF `x <br /> Relocation /� detached garage ElOffice/Commercial tom,Private Sewer <br /> Other: (specify) L1 ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may also require ❑ Commercial Other(specify) <br /> MCWD review& permits. ElIndustrial -Cl �� ❑ 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) <br />