Laserfiche WebLink
/ -/ <br /> , CITY OF ORONO )- 1-7-1.5 <br /> BUILDING PERMIT APPLICATION if/ <br /> FOR NEW STRUCTURES OR ADDITIONS ��� <br /> �O1 V Mailing Address: Permit number: ao 13— o-03'1S <br /> O PO Box 66 <br /> Crystal Bay, MN 55323-0066 Date received: -I 3- <br /> Street Address:' Received by: �J <br /> 2750 KelleyParkwacis <br /> y <br /> �✓ <br /> ti� G� Y Plan review fee: a D J 3 - DO kik <br /> t-,ESHD�� Orono, MN 55356 Ito.)D o../ <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 /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: , <br /> VV/ � � <br /> Job Site Address: / I c- ILD/Igegr 7-61-IL <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes o <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 ill 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: <br /> State License# Expiration Date: <br /> Phone: (cell) (office) <br /> Mailing Address: City: ZIP: <br /> Contact Person: Applicant is: Contractor / Homeowner (Circle One) <br /> Email and/or Fax: <br /> PROPERTY OWNER INFORMATION:_ 3,ay <br /> Name: r iCkw z°/ �P7Q 4J e Phone (day): �/ ^ a-7,?-` �l _ , �vr�,��j ZIP: �S C� <br /> Address: 1 .q zit)/LcCI1tu v-4 [ L� City: <br /> Email and/or Fax ja ji 31�z (k--- g 14.CL t/ , -Oit. <br /> ARCHITECT/ENGINEER INFORMATION: �J <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 /> .21c ew Construction ❑ 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 ❑ Private Sewer <br /> ►! ether: (specify) Del!-/Z--- ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> **Any earth movement may also require ❑ Commercial ❑ Other(specify) <br /> MCWD review&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.orq <br /> � � 7 <br /> /1 .1•�� -7---0 <br /> Estimated Construction Valuation (excluding land) $ ` ��0 <br />