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2017-00931 - addn/remodel/repair
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3065 Watertown Rd - 04-117-23-22-0033
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2017-00931 - addn/remodel/repair
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Last modified
8/22/2023 5:09:50 PM
Creation date
7/29/2019 9:49:02 AM
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x Address Old
House Number
3065
Street Name
Watertown
Street Type
Road
Address
3065 Watertown Rd
Document Type
Permits/Inspections
PIN
0411723220033
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City of Orono 14q. d\-D <br /> Building Permit Application <br /> for New Structures or Additions <br /> Mailing Address: Permit number: <br /> PO Box 66 RECEIVE <br /> Crystal Bay, MN 55323-0066 tn1 Date received: 8" 0 - <br /> Street Address:' AUG 0 8 2u Received by: 3A_-4 AIF <br /> 2750 Kelley Parkway <br /> � Ian review fee: 7 Q. 7 <br /> Orono, MN 55356 CITY OF ORON <br /> �xesrio4� Main: 952-249-4600 Total Fee: OBD 7 -005; <br /> Fax: 952-249-4616 www.ci.orono.mn.us 7— <br /> This application form must be completed in full and all required information must be submitted. C$ <br /> GENERAL INFORMATION* Incomplete applications will be returned. (Please print) <br /> Job Site Address: <br /> Will this be a Parade of Homes, Remodelers Showcase Homb or other Display Home? ❑ Yes ❑ No <br /> ff 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: ll <br /> Name: r -,. 04 C,J e i <br /> ..ix 4 �L <br /> State License# 3 t-, 7 Expiration Date: .31 <br /> Phone: (cell) 6s-i -,;163 -7(;,Y0 (office) <br /> Mailing Address City: L)41 e ZIP: <br /> S' <br /> Contact Person: 0'i � Applicant is: ontractor / Homeowner (Circle One) <br /> Email and/or Fax: T„�r ��t,,.a5 cj:,�r�c'tca.�� A-t4i (664 <br /> PROPERTY OWNS INFO MAT ION: <br /> Name: ZO 1 ':y;e-F rq.`1 <br /> Phone (day): 619- , a 7o_15,5- <br /> Address: <br /> - pfAddress: 3c,6 S- k)wrwr--rp cv 4-- City: 0Co 4 b ZIP: SS3 <br /> Email and/or Fax <br /> ARCHITECT ENGINEER INFORMATIO <br /> Name: ryt ' L <br /> Phone (day): I r S- '' <br /> Address: 0.3 e bj-As L.)e i,J e s'-r City: , 19A&A f ZIP: SS <br /> Email and/or Fax: r11ik e-&c- i'Cp}r d crg,e-,4c <br /> ARCHITECT/ ENGINEER INFORMATION: <br /> Name: <br /> Phone (day): <br /> Address: City: ZIP: <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 /> ElNew Construction Single Family with Accessory Bldg./Garage <br /> 2 Addition attached garage RDeck p,,eCfc Porc k ❑ Public Sewer <br /> ❑Accessory Buildingn �cr C ElSingle Family with ElOffice/Commercial <br /> El Relocation SC i.c�° � detached garage El Residence Septic <br /> El Other: (specify)Ze Je I � ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate <br /> ❑ Public 4-feet or greater may be required) <br /> "Any earth movement may require ❑ Commercial ❑ Storage <br /> MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Public Water <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) ❑ Other(specify) / <br /> 15320 Minnetonka Blvd;Minnetonka,MN 55345 Scr"2 t„t Pow-C.l�� ❑ Private Well <br /> Phone: 952-471-0590 / Fax: 952-471-0682 <br /> www.minnehahacreek.org L)e <br /> Estimated Construction Valuation (excluding land) $ <br /> Packet Last Updated: January 2016 <br /> Page 21 <br />
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